Enhancement of Learning Associated Neural Plasticity by Selective Serotonin Reuptake Inhibitors

Enhancement of Learning Associated Neural Plasticity by Selective Serotonin Reuptake Inhibitors

Sponsors

Lead sponsor: Medical University of Vienna

Source Medical University of Vienna
Brief Summary

Background:

Conclusive evidence states that the serotonergic system mediates neuroplasticity from early embryonic development until brain maturation in adulthood. This study aims to demonstrate that selective serotonin reuptake inhibitors (SSRIs) enhance learning-dependent neuroplasticity in vivo, hereby contributing to the investigators understanding of the mechanism of action of therapy with SSRIs.

Objectives:

1. To prove a positive influence of SSRIs on structural remodeling during learning, reflected by enhancements of gray and white matter microstructure, connectivity and functionality in brain regions involved in learning processes.

2. To show that this effect is topologically specific, i.e. that enhancements of plasticity markers are found in different regions depending on their involvement during the performance of specific learning tasks.

Study design:

Randomized, double-blind, placebo-controlled, longitudinal mono-center study. 80 healthy subjects will undergo three MRI scanning sessions: 1. baseline, at study entry, 2. after 3 weeks of facial/emotional (n=40) or Chinese character-meaning learning (n=40) and 3. after 3 weeks learning of new associations under administration of an SSRI or placebo.

Methods:

MRI measurements will be performed on a 3 Tesla PRISMA MAGNETOM MR scanner. Changes in gray matter microstructure will be assessed using high-resolution structural MRI and analyzed with voxel-based morphometry (VBM). Diffusion tensor imaging (DTI) enables non-invasive investigation of neuroplasticity in the human brain based on the reduction in mean diffusivity associated with swelling of astrocytes after increased synaptic activity. Resting-state functional MRI (fMRI) will allow for the measurement of changes in functional coupling between brain regions, and fMRI during tasks will assess differential activity in brain regions during learning.

Relevance and implications:

This study aims to provide evidence that SSRIs facilitate cytoarchitectonical restructuring. In addition to expanding the investigators current knowledge on the trophic effects of SSRIs, the results of this study will also elucidate interactions between the serotonergic system and changes to neuronal networks during learning as well as their behavioral consequences. By probing the neurobiological correlates of the antidepressant and anti-anxiety effects of SSRIs, this study will provide a rationale for targeted interventions that harness the neuroplasticity enhancing properties of SSRIs to facilitate therapeutic processes.

Overall Status Unknown status
Start Date August 2016
Primary Completion Date August 2019
Phase Phase 4
Study Type Interventional
Primary Outcome
Measure Time Frame
Gray matter volume 21 days
Gray matter volume 21 days
Gray matter volume 21 days
Mean diffusivity 21 days
Mean diffusivity 21 days
Mean diffusivity 21 days
Secondary Outcome
Measure Time Frame
BOLD signal 21 days
Enrollment 80
Condition
Intervention

Intervention type: Drug

Intervention name: Escitalopram

Description: Tablet 10mg, 21 days

Arm group label: SSRI treatment

Intervention type: Drug

Intervention name: Placebo

Description: Tablet, 21 days

Arm group label: Placebo treatment

Intervention type: Other

Intervention name: 3xMR scan (fMRI, DTI, strucutral MRI)

Description: 3 Tesla PRISMA MAGNETOM MR scanner; performed at baseline, after 21 days of performing learning paradigms and after 21 days of drug/placebo treatment and re-learning paradigms

Intervention type: Behavioral

Intervention name: Association learning paradigm

Description: 21 daily internet-based sessions (20min) of learning associations (pairs) of stimuli

Intervention type: Behavioral

Intervention name: Association re-learning paradigm

Description: 21 daily internet-based sessions (20min) of learning new associations (pairs) of stimuli performed during escitalopram/placebo treatment

Eligibility

Criteria:

Inclusion Criteria:

- General health based on medical history, physical examination and structured clinical interview for DSM-IV (SCID)

- Willingness and competence to sign the informed consent form

- Right-handedness

- Non-smoker, and non-alcohol drinker

Exclusion Criteria:

- Any medical, psychiatric or neurological illness

- Current or former substance abuse

- Any implant or stainless steel graft or any other contraindications for MRI

- First degree relatives with a history of psychiatric illness or substance abuse

- Color blindness, any Chinese language skills

- Failure to comply with the study protocol or to follow the instructions of the investigating team

- Lifetime use of SSRIs or related psychotropic agents

- Non-Caucasian

Gender: All

Minimum age: 18 Years

Maximum age: 55 Years

Healthy volunteers: Accepts Healthy Volunteers

Location
facility
Department of Psychiatry and Psychotherapy, Medical University of Vienna
Location Countries

Austria

Verification Date

April 2016

Responsible Party

Responsible party type: Principal Investigator

Investigator affiliation: Medical University of Vienna

Investigator full name: Rupert Lanzenberger

Investigator title: Prof MD

Has Expanded Access No
Number Of Arms 2
Arm Group

Arm group label: SSRI treatment

Arm group type: Experimental

Description: Subjects will receive 21 days of 10mg escitalopram treatment while performing learning paradigms.

Arm group label: Placebo treatment

Arm group type: Placebo Comparator

Description: Subjects will receive 21 days of placebo treatment while performing learning paradigms.

Study Design Info

Allocation: Randomized

Intervention model: Parallel Assignment

Primary purpose: Basic Science

Masking: Double (Participant, Investigator)

Source: ClinicalTrials.gov