- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02859103
Dimensional Approach to Evaluate Reward Processing in Major Depressive Disorder Pre- and Post-Desvenlafaxine Treatment
October 28, 2020 updated by: Sakina Rizvi, Unity Health Toronto
A Dimensional Approach to Evaluate Reward Processing in Major Depressive Disorder Before and After Treatment With Desvenlafaxine
Anhedonia (the lack of pleasure in normally pleasurable things) is a common symptom of major depressive disorder (MDD), and it may impact how patients with depression experience reward.
Understanding how anhedonia is related to the experience of reward may help improve how depression is treated.
Computer tasks can be used to measure how reward is experienced, and these measures might be able to predict things like who is likely to become depressed, or who will respond to antidepressant medication.
Studying the relationship between anhedonia and reward in patients with depression might also tell us something about how to improve diagnosis and treatment of other psychiatric disorders.This is an open label controlled treatment study lasting 8 weeks.
The brain scans will be used to find changes in brain areas that may be related to how people perform on the tasks.
The investigators goal is to use this information to help us find a reliable predictor that can be used to guide MDD treatment.
Study Overview
Study Type
Interventional
Enrollment (Actual)
56
Phase
- Phase 4
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
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Ontario
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Toronto, Ontario, Canada, M5B 1M8
- St. Michael's Hospital
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years to 60 years (Adult)
Accepts Healthy Volunteers
Yes
Genders Eligible for Study
All
Description
Inclusion/exclusion criteria for MDD patients (n=40) are as follows:
Inclusion Criteria
- DSM-5 criteria for Major Depressive Episode (MDE) within a MDD, confirmed through MINI diagnosis
- Age between 18 and 60 years
- Hamilton Depression Rating Scale - 17 item (HRSD-17)58 > 17 (moderate to severe symptoms)
- Free of psychotropic medications for at least 5 half-lives before baseline visit
- Ability to undergo MRI scanning (absence of metal, pacemakers, etc.)
Exclusion Criteria
- Pregnancy/lactation
- Medical condition requiring immediate investigation or treatment
- Recent (< 6 months)/current history of drug abuse/dependence (other than caffeine, or nicotine)
- Lifetime history of psychosis, other Axis I comorbidities are allowable
- Significant Axis II diagnosis
- Previous intolerance or failure to respond to an adequate trial of desvenlafaxine
- Failure of > 2 antidepressant treatments of adequate dose and duration for current MDE
Inclusion/exclusion criteria for Healthy Controls (n=20) are as follows:
Inclusion Criteria
- Age between 18 and 60 years
- Ability to undergo MRI scanning (absence of metal, pacemakers, etc.)
Exclusion Criteria
- Pregnancy/lactation
- Medical condition requiring immediate investigation or treatment
- Lifetime history of any psychiatric disorder
- Lifetime history of receiving an antidepressant
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Treatment
Patients in this arm will receive treatment with desvenlafaxine for 8 weeks.
|
Patients will be provided 50mg dose of desvenlafaxine for 1 week titrated up to 100mg dose of desvenlafaxine for 7 weeks.
Other Names:
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No Intervention: Healthy Control
Patients in this arm are healthy controls and will not receive any medication.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Measuring Reward association and valuation using the Reward Association Task
Time Frame: Change from Baseline at 8 Weeks
|
Based on signal detection theory, it evaluates response bias as a function of prior reward and permits an objective assessment of disorder-related sensitivity to reward.
To evaluate the how the 6 facets of reward are related to each other in unmedicated MDD patients in order to develop a clearer understanding of reward pathways
|
Change from Baseline at 8 Weeks
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Measuring Expectation using a prediction error task, to measure learning and choosing, during functional Magnetic Resonance Imaging (fMRI)
Time Frame: Change from Baseline at 8 Weeks
|
This distinction was included in the design in order to dissociate potentially different neural circuits subserving learning reward associations and using them to guide behavior.
To evaluate the how the 6 facets of reward are related to each other in unmedicated MDD patients in order to develop a clearer understanding of reward pathways
|
Change from Baseline at 8 Weeks
|
Anticipation of reward using the monetary incentive delay during fMRI
Time Frame: Change from Baseline at 8 Weeks
|
This task was designed to disentangle anticipatory vs. consummatory phases of reward processing.
To evaluate the how the 6 facets of reward are related to each other in unmedicated MDD patients in order to develop a clearer understanding of reward pathways
|
Change from Baseline at 8 Weeks
|
Motivation/effort using the Cued-Reinforcement Reaction Time Task and the EEfRT task.
Time Frame: Change from Baseline at 8 Weeks
|
The Cued-Reinforcement Reaction Time Task (CRRT) provides an evaluation of reward-based reaction time speed as an index of incentive motivation.The EEfRT task allows analysis of the predictive value of reward probability and magnitude on effort-based decision making.
To evaluate the how the 6 facets of reward are related to each other in unmedicated MDD patients in order to develop a clearer understanding of reward pathways
|
Change from Baseline at 8 Weeks
|
Pleasure/Liking using the monetary incentive delay task in an fMRI
Time Frame: Change from Baseline at 8 Weeks
|
This task was designed to disentangle anticipatory vs. consummatory phases of reward processing.
To evaluate the how the 6 facets of reward are related to each other in unmedicated MDD patients in order to develop a clearer understanding of reward pathways.
To evaluate the how the 6 facets of reward are related to each other in unmedicated MDD patients in order to develop a clearer understanding of reward pathways
|
Change from Baseline at 8 Weeks
|
Feedback integration using the Probabilistic Reversal Learning task during fMRI
Time Frame: Change from Baseline at 8 Weeks
|
participants are presented with a choice of two stimuli.
Based on their first choice, the selected stimulus will be rewarded with a high probability, while the other will be rewarded with a low probability.To evaluate the how the 6 facets of reward are related to each other in unmedicated MDD patients in order to develop a clearer understanding of reward pathways
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Change from Baseline at 8 Weeks
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Sakina Rizvi, PhD, Unity Health Toronto
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
June 1, 2017
Primary Completion (Actual)
November 4, 2019
Study Completion (Actual)
November 4, 2019
Study Registration Dates
First Submitted
July 15, 2016
First Submitted That Met QC Criteria
August 3, 2016
First Posted (Estimate)
August 8, 2016
Study Record Updates
Last Update Posted (Actual)
November 2, 2020
Last Update Submitted That Met QC Criteria
October 28, 2020
Last Verified
October 1, 2020
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Mental Disorders
- Nervous System Diseases
- Mood Disorders
- Neurologic Manifestations
- Neurobehavioral Manifestations
- Depressive Disorder
- Anhedonia
- Depressive Disorder, Major
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Psychotropic Drugs
- Neurotransmitter Uptake Inhibitors
- Membrane Transport Modulators
- Antidepressive Agents
- Serotonin and Noradrenaline Reuptake Inhibitors
- Desvenlafaxine Succinate
Other Study ID Numbers
- DVS-01
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
product manufactured in and exported from the U.S.
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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