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| Sponsor: | National Institute of Neurological Disorders and Stroke (NINDS) |
|---|---|
| Information provided by: | National Institutes of Health Clinical Center (CC) |
| ClinicalTrials.gov Identifier: | NCT00931619 |
Purpose
Objective: To study the relative balance of GABA (A) binding potential and glutamate utilization in subjects with localization-related epilepsy with and without depression, subjects with major depressive disorder alone, and in subjects with generalized epilepsy (expected not to have significant comorbid depression). Pilot data shows that GABA(A) binding potential and glutamate utilization are tightly coupled in healthy subjects particularly in the mesial temporal lobe. We hypothesize that subjects with epilepsy will not exhibit the same degree of coupling, and that subjects with both epilepsy and depression will exhibit an even more pronounced decoupling.
Study Population: Subjects aged 18-55 with localization-related epilepsy with and without depression, subjects with generalized epilepsy, subjects with major depressive disorder (MDD) alone, and healthy controls.
Design: This is a neuroimaging study, using positron emission tomography (PET) with [11C]flumazenil, to measure GABA(A) binding potential, and [18F]fluorodeoxyglucose, to measure glucose utilization (reflective of neuronal glutamate release) Magnetic resonance spectroscopy (MRS), will be used to measure GABA and glutamate in the mesial temporal cortex, and corroborate the PET results. Structural magnetic resonance images (MRI) will be obtained for MRS localization and partial volume correction of PET images.
Outcome measures: The binding potential of GABA(A), the regional rate of glucose metabolism, and the levels of GABA and glutamate as measured by MRS. Patients will be stratified by seizure type and depression ratings.
| Condition |
|---|
|
Epilepsy Epilepsy, Temporal Lobe Depression Depressive Disorder, Major |
| Study Type: | Observational |
| Study Design: | Time Perspective: Prospective |
| Official Title: | GABA/Glutamate Balance in Temporal Lobe Epilepsy With and Without Major Depression |
| Estimated Enrollment: | 140 |
| Study Start Date: | June 2009 |
Objective: To study the relative balance of GABA (A) binding potential and glutamate utilization in subjects with localization-related epilepsy with and without depression, subjects with major depressive disorder alone, and in subjects with generalized epilepsy (expected not to have significant comorbid depression). Pilot data shows that GABA(A) binding potential and glutamate utilization are tightly coupled in healthy subjects, particularly in the mesial temporal lobe. We hypothesize that subjects with epilepsy will not exhibit the same degree of coupling, and that subjects with both epilepsy and depression will exhibit an even more pronounced decoupling.
Study Population: Subjects aged 18-55 with localization-related epilepsy without clinically significant depression, subjects with generalized epilepsy, and healthy controls.
Design: This is a neuroimaging study, using positron emission tomography (PET) with [11C]flumazenil, to measure GABA(A) binding potential, and [18F]fluorodeoxyglucose, to measure glucose utilization (reflective of neuronal glutamate release). Magnetic resonance spectroscopy (MRS) will be used to measure GABA and glutamate in the mesial temporal cortex and corroborate the PET results. Structural magnetic resonance images (MRI) will be obtained for MRS localization and partial volume correction of PET images.
Outcome measures: The binding potential of GABA(A), the regional rate of glucose metabolism, and the levels of GABA and glutamate as measured by MRS. Patients will be stratified by seizure type.
Eligibility| Ages Eligible for Study: | 18 Years to 55 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
Subjects with epilepsy must currently be taking an AED which exerts its primary method of action on a system other than GABA. Examples include sodium or calcium channel blockers (phenytoin, carbamazepine, oxcarbazepine, lamotrigine, zonisamide, and ethosuximide), drugs that bind to SV2A sites (levetiracetam), or drugs which bind to the alpha2delta subunit of calcium channels (gabapentin and pregbalin). Patients on AEDs that have direct effects on GABA and glutamate (vigabatrin, phenobarbital, benzodiazepines, tiagabine) will be excluded. No subject's medication will be changed for the purpose of inclusion in this study.
EXCLUSION CRITERIA:
Contacts and Locations| Contact: Patient Recruitment and Public Liaison Office | (800) 411-1222 | prpl@mail.cc.nih.gov |
| Contact: TTY | 1-866-411-1010 |
| United States, Maryland | |
| National Institutes of Health Clinical Center, 9000 Rockville Pike | Recruiting |
| Bethesda, Maryland, United States, 20892 | |
| Sub-Investigator: Patient Recruitment and Public Liaison Office (PRPL) For more information at the NIH Clinical Center contact | |
More Information
| ClinicalTrials.gov Identifier: | NCT00931619 History of Changes |
| Other Study ID Numbers: | 090182, 09-N-0182 |
| Study First Received: | July 1, 2009 |
| Last Updated: | December 22, 2011 |
| Health Authority: | United States: Federal Government |
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Fluorine-18 Fluorodeoxyglucose Epilepsy Epileptic Focus Temporal Lobe Epilepsy |
Depression Major Depressive Disorder Healthy Volunteer HV |
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Depression Depressive Disorder Epilepsy Epilepsy, Temporal Lobe Depressive Disorder, Major Behavioral Symptoms |
Mood Disorders Mental Disorders Brain Diseases Central Nervous System Diseases Nervous System Diseases Epilepsies, Partial |