Conduct Disorder Clinical Trial
Official title:
Individual Differences in Reward and Impulse Control Circuitry as Risk Factors for Addiction
Background:
- The risk for becoming addicted to drugs varies from person to person, even among those who
use similar drugs in a similar way. Studies suggest that certain personality traits seen in
people with drug addiction may be present before drug use. These traits include responding
differently to rewards or impulsivity. Early use of drugs (before age 15) is also associated
strongly with drug addiction later in life. Researchers want to study teenagers with and
without certain behavioral problems, including those who have used drugs and those who have
not. This may help them better understand behaviors that might predict future drug addiction.
Objectives:
- To understand brain function in teenagers who may be at a higher risk than others to drug
addiction.
Eligibility:
- Teenagers between 13 and 17 years of age who fit into one of four groups:
- Have never or rarely used drugs
- Have never or rarely used drugs and have conduct or behavior disorders
- Have used drugs on many occasions
- Have used drugs on many occasions and have conduct or behavior disorders
Design:
- Participants will be screened with a medical history, and physical and neurological
exams. They will also have blood and urine tests. Participants will answer questions
about past drug use and any current medications. They will also have a breathalyzer and
carbon monoxide breath test to check for recent drug and alcohol use.
- This study requires four visits to the clinical center for magnetic resonance imaging
(MRI) scans and other tests.
- The first study visit will include training for the MRI scans. Participants will
practice the tasks in front of a computer and in a mock (fake) MRI machine. Participants
will also be asked several questions about their personality and past experiences.
- Researchers will test changes to tryptophan and dopamine levels. Both of these chemicals
affect decision making and brain function. On the three study visits, participants will
have the following tests in a randomly selected order. One study will be done at each
visit.
- MRI scans with changes to dopamine and tryptophan levels
- MRI scans with changes to dopamine only (with placebo)
- MRI scans with changes to tryptophan only (with placebo)
- Participants will be monitored with frequent blood draws and other tests during the
study visits....
Background: Even under similar drug use patterns, the risk for drug addiction varies from
individual to individual. However, the neurobiological mechanisms underlying this variability
are poorly understood and characterized. Studies suggest that certain traits observed in
substance dependent individuals may actually precede drug use, and could augur future
substance dependence. Understanding how the presence of these traits increases vulnerability
to substance addiction could aid in the development of early intervention, preventative
measures, as well as better treatment strategies.
Objective: The primary goal of this protocol is to improve our understanding of increased
susceptibility to developing substance addiction. We focus here on reward and punishment
learning, and impulse control, with an emphasis on the underlying role of dopamine and
serotonin function in these two cognitive functions. Further, given that cortical plasticity
is enhanced during childhood and adolescence, we begin to address whether early exposure to
substances enhances neurobiological changes that make an individual vulnerable to subsequent
substance addiction.
Subject Population: We focus on adolescents (13-17 years old) with known increased
vulnerability to substance addiction individuals with early exposure to substances, i.e. ,
those who have used drugs on multiple occasions before the age of 15, and those diagnosed
with conduct disorder and who are not as yet substance dependent, along with matched
controls.
Experimental Design: This study involves cognitive, pharmacological and functional magnetic
resonance imaging (fMRI) testing in a mixed, within/between-subject design. Based upon power
analyses, we estimate needing 30 participants in each of 4 groups early exposure (EE),
conduct disorder (CD-NE), conduct disorder with early exposure (CD-EE), and controls with no
early exposure (NE) to complete the experiment. This is a within subjects, placebo
controlled, crossover design with participants tested before and after 1) cabergoline (D2
receptor agonist) treatment, 2) acute tryptophan depletion, and 3) placebo.
Outcome Measures: The primary outcome measures will be BOLD fMRI activation and behavioral
performance on various cognitive tasks that deal with impulse control and reward learning
before and after each of the three treatments listed above. Secondary outcome measures
include gene x environment interactions and stress and novelty-seeking measures.
;
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