Energetics and Glutamate in Schizophrenia

Schizophrenia Clinical Trial

— EAGLES  

Official title:

Energetics and Glutamate in Schizophrenia

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT06236048
• Other study ID #: 328488
• Status: Recruiting
• Start date: March 1, 2024
• Est. completion date: December 1, 2028

Study information

• Verified date: February 2024
• Source: King's College London
• Contact: Alice Egerton, PhD
• Phone: +442078480721
• Email: alice.egerton[@]kcl.ac.uk
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

The goal of this case-control study is to compare brain glutamate, glucose utilisation, lactate production and brain activity in healthy volunteers and people with a diagnosis of schizophrenia. It investigates the following main questions: Whether, compared to healthy volunteers, participants with schizophrenia show: 1. reduction in brain glucose utilisation 2. increased brain lactate 3. greater variability in brain glutamate Participants will be asked to have a screening visit, a MRI brain scan and a PET-MRI brain scan.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 75
• Est. completion date: December 1, 2028
• Est. primary completion date: December 31, 2027
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years to 65 Years

Eligibility

Inclusion Criteria:

Healthy volunteer group:

1. No history of psychiatric illness, as assessed on the Mini neuropsychiatric Interview (MINI).

Treatment responsive schizophrenia group:

1. Meeting ICD-11 criteria for schizophrenia (F20)

2. Meeting symptomatic consensus criteria for remission, defined as scores of mild or less on items P1, P2, P3, N1, N4, N6, G5 and G9 of the PANSS and no history of symptomatic relapse in the past 6 months.

3. Currently receiving one or more of the following antipsychotic medications:

Olanzapine; Risperidone; Quetiapine; Amisulpride; Aripiprazole; Paliperidone.

4. Antipsychotic adherent, defined as having a score of >=moderate adherence on the Kemp scale.

Treatment-resistant schizophrenia group:

1. Meeting ICD-11 criteria for schizophrenia (F20)

2. Meeting modified consensus criteria for treatment resistance, including history of at least two antipsychotic treatment trials each lasting =6 weeks at a dose of =400mg chlorpromazine equivalents.

3. Total PANSS total score > 70

4. Moderate functional impairment (<60 on the SOFAS)

5. Currently receiving one or more of the following antipsychotic medications: Clozapine; Olanzapine; Risperidone; Quetiapine; Amisulpride; Aripiprazole; Paliperidone.

6. Antipsychotic adherent, defined as having a score of >=moderate adherence on the Kemp scale. Exclusion Criteria:

All participants:

1. Pregnancy or breastfeeding

2. Lacking in mental capacity to provide informed consent to study participation.

2. Diabetes or history of taking an antidiabetic medication 3. Presence of contraindication to MRI at 7 Tesla, including metallic or electronic implants and dental wires.

4. Severe claustrophobia prohibiting participation on PET or MRI 5. Body size above the comfortable limits for the MRI scanner. 6. Previous participation in research or clinical procedure/s involving ionising radiation, which, including the current study, would result in total radiation exposure >=10mSv within 12 months 7. History of head injury resulting in loss of consciousness for > 5 minutes 8. Meeting ICD-11 criteria for organic mental disorder (F00-F09) 9. Meeting ICD-11 criteria for mental and behavioural disorders due to psychoactive substance use (F10-F19) 10. With exclusion of nicotine or cannabis, meeting ICD-11 criteria for psychoactive substance dependence 11. Participation in clinical trial investigating any pharmacological agent other than a licensed antipsychotic compound in the last month.

Related Conditions & MeSH terms

• Schizophrenia

Intervention

Procedure:
• MRI scan
7 Tesla MRI scan
• PET-MR scan
18F-fluorodeoxyglucose PET-MR scan

Locations

Country	Name	City	State
United Kingdom	South London and the Maudsley NHS Foundation Trust	London

Sponsors (1)

Lead Sponsor	Collaborator
King's College London

Country where clinical trial is conducted

United Kingdom, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Brain glucose utilisation	Measured using fully quantitative 18F-fluorodeoxyglucose PET (CMRglc)	1 day
Primary	Glutamate - anterior cingulate cortex	Glutamate and glutamine measured using magnetic resonance spectroscopy at 7 Tesla	1 day
Primary	Lactate - visual cortex	Measured using magnetic resonance spectroscopy at 7 Tesla at rest and during visual stimulation	1 day
Primary	Cerebral blood flow	Measured using arterial spin labelling, 3 Tesla MRI	1 day
Primary	Cortical network activity	Network activity / connectivity as measured using fMRI at 3 Tesla	1 day