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| Sponsored by: |
National Institute of Mental Health (NIMH) |
|---|---|
| Information provided by: | National Institutes of Health Clinical Center (CC) |
| ClinicalTrials.gov Identifier: | NCT00097175 |
Purpose
This study will investigate how the brain process emotions in healthy people and in patients who have major depression in order to better understand the causes of depression. It will examine what happens in the brain when a person responds to words related to different emotions while the brain's ability to manufacture a chemical called serotonin is reduced. Serotonin regulates functions such as emotion, anxiety and sleep, and stress hormones such as cortisol. In this study, participants' serotonin levels are reduced by depleting tryptophan, an amino acid that is the main building block for serotonin.
Healthy volunteers and patients with major depression that has been in remission for at least 3 months may be eligible for this study. Candidates must be between 18 and 50 years of age and right-handed. They are interviewed about their medical and psychiatric history, current emotional state and sleep pattern, and family history of psychiatric disorders. Screening also includes psychiatric interviews and rating scales, neuropsychological tests, physical examination, electrocardiogram (EKG), and blood, urine, and saliva tests. Women have their menstrual phase determined by a blood test and home urine ovulation test kit.
The study involves two clinic visits in which participants undergo tryptophan depletion and magnetic resonance imaging (MRI). Subjects arrive at the NIH Clinical Center in the morning after fasting overnight. They fill out questionnaires have a blood sample drawn, and then take 74 capsules that contain a mixture of amino acids found in the diet. At one visit they are given capsules that contain a balanced mixture of amino acids one would normally eat in a day; at the other visit, some of the capsules contain lactose instead of tryptophan, causing tryptophan depletion. At 2 p.m. participants fill out the same questionnaires they completed at the beginning of the day and have another blood sample drawn. Then they do a computerized test in the MRI scanner.
MRI uses a magnet and radio waves to obtain pictures of the brain. For the test, subjects lie on a narrow bed that slides into the cylindrical MRI scanner. They are asked to press a button in response to words associated with different emotions that appear on a screen. Arterial spin labeling - a test that uses magnetism to measure blood flow in different areas of the brain-is also done during the procedure. After the scan, subjects eat a meal and then return home.
DNA from the participants' blood samples is also examined to try to better understand the genetic causes of depression. Some of the white cells from the samples may also be grown in the laboratory so that additional studies can be done later.
| Condition |
|---|
|
Depressive Disorder, Major |
| Study Type: | Observational |
| Official Title: | The Effects of Mood and Tryptophan Depletion on the Neural Correlates of Affective Shifting in Mood Disorders |
| Estimated Enrollment: | 200 |
| Study Start Date: | November 2004 |
| Estimated Study Completion Date: | September 2006 |
| Estimated Primary Completion Date: | September 2006 (Final data collection date for primary outcome measure) |
Show Detailed Description
Eligibility| Ages Eligible for Study: | 18 Years to 50 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
Healthy Volunteers (n=80)
Right-handed subjects (ages 18-50) will be selected who have not met criteria for any major psychiatric disorder, have no known first-degree relatives with mood disorders, and have a current score on the Hamilton Depression Rating Scale (HDRS; 17 item) in the not depressed range (<= 7). Control subjects will be matched to depressed subjects and their relatives for age, gender, and education.
MDD Samples (n = 80)
Right-handed subjects (ages 18-50) will be selected with a past history of MDD by DSM-IV criteria.
Healthy Relatives (n=40)
Healthy, right-handed, first-degree relatives of patients with MDD will be recruited.
EXCLUSION CRITERIA:
Subjects must not have taken antidepressant drugs for at least 3 months (4 months for fluoxetine) prior to the fMRI studies or other medications likely to alter monoamine neurochemistry or cerebrovascular and cardiovascular function for at least 3 weeks prior to imaging. However, effective medications will not be discontinued for the purposes of this study. Subjects will also be excluded if they have:
GENERAL MRI EXCLUSION CRITERIA:
Subjects must exhibit no or only moderate alcohol use. Subjects with current or previous regular use (greater than 4 weeks) of BZDs and excessive use of alcohol (greater than 8 ounces/day for men and greater than 6 ounces/day for women) in the past or present are ineligible for participation, as such drug use may confound the results (Primus and Gallager 1992; Ulrichsen et al. 1996). Smokers (regular use within the last 3 months) are ineligible because of the evidence for interactions between nicotine and depression (Ong and Walsh 2001), and the possibility of withdrawal symptoms that may affect behavioral and neural responses to TD.
Subjects beyond age 50 are excluded to address the biological heterogeneity encompassed by the MDD criteria, since depressives whose age-at-onset is later than 50 have a far greater likelihood of having MRI correlates of cerebrovascular disease than age-matched healthy controls or age-matched early-onset depressives (Krishnan et al. 1993). Subjects whose first major depressive episodes arose temporally after other medical or psychiatric conditions will also be excluded, since their functional imaging results generally differ from those reported in primary MDD (Drevets 2000).
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 | |
More Information
| Study ID Numbers: | 050035, 05-M-0035 |
| Study First Received: | November 17, 2004 |
| Last Updated: | June 9, 2009 |
| ClinicalTrials.gov Identifier: | NCT00097175 History of Changes |
| Health Authority: | United States: Federal Government |
|
Major Depressive Disorder Serotonin Functional MRI Genotype Negative Affect |
Major Depressive Disorder MDD Healthy Volunteer HV |
|
Tryptophan Depression Mental Disorders Psychotropic Drugs Mood Disorders Healthy |
Depressive Disorder, Major Antidepressive Agents, Second-Generation Depressive Disorder Antidepressive Agents Serotonin Behavioral Symptoms |
|
Tryptophan Depression Disease Psychotropic Drugs Depressive Disorder, Major Depressive Disorder Pharmacologic Actions Behavioral Symptoms |
Pathologic Processes Mental Disorders Therapeutic Uses Mood Disorders Antidepressive Agents, Second-Generation Central Nervous System Agents Antidepressive Agents |