Depression Clinical Trial
Official title:
GABA/Glutamate Balance in Temporal Lobe Epilepsy With and Without Major Depression
Objective: To study the relative balance of GABA (A) binding potential and glutamate
utilization in subjects with localization-related epilepsy with and without depression,
subjects with major depressive disorder alone, and in subjects with generalized epilepsy
(expected not to have significant comorbid depression). Pilot data shows that GABA(A) binding
potential and glutamate utilization are tightly coupled in healthy subjects particularly in
the mesial temporal lobe. We hypothesize that subjects with epilepsy will not exhibit the
same degree of coupling, and that subjects with both epilepsy and depression will exhibit an
even more pronounced decoupling.
Study Population: Subjects aged 18-55 with localization-related epilepsy with and without
depression, subjects with generalized epilepsy, subjects with major depressive disorder (MDD)
alone, and healthy controls.
Design: This is a neuroimaging study, using positron emission tomography (PET) with
[11C]flumazenil, to measure GABA(A) binding potential, and [18F]fluorodeoxyglucose, to
measure glucose utilization (reflective of neuronal glutamate release) Magnetic resonance
spectroscopy (MRS), will be used to measure GABA and glutamate in the mesial temporal cortex,
and corroborate the PET results. Structural magnetic resonance images (MRI) will be obtained
for MRS localization and partial volume correction of PET images.
Outcome measures: The binding potential of GABA(A), the regional rate of glucose metabolism,
and the levels of GABA and glutamate as measured by MRS. Patients will be stratified by
seizure type and depression ratings.
...
Objective: To study the relative balance of GABA (A) binding potential and glutamate
utilization in subjects with localization-related epilepsy with and without depression,
subjects with major depressive disorder alone, and in subjects with generalized epilepsy
(expected not to have significant comorbid depression). Pilot data shows that GABA(A) binding
potential and glutamate utilization are tightly coupled in healthy subjects, particularly in
the mesial temporal lobe. We hypothesize that subjects with epilepsy will not exhibit the
same degree of coupling, and that subjects with both epilepsy and depression will exhibit an
even more pronounced decoupling.
Study Population: Subjects aged 18-55 with localization-related epilepsy without clinically
significant depression, subjects with generalized epilepsy, and healthy controls.
Design: This is a neuroimaging study, using positron emission tomography (PET) with
[11C]flumazenil, to measure GABA(A) binding potential, and [18F]fluorodeoxyglucose, to
measure glucose utilization (reflective of neuronal glutamate release). Magnetic resonance
spectroscopy (MRS) will be used to measure GABA and glutamate in the mesial temporal cortex
and corroborate the PET results. Structural magnetic resonance images (MRI) will be obtained
for MRS localization and partial volume correction of PET images.
Outcome measures: The binding potential of GABA(A), the regional rate of glucose metabolism,
and the levels of GABA and glutamate as measured by MRS. Patients will be stratified by
seizure type.
;
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