Bipolar Depression Clinical Trial
Official title:
Oral Administration of CoQ10 and Phosphorus-31 Magnetization Transfer Magnetic Resonance Spectroscopy in Geriatric Bipolar Disorder and Healthy Older Adults
We propose to study and compare measures of brain energy metabolism in geriatric bipolar individuals and healthy older adults. We would also like to investigate changes in brain energy metabolites and in vivo creatine kinase (CK) enzymatic activity associated with CoQ10 administration in older bipolar individuals.
Hypotheses
1. At baseline, the forward rate constant (kfor) of CK enzymatic activity in the frontal
lobe of older subjects with bipolar depression will be significantly decreased relative
to that of age-matched healthy controls.
2. After 8 weeks of treatment, bipolar depression subjects will demonstrate an increase in
the kfor of CK after 8 weeks of CoQ 10 treatment.
3. Increases in the CK forward rate constant (kfor) will correlate with improvement in
subjects' mood state as assessed by the Montgomery Asberg Depression Rating Scale
(MADRS).
4. Baseline measures of executive functioning and information processing speed (measured
by performance on the Wisconsin Card Sorting Test (WCST), Trails A and B and Stroop
tests) will be impaired in subjects with geriatric bipolar depression compared with
healthy controls. These measures will improve with successful treatment with CoQ10 and
correlate with increases in the CK forward rate constant (kfor).
Summary:
A review of literature suggests a distinct pattern of bioenergetic changes, possibly related
to mitochondrial dysfunction and abnormal CK function, in older adults and in individuals
with bipolar disorder. As opposed to rudimentary measurements of static metabolite
concentrations, the novel use of MT-MRS in such individuals will offer insight into the
enzyme kinetics of CK, specifically examining the rate at which ATP is formed from PCr. From
previous investigations it would seem that the dietary-supplement, CoQ10, is able to improve
the efficiency of mitochondrial function in subjects with altered bioenergetics. We propose
to measure CK activity and PCr turnover rate before and after CoQ10 treatment, with the
overall aim of understanding metabolic relationships between brain bioenergetic alterations
and treatment with CoQ10 in geriatric bipolar depression.
;
Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Basic Science
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