Attenuated Psychosis Syndrome Clinical Trial
Official title:
Exercise and Markers of Medial Temporal Health in Youth at Ultra High-risk for Psychosis
Verified date | March 2024 |
Source | University of Colorado, Boulder |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
The goal of this proposal is to test the feasibility and effectiveness of cardiovascular exercise in promoting brain health and improving related symptoms (e.g., hearing sounds that are not there, feeling emotionally detached from self and others), cognitive difficulties (troubles with memory and learning), and every day social-occupational functioning in youth at imminent risk for developing a psychotic disorder such as schizophrenia. Understanding how exercise may protect or improve the health of a brain area that is implicated as a major contributing factor to the onset of psychosis may lead to a path-breaking new intervention that does not suffer from many of the side effects, costs, and other barriers that characterize treatments that are currently available for this group. Because a significant portion of high-risk youth go on to develop a psychotic disorder in a short period, intervening at this stage may help to improve the clinical course and ultimately prevent the onset of a devastating and prevalent mental illness.
Status | Completed |
Enrollment | 50 |
Est. completion date | July 2022 |
Est. primary completion date | July 2022 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 16 Years to 24 Years |
Eligibility | Inclusion Criteria: - age 16-24 - no history of brain injury or neurological disease - no contraindications to exercise training (as assessed by a Clinical Translational Research Center CTRC physician) - no history or current treatment with antipsychotics - no contraindications for being in an magnetic resonance imaging scanner. - meet criteria for a prodromal syndrome based upon the Structure Interview for Prodromal Syndromes (SIPS) interview. Exclusion Criteria: - people who are extremely claustrophobic - have a history of significant head injury - other physical disorder that could affect brain functioning - mental retardation - history of substance use disorder within 6 months of screening interview - have a psychotic disorder (at study entry) and/or have exhibited serious self-harm behaviors - pregnant females - people who have contraindications to magnetic resonance (MR) scanning including intracranial, intraorbital or intraspinal metal, pacemakers, cochlear implants or other non-MR-compatible devices - inability of the subject or their parent/guardian to understand the informed consent document - meeting criteria for an Axis I psychotic disorder |
Country | Name | City | State |
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United States | ADAPT Program | Boulder | Colorado |
Lead Sponsor | Collaborator |
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University of Colorado, Boulder | National Institute of Mental Health (NIMH), Northwestern University, University of Colorado, Denver |
United States,
Miller TJ, McGlashan TH, Rosen JL, Cadenhead K, Cannon T, Ventura J, McFarlane W, Perkins DO, Pearlson GD, Woods SW. Prodromal assessment with the structured interview for prodromal syndromes and the scale of prodromal symptoms: predictive validity, interrater reliability, and training to reliability. Schizophr Bull. 2003;29(4):703-15. doi: 10.1093/oxfordjournals.schbul.a007040. Erratum In: Schizophr Bull. 2004;30(2):following 217. — View Citation
Mittal VA, Gupta T, Orr JM, Pelletier-Baldelli A, Dean DJ, Lunsford-Avery JR, Smith AK, Robustelli BL, Leopold DR, Millman ZB. Physical activity level and medial temporal health in youth at ultra high-risk for psychosis. J Abnorm Psychol. 2013 Nov;122(4):1101-10. doi: 10.1037/a0034085. — View Citation
Niendam TA, Bearden CE, Zinberg J, Johnson JK, O'Brien M, Cannon TD. The course of neurocognition and social functioning in individuals at ultra high risk for psychosis. Schizophr Bull. 2007 May;33(3):772-81. doi: 10.1093/schbul/sbm020. Epub 2007 Apr 9. — View Citation
Nuechterlein KH, Green MF, Kern RS, Baade LE, Barch DM, Cohen JD, Essock S, Fenton WS, Frese FJ 3rd, Gold JM, Goldberg T, Heaton RK, Keefe RS, Kraemer H, Mesholam-Gately R, Seidman LJ, Stover E, Weinberger DR, Young AS, Zalcman S, Marder SR. The MATRICS Consensus Cognitive Battery, part 1: test selection, reliability, and validity. Am J Psychiatry. 2008 Feb;165(2):203-13. doi: 10.1176/appi.ajp.2007.07010042. Epub 2008 Jan 2. — View Citation
Patenaude B, Smith SM, Kennedy DN, Jenkinson M. A Bayesian model of shape and appearance for subcortical brain segmentation. Neuroimage. 2011 Jun 1;56(3):907-22. doi: 10.1016/j.neuroimage.2011.02.046. Epub 2011 Feb 23. — View Citation
Ragland JD, Ranganath C, Barch DM, Gold JM, Haley B, MacDonald AW 3rd, Silverstein SM, Strauss ME, Yonelinas AP, Carter CS. Relational and Item-Specific Encoding (RISE): task development and psychometric characteristics. Schizophr Bull. 2012 Jan;38(1):114-24. doi: 10.1093/schbul/sbr146. Epub 2011 Nov 28. — View Citation
Type | Measure | Description | Time frame | Safety issue |
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Other | Attenuated Psychosis Positive Symptom Subscales | The Structured Interview for Prodromal Symptoms (SIPS) will be administered to formally assess attenuated positive symptoms after inclusion in the study. It will also be administered post-trial to track changes in clinical symptoms post intervention trial. The SIPS rates the severity of relevant dimensions including positive symptoms along a 7-point scale ranging from absent (0) to severe and psychotic (6) across five symptom categories, resulting in a score that ranges from 0 (no positive symptoms) to 30 (psychosis along all symptoms dimensions). | pre-trial, post-trial (3-months) | |
Other | Aerobic Fitness | VO2max was assessed via a modified Balke protocol by an exercise physiologist under the supervision of a physician. In this modified Balke protocol, the treadmill speed was individualized in a procedure to elicit 70% of the age-predicted max heart rate and ratings of a "somewhat hard" perceived exertion (RPE). Then, the speed of the treadmill remained the same throughout the test, but the incline of the treadmill belt increased 2% every 2 min (or 2.5% for speeds 6 mph or greater) to exhaustion. Tests generally lasted 8-12 minutes to attain the recommended target for VO2max testing. Measures indicate cardiovascular health with higher scores indicating greater health. | pre-trial, post-trial (3 months) | |
Primary | Brain Volume | Medial temporal structures (hippocampus and parahippocampal gyrus) will be delineated automatically using the FMRIB's Integrated Registration and Segmentation Tool algorithm within the FMRIB's Software Library (FSL) image-processing suite. Secondly, the structures will be evaluated with vertex analyses (assessing changes in shape post trial on a per-vertex basis), which will also be carried out utilizing FIRST. Shape/appearance models used in FIRST are constructed from manually segmented images provided by the Center for Morphometric Analysis (CMA, Boston). This approach is different from using a whole-structure summary measure like volume, as it allows visualization of the region of the shape that is changing as well as the type of shape change. | pre-trial, post-trial (3-months) | |
Secondary | Working Memory Assessment | Working Memory Assessment - Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) battery working memory subscale - a higher score indicates working memory better performance. The Relational and Item-Specific Encoding task includes visual object representations of word stimuli. Subjects make a two-button "yes/no" response to indicate whether items in each pair had been presented "together."To prevent additional encoding of the relational object pairs the item recognition task precedes the associated recognition task. Higher scores reflect the familiarity and recollection performance as well as hit rates and false alarm rates following encoding - better performance. MATRICS Consensus Cognitive Battery working memory subscale using a t-score (0=population mean, standard deviation=10) and Relational and Item-Specific Encoding Task accuracy score in the RCT study using a task specific accuracy (d prime range; 0-100%). | pre-trial, post-trial (3-months) |
Status | Clinical Trial | Phase | |
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Terminated |
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