Effects of a Single Dose of Amisulpride on Functional Brain Changes
Study Details
Study Description
Brief Summary
This study is designed to investigate effects of a single dose of amisulpride on functional brain changes during reward- and motivation-related processing and at rest in healthy volunteers (HV) and in patients with Major Depressive Disorder (MDD).
Condition or Disease | Intervention/Treatment | Phase |
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Phase 1 |
Detailed Description
Double blind, placebo-controlled, randomized, single dose, parallel-group design The study is designed to investigate effects of a single dose of amisulpride on functional brain changes during reward- and motivation-related processing and at rest. Measurement of functional brain changes will occur after a single dose of amisulpride or placebo in HV and patients with MDD. It is hypothesized that functional brain changes previously linked to reward- and motivation-related processing require dopaminergic signaling and are diminished in MDD compared to HV. In MDD, but not in HV, treatment with a single low dose (100 mg) amisulpride should increase brain activation associated with reward- and motivation-related processing. To test these hypotheses, we will implement a randomized, placebo-controlled, parallel- group design with 4 treatment arms (MDD/placebo, MDD/amisulpride, HV/placebo and HV/ amisulpride). All subjects will undergo MRI scanning sessions at Visit 3 and Visit 4. Treatment with amisulpride or matching placebo will occur 3.5 to 4 hours before the start of each scanning session. Time of treatment will be standardized across subjects.
At Visit 3 and Visit 4, blood samples will be taken 30 minutes pre-dose, and 1 hour, 3.5 to 4 hours, and 4.5 to 5 hours after oral drug administration to determine target plasma levels of amisulpride.
The study is composed of 4 outpatient visits: Screening, baseline and 2 scanning sessions.
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Placebo Comparator: Healthy Volunteers Placebo placebo pill at two time points |
Drug: Placebo
two doses, orally
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Active Comparator: Healthy Volunteers Amisulpride amisulpride pill at two time points |
Drug: Amisulpride Pill
Two single low doses amisulpride (100 mg); orally
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Active Comparator: MDD Patients Placebo placebo pill at two time points |
Drug: Placebo
two doses, orally
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Experimental: MDD Patients Amisulpride amisulpride pill at two time points |
Drug: Amisulpride Pill
Two single low doses amisulpride (100 mg); orally
|
Outcome Measures
Primary Outcome Measures
- BOLD fMRI parameter estimates [during MID task at treatment day 1]
Blood oxygen level dependent (BOLD) fMRI parameter estimates (ß-weights within the GLM analysis) will be extracted from task-related regions of interest (average %BOLD signal change and 90th percentile thereof within ROIs) under the following task-specific contrasts: Monetary Incentive Delay (MID) task: Contrast of 'High-gain'vs. 'No-gain' condition during the task CUE period ROIs ventral striatum (including nucleus accumbens)
Other Outcome Measures
- Exploratory endpoint: average %BOLD signal change and 90th percentile thereof within ROIs during SID [during SID task at treatment day 2]
Blood oxygen level dependent (BOLD) fMRI parameter estimates (ß-weights within the GLM analysis) will be extracted from task-related regions of interest (average %BOLD signal change and 90th percentile thereof within ROIs) under the following task-specific contrasts: Social Incentive Delay (SID) task: Contrast of 'High-gain' vs. 'No-gain' condition during the task CUE period ROIs: ventral striatum (including nucelues accumbens), ventral tegmental area, dorsal anterior cingulate cortex, insula, ventromedial prefrontal cortex/ orbitofrontal cortex and ventral pallidum
- Exploratory endpoint: average %BOLD signal change and 90th percentile thereof within ROIs during intstrumental learning task [during instrumental learning task at treatment day 1]
Blood oxygen level dependent (BOLD) fMRI parameter estimates (ß-weights within the GLM analysis) will be extracted from task-related regions of interest (average %BOLD signal change and 90th percentile thereof within ROIs) under the following task-specific contrasts: Instrumental Learning task: Contrast of the Gain-cue vs. neutral cue conditions during the task cue and feedback periods ROIs: ventral striatum (including nucelues accumbens), ventral tegmental area, dorsal anterior cingulate cortex, insula, ventromedial prefrontal cortex/ orbitofrontal cortex and ventral pallidum
- Exploratory endpoint: average %BOLD signal change and 90th percentile thereof within ROIs during effort-based decision making task [during effort-based decision making task at treatment day 2]
Blood oxygen level dependent (BOLD) fMRI parameter estimates (ß-weights within the GLM analysis) will be extracted from task-related regions of interest (average %BOLD signal change and 90th percentile thereof within ROIs) under the following task-specific contrasts: Effort-based Decision Making task: Contrast of the High reward vs. Low reward conditions during the task CUE2 period Contrast of the High effort vs. Low effort conditions during the task CUE2 period ROIs: ventral striatum (including nucelues accumbens), ventral tegmental area, dorsal anterior cingulate cortex, insula, ventromedial prefrontal cortex/ orbitofrontal cortex and ventral pallidum
- Exploratory endpoint: reaction times in ms [during all tasks at treatment day 1 and day 2]
Reaction times in ms extracted from the in- scanner protocol log files
- Exploratory endpoint: response accuracy in percent [during all tasks at treatment day 1 and day 2]
Estimates of response accuracy extracted from the in- scanner protocol log files
- Exploratory endpoint:average %BOLD signal change and 90th percentile thereof within ROIs during resting state [during resting state at treatment day 1]
Blood oxygen level dependent (BOLD) fMRI signal magnitude and BOLD signal standard deviation during Resting State within the following a-priori defined regions: Default Mode Network (posterior cingulate, vmPFC and medial temporal lobe), Central Executive Network (dorsolateral prefrontal cortex, premotor cortex, precuneus), and Salience Network Network (amygdala, insula and dorsal anterior cingulate)
- Exploratory endpoint: Arterial Spin Labeling (ASL) [during asl at treatment day 1]
Changes in relative and absolute cerebral blood flow measured through Arterial Spin Labelling MR in whole brain and in the following brain regions: (bilateral): ventral striatum, ventromedial prefrontal cortex/ orbitofrontal cortex, ventral tegmental area, dorsal anterior cingulate cortex, insula, and ventral pallidum after amisulpride administration
- Exploratory endpoint (Correlation between BOLD signal and self-reported anhedonia ) [treatment day 1 and treatment day 2]
Correlation between magnitude of BOLD signal during reward-and motivation-related processing and self-reported anhedonia after amisulpride administration as compared to placebo in MDD patients relative to HV
- Exploratory endpoint (Correlation between BOLD signal and behavioral measures) [treatment day 1 and treatment day 2]
Correlation between magnitude of BOLD signal during reward-and motivation-related processing and behavioral measures after amisulpride administration as compared to placebo in MDD patients relative to HV
- Exploratory endpoint (Correlation between functional connectivity and self-reported anhedonia) [treatment day 1 and treatment day 2]
Correlation between resting state functional connectivity and self- reported anhedonia after amisulpride administration as compared to placebo in MDD patients relative to HV
- Exploratory endpoint (Correlation between functional connectivity and behavioral measures) [treatment day 1 and treatment day 2]
Correlation between resting state functional connectivity and behavioral measures after amisulpride administration as compared to placebo in MDD patients relative to HV
- Exploratory endpoint (Change in plasma levels of amisulpride) [treatment day 1 and treatment day 2]
Changes in plasma levels of amisulpride including correlation to changes in BOLD signal in MDD patients relative to HV
- Exploratory endpoint (Change in whole brain BOLD signal) [treatment day 1 and treatment day 2]
Changes in whole brain BOLD signal after amisulpride administration as compared to placebo in MDD patients relative to HV
Eligibility Criteria
Criteria
MDD Patients:
Inclusion:
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Male and female patients with MDD; aged 18 to 45 years
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Montgomery-Åsberg Depression Rating Scale (MADRS) score > 7 and <26 at screening.
Exclusion:
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Meeting diagnostic criteria for any major psychiatric disorder (other than MDD), as determined by DSM-5 at screening.
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Having received prescribed medication (including antidepressants (AD)) within 14 days or fluoxetine within 90 days prior to Visit 3 (apart from the contraceptive pill).
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Having received psychotherapy within 14 days prior to Visit 3.
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Positive severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) test.
Healthy Volunteers:
Inclusion:
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Healthy
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aged 18 to 45 years
Exclusion:
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Meeting diagnostic criteria for any major psychiatric disorder.
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A history of psychiatric or neurologic disorders.
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Having received prescribed medication within 14 days prior to Visit 3 (apart from the contraceptive pill).
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Positive SARS-CoV-2 test.
Contacts and Locations
Locations
No locations specified.Sponsors and Collaborators
- Simone Grimm
- Charité Research Organisation GmbH
- Boehringer Ingelheim
Investigators
- Principal Investigator: Christian Keicher, Dr. med., Charite University, Berlin, Germany
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- MSB-C002