Major Depressive Disorder Clinical Trial
Official title:
Ventrostriatal Dopamine Release and Reward Motivation in MDD
Verified date | October 2019 |
Source | New York State Psychiatric Institute |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
This study aims to determine whether ventral striatal dopamine release is a mechanism of reward motivation in major depression, whether dopamine release is low in depression, and whether DA release and reward motivation predict response to dopamine-targeted treatment with pramipexole.
Status | Completed |
Enrollment | 52 |
Est. completion date | July 2017 |
Est. primary completion date | December 2016 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 18 Years to 50 Years |
Eligibility |
Inclusion Criteria: - Weight between 44 kg and 115 kg - Meets DSM-IV criteria for principal diagnosis of MDD, current major depressive episode, without psychotic features - Score of >16 and <29 on 17-item Hamilton Rating Scale for Depression - Psychotropic-naïve, as defined by lifetime <2 weeks treatment with antidepressants, anxiolytics or antipsychotics - Able to tolerate a treatment-free period during study participation - Able to provide informed consent Exclusion Criteria: - A principal diagnosis of any current Axis I psychiatric disorder other than the MDD - Lifetime diagnosis of any psychotic disorder, bipolar disorder, mental retardation, attention deficit/hyperactivity disorder, or substance use disorders (including nicotine use disorders) - Serious suicidal risk or history of violent behavior which would make participation in the protocol unsafe - Any tobacco use in the prior three months (if not already excluded for abuse/dependence by #1) - Illicit drug use in the prior three months, as evidenced by history or urine toxicology screen - Women who are pregnant, nursing, postmenopausal, or using hormonal methods of birth control - Women who are not using an effective birth control method or sexual abstinence during the ten days before the scan - Any medical or neurological problem that might affect interpretation of findings or safety of participation (e.g., blood dyscrasias, lymphomas, hypersplenism, endocrinopathies, renal failure or chronic obstructive lung disease, malignancy, neurological diseases of the brain, history of seizures or head trauma), low hemoglobin (Hb < 12 gm/dL in males, Hb < 10.5 gm/dL in females)) - Blood donation within 4 weeks of study - Metal implants or paramagnetic objects in the body that might affect safety of undergoing MRI (e.g., heart pacemaker, shrapnel, bullets, surgical prostheses or surgical clips), as determined in consultation with a neuroradiologist and according to the guidelines set forth in the reference: "Guide to MR procedures and metallic objects" Shellock; Lippincott Williams and Wilkins, NY, 2001 - More than one major risk factor for coronary artery disease (e.g. hyperlipidemia, sedentary lifestyle). Smokers are already excluded by #4 above, and diabetics by #8 above - Systolic blood pressure > 140 or diastolic blood pressure > 90 based on at least two readings at rest - History of untoward reaction to amphetamine or other stimulant medication, or pramipexole - Any psychotropic treatment in the past 3 weeks (or depot medication in the past 6 months), except for lorazepam,which may be administered as needed prior to imaging day - Current, past or anticipated exposure to radiation in the workplace, or participation in nuclear medicine procedures, including research protocols (In case of previous exposure to activity due to research studies, subjects will be eligible if all conditions listed below are fulfilled: 1) The injected dose and dosimetry of the radiotracer are known; 2) Except for research studies, the subject has not been exposed to radiation (workplace and medical); 3) Adding prior exposure to the exposure due to the study will result in a yearly cumulative exposure lower than the FDA limit for research studies - Family history of schizophrenia in parents, siblings, or children - Ongoing cognitive-behavioral or interpersonal psychotherapy for depression (Supportive therapy is not an exclusion) - Ongoing treatment with cimetidine |
Country | Name | City | State |
---|---|---|---|
United States | New York State Psychiatric Institute | New York | New York |
Lead Sponsor | Collaborator |
---|---|
New York State Psychiatric Institute | Columbia University, Icahn School of Medicine at Mount Sinai, Mclean Hospital, National Institute of Mental Health (NIMH), Research Foundation for Mental Hygiene, Inc. |
United States,
Forbes EE, Hariri AR, Martin SL, Silk JS, Moyles DL, Fisher PM, Brown SM, Ryan ND, Birmaher B, Axelson DA, Dahl RE. Altered striatal activation predicting real-world positive affect in adolescent major depressive disorder. Am J Psychiatry. 2009 Jan;166(1):64-73. doi: 10.1176/appi.ajp.2008.07081336. Epub 2008 Dec 1. — View Citation
Kumar P, Waiter G, Ahearn T, Milders M, Reid I, Steele JD. Abnormal temporal difference reward-learning signals in major depression. Brain. 2008 Aug;131(Pt 8):2084-93. doi: 10.1093/brain/awn136. Epub 2008 Jun 25. — View Citation
Pizzagalli DA, Iosifescu D, Hallett LA, Ratner KG, Fava M. Reduced hedonic capacity in major depressive disorder: evidence from a probabilistic reward task. J Psychiatr Res. 2008 Nov;43(1):76-87. doi: 10.1016/j.jpsychires.2008.03.001. Epub 2008 Apr 22. — View Citation
Sanislow CA, Pine DS, Quinn KJ, Kozak MJ, Garvey MA, Heinssen RK, Wang PS, Cuthbert BN. Developing constructs for psychopathology research: research domain criteria. J Abnorm Psychol. 2010 Nov;119(4):631-9. doi: 10.1037/a0020909. — View Citation
Treadway MT, Zald DH. Reconsidering anhedonia in depression: lessons from translational neuroscience. Neurosci Biobehav Rev. 2011 Jan;35(3):537-55. doi: 10.1016/j.neubiorev.2010.06.006. Epub 2010 Jul 11. Review. — View Citation
Vrieze E, Pizzagalli DA, Demyttenaere K, Hompes T, Sienaert P, de Boer P, Schmidt M, Claes S. Reduced reward learning predicts outcome in major depressive disorder. Biol Psychiatry. 2013 Apr 1;73(7):639-45. doi: 10.1016/j.biopsych.2012.10.014. Epub 2012 Dec 8. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Change in Hamilton Rating Scale for Depression | Hamilton Rating Scale for Depression (HRSD), 17-item version. This standard scale will be used to assess severity of depression, looking at change in total score from baseline to week 6, rating severity of depression on a scale from 0 (least depression) to 50 (greatest depression) | Baseline and 6 weeks | |
Secondary | Change in Snaith Hamilton Pleasure Scale | Fourteen-item self-rated anhedonia scale. Items were comprised of statements that participants rated as "strongly disagree" (1), "disagree" (2), "agree" (3), or "strongly agree" (4). The lowest possible score was 14, the highest possible score was 56. | Baseline and 6 weeks | |
Secondary | Change in Temporal Experience of Pleasure Scale - Anticipatory Subscale | A validated self-rated scale shown to assess anticipatory pleasure. It will be used for exploratory analyses of anhedonia. 18 items were measured on a scale of 1 (very false for me) to 6 (very true for me). Higher scores indicate higher pleasure. Item scores were added for a lowest possible score of 18 and highest possible score of 108. |
Baseline and 6 weeks | |
Secondary | Change in Mood and Anxiety Symptom Questionnaire, Short Form | Change in Mood and Anxiety Symptom Questionnaire, Short Form. A 62-item scale assessing anxiety and depression. Items were measured on a scale of 1-5, higher number indicating higher levels of symptoms.The lowest possible score was 62, and the highest 310. | Baseline and 6 weeks | |
Secondary | Change in the Apathy Evaluation Rating Scale | A validated self-rated 18 item scale assessing apathy. Items were rated from 1 (not at all true) to 4 (very true). Higher scores indicate lower apathy, lower scores indicate higher apathy. Lowest possible score is 18, highest possible score is 72. | Baseline and 6 weeks | |
Secondary | Change in Clinical Global Improvement - Severity Scale | Seven-point Likert scale rating clinical severity of mental illness from 1 (least severe) to 7 ( most severe). Physician-rated scale. One item. | 6 weeks | |
Secondary | Change in Temporal Experiences of Pleasure Scale -- Consummatory Subscale | A validated self-rated scale shown to assess consummatory pleasure. It will be used for exploratory analyses of anhedonia. 18 items were measured on a scale of 1 (very false for me) to 6 (very true for me). Higher scores indicate higher pleasure. Item scores were added for a lowest possible score of 18 and highest possible score of 108. |
Baseline and 6 weeks |
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