- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05186077
Brain Circuitry Analysis in Bipolar Disorder
October 18, 2023 updated by: Jennifer Sweet
The goal of this cross-sectional study is to use diffusion-weighted imaging based tractography (DWT) to assess white matter (WM) pathways in treatment-refractory bipolar disorder (REF-BD) and treatment responsive bipolar disorder (RSP-BD) subjects compared to healthy controls (HCs).
This project will include a prospective controlled trial to include 50 subjects with REF-BD, 50 patients RSP-BD and 50 healthy volunteers.
Study Overview
Status
Suspended
Conditions
Intervention / Treatment
Study Type
Observational
Enrollment (Estimated)
42
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
-
-
Ohio
-
Cleveland, Ohio, United States, 44106
- University Hospitals Cleveland Medical Center
-
-
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 and older (Adult, Older Adult)
Accepts Healthy Volunteers
Yes
Sampling Method
Non-Probability Sample
Study Population
Participants from all three groups will be made up of those who respond to IRB approved advertisements or are referred by a provider within the UHCMC Department of Psychiatry or other provider referral.
Description
Group 1: Healthy Volunteers
Inclusion Criteria for Group 1:
- Male or female ≥18 years of age
- Capable of understanding/complying with protocol requirements
- Has competency to understand and sign informed consent form
- Physically healthy with no acute medical condition and ≤3 stable, chronic medical conditions
- Without current and/or lifetime psychiatric disorders as assessed by the Mini International Neuropsychiatric Interview for DSM-5 (MINI)
Exclusion Criteria for Group 1:
- Acute medical condition or >3 stable, chronic health conditions
- Significant structural brain lesion
- Progressive neurological disease
- Preexisting implanted electrical device
- Currently pregnant or planning to become pregnant
- Contraindications to MR imaging
- Tests positive for cannabis, illegal substances, or prescription medications without valid prescription
- Currently taking steroids, opioids, or other agents that might affect brain circuitry per research team discretion
- Use of cigarettes or other nicotine products within 12 hours of imaging visit
- Use of stimulants 24 hours prior MRI visit
- Presents an immediate danger to self or others as judged by research psychiatrist
- Has psychiatric disorder, including alcohol/drug use disorder or personality disorder
Group 2: Treatment-Responsive BDI
Inclusion Criteria for Group 2:
- Male or female ≥18 years of age
- Capable of understanding/complying with protocol requirements
- Has competency to understand and sign informed consent form
- Physically healthy with no acute medical condition and ≤3 stable, chronic medical conditions
- Meets diagnostic criteria for BDI or BDII according to the DSM-5 criteria
- Must be stable on current BD medications with no dosing changes in the last 30 days or not currently taking any BD medications.
- Recent mood episode must currently be in remission for > 8 weeks
- Montgomery-Asberg Depression Rating Scale (MADRS) ≤10 total score during the psychiatric assessments portion and at the MRI visit (if repeated at MRI visit)
- Young Mania Rating Scale (YMRS) ≤12 total score during the psychiatric assessments portion and at the MRI visit (if repeated at MRI visit)
- Clinical Global Impression-Severity for Bipolar Disorder (CGI-S-BD) ≤2 during the psychiatric assessments visit
- Must be adherent (≥ 80%) with BD medication(s)
Exclusion Criteria for Group 2:
- Acute medical condition or >3 stable, chronic health conditions
- Significant structural brain lesion
- Progressive neurological disease
- Preexisting implanted electrical device
- Currently pregnant or planning to become pregnant
- Contraindications to MR imaging
- Tests positive for cannabis, illegal substances, or prescription medications without valid prescription
- Currently taking steroids, opioids, or other agents that might affect brain circuitry per research team discretion
- Use of cigarettes or other nicotine products within 12 hours of imaging visit
- Use of stimulants within 24 hours of imaging visit
- Presents an immediate danger to self or others as judged by research psychiatrist
- Has had changes in medications within 30 days
- Contribution of any co-occurring psychiatric comorbidity disproportionate to contribution of BDI or BDII
- Meets DSM-5 criteria for current borderline or antisocial personality disorder
- Meets DSM-5 criteria for alcohol and/or drug use disorder within 6 months, excluding caffeine and/or nicotine
Group 3: Treatment-Refractory BDI
Inclusion Criteria for Group 3:
- Male or female ≥18 years of age
- Capable of understanding/complying with protocol requirements
- Has competency to understand and sign informed consent form
- Physically healthy with no acute medical condition and ≤3 stable, chronic medical conditions
- Meets diagnostic criteria for BDI or BDII according to the DSM-5 criteria
- Must be stable on drugs, including at least 1 mood stabilizer, with no dosing changes in the last 30 days
- GCI-S-BD >3 at the psychiatric assessments visit
- MADRS ≥20 total score or YMRS ≥18 total score during the psychiatric assessments portion and at the MRI visit (if repeated at MRI visit)
- BD-associated mood episodes are primary source of disability, according to both subject and psychiatrist
- Current depressive episode lasting ≥6 months despite ≥ 2 adequate evidence-based first-line treatment > 8 weeks, current manic/hypomanic episode lasting ≥2 months despite ≥ 2 adequate evidence-based first-line treatment > 4 weeks, or meeting rapid cycling criteria in last 12 months despite ≥2 evidence-based first-line treatments for BDI or BDII assessed with assistance of Modified Antidepressant Treatment History Form (MATHF)
- Severe impairment with score of ≥7 on at least one of three subscales of Sheehan Disability Scale (SDS), which includes assessment of work-life, family-life, and social life during the psychiatric assessments portion
Exclusion Criteria for Group 3:
- Acute medical condition or >3 stable, chronic health conditions
- Significant structural brain lesion
- Progressive neurological disease
- Preexisting implanted electrical device
- Currently pregnant or planning to become pregnant
- Contraindications to MR imaging
- Tests positive for cannabis, illegal substances, or prescription medications without valid prescription
- Currently taking steroids, opioids, or other agents that might affect brain circuitry per research team discretion
- Use of cigarettes or other nicotine products within 12 hours of imaging visit
- Use of stimulants within 24 hours of imaging visit
- Presents an immediate danger to self or others as judged by research psychiatrist
- Has had changes in medications within 30 days
- Contribution of any co-occurring psychiatric comorbidity disproportionate to contribution of BDI or BDII
- Meets DSM-5 criteria for current borderline or antisocial personality disorder
- Meets DSM-5 criteria for alcohol and/or drug use disorder within 6 months, excluding caffeine and/or nicotine
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
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Healthy Controls
These participants will not have any psychiatric disorder as assessed by a structured clinical interview for psychiatric disorders.
|
Imaging data for research purposes (high-resolution T1 structural and DWI MRI) will be acquired
|
Treatment-Responsive BD
This group will be composed of participants who have BDI or BDII and have most recently been depressed but are currently in remission with evidence-based treatments for bipolar disorder
|
Imaging data for research purposes (high-resolution T1 structural and DWI MRI) will be acquired
Subjects will be evaluated using psychiatric assessments
Eye-tracking assessments will be done to biases toward positive and negative stimuli including images of neutral, fearful/threatening, sad, and happy.
The neuropsychology evaluation will measure verbal learning/memory, attention/working memory, psychomotor speed, verbal fluency/processing speed, and executive function
|
Treatment-Refractory BD
This group will be composed of participants who have BDI or BDII, are currently depressed or manic with their current episode lasting at least 6months and not responding to 2 or more adequate evidence-based treatments for BDI or BDII.
|
Imaging data for research purposes (high-resolution T1 structural and DWI MRI) will be acquired
Subjects will be evaluated using psychiatric assessments
Eye-tracking assessments will be done to biases toward positive and negative stimuli including images of neutral, fearful/threatening, sad, and happy.
The neuropsychology evaluation will measure verbal learning/memory, attention/working memory, psychomotor speed, verbal fluency/processing speed, and executive function
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Characterize white matter (WM) connectivity with DWT to identify an anatomical substrate for BD that has future potential as a therapeutic target
Time Frame: Day 1
|
The imaging visit will consist of an MRI with diffusion-weighted imaging (DWI) sequences
|
Day 1
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: Jennifer Sweet, MD, University Hospitals Cleveland Medical Center
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)
October 15, 2020
Primary Completion (Estimated)
July 31, 2024
Study Completion (Estimated)
July 31, 2024
Study Registration Dates
First Submitted
December 23, 2021
First Submitted That Met QC Criteria
December 23, 2021
First Posted (Actual)
January 11, 2022
Study Record Updates
Last Update Posted (Actual)
October 19, 2023
Last Update Submitted That Met QC Criteria
October 18, 2023
Last Verified
October 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- STUDY20201112
- 1R56MH121598-01A1 (U.S. NIH Grant/Contract)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
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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