Patient Stratification and Treatment Response Prediction in Neuropharmacotherapy Using Hybrid Positron Emmission Tomography/Magnetic Resconance Imaging (PET/MR)
Study Details
Study Description
Brief Summary
Selective serotonin reuptake inhibitors (SSRIs) raise serotonin (5-HT) in the synaptic cleft and are the current first line of pharmacological antidepressive treatment. Yet, there is a missing link between this first molecular step in their mechanism of action and observed clinical improvement. We have determined to establish a framework combining genuine molecular and functional imaging, i.e. hybrid pharmaco-PET/MR imaging, of the human serotonergic system in order to predict antidepressant treatment response.
Objectives:
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To predict antidepressant treatment response from data obtained using hybrid PET/MR with acute pharmacological challenge.
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To discriminate healthy from depressed subjects using this paradigm.
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To establish models connecting regional changes in occupancy of serotonin transporters (5-HTT) following citalopram infusion, with changes in brain activation and connectivity of major resting-state hub networks.
Design: Randomized, double-blind, placebo-controlled, cross-over mono-center study.
Materials and methods:
40 major depressed (MDD) and 40 healthy subjects will undergo 2 PET/MR scans on a 3T SIEMENS mMR Biograph scanner: 1. challenge with citalopram 8mg 2. placebo (saline). After structural imaging, functional MRI will be continuously acquired. [11C]DASB will be applied using a bolus + constant infusion paradigm to probe 5-HTT binding potentials and monitor 5-HTT occupancy with drug challenge, applied after 70min, in a single session. Scanning will be terminated 80min after challenge. MDD patients will receive subsequent escitalopram treatment with repeated evaluation of response for 3 months.
Condition or Disease | Intervention/Treatment | Phase |
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Phase 4 |
Study Design
Outcome Measures
Primary Outcome Measures
- Hamilton Depression Scale (HDRS) [12 weeks]
Eligibility Criteria
Criteria
Inclusion Criteria:
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General health based on medical history, physical examination and structured clinical interview for DSM-IV (SCID)
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HAM-D≥18 (patients)
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Willingness and competence to sign the informed consent form
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Age 18 to 55 years
Exclusion Criteria:
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Any medical, psychiatric or neurological illness (other than MDD)
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Current or former psychopharmacological treatment
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Current or former substance abuse
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Pregnancy
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Any implant or stainless steel graft or any other contraindications for MRI
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Failure to comply with the study protocol or to follow the instructions of the investigating team
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Participation in studies involving radiation exposure in the past 10 years.
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Body mass index <17 or >30
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Department of Psychiatry and Psychotherapy, Medical University of Vienna | Vienna | Austria | 1090 |
Sponsors and Collaborators
- Medical University of Vienna
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 1.6_20180316