The Role of Dopaminergic and Glutamatergic Neurotransmission for Dysfunctional Learning in Alcohol Use Disorders (LeADP5)
The Role of Dopaminergic and Glutamatergic Neurotransmission for Dysfunctional Learning in Alcohol Use Disorders (LeAD P5)
The aim of this project is to assess reward- based learning behavior and its association with alterations in dopaminergic and glutamatergic transmission in detoxified alcohol-dependent patients and matched controls.
The investigators will explore how these alterations interact with clinical and psychosocial factors which can modify the relapse risk and learning deficits.
Patients will be detoxified in an inpatient setting. Clinical assessments, behavioral paradigms of learning and brain imaging will be carried out within at least 4 half- lives after any psychotropic medication.
The investigators will implement and apply functional imaging paradigms assessing Pavlovian-to-instrumental transfer and reversal learning tasks and associate model parameters of learning with alcohol craving, intake and prospective relapse risk.
In this project, the impact of the dopamine x glutamate interaction on learning deficits and consecutive relapse probability is targeted with [18F]fallypride PET and the measurement of absolute concentrations of glutamate with magnetic resonance spectroscopy (MRS).
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
Alcohol consumption despite negative consequences may rely on impaired flexibility in adapting the behavior to environmental changes, i.e. learning in response to reward contingencies. This learning deficit is of clinical relevance particularly during therapy and for the psychosocial outcome.
The reduced availability of central dopamine D2-receptors in detoxified alcohol dependent patients observed in PET investigations and their hypothetical effects on reward-related learning are in line with evidence for learning deficits in hypodopaminergic states, particularly for avoidance learning in non-dependent samples. Growing evidence indicates that the learning-related striatal dopamine signals are modulated by higher executive functions involving, e.g., the prefrontal cortex.
Here, broad glutamatergic outputs of the prefrontal cortex are crucial for subcortical learning mechanisms and match with recent models of interactive dopamine-glutamate dysfunctions and models of neurotrophic signaling in alcohol dependence.
Type d'étude
Inscription (Réel)
Contacts et emplacements
Lieux d'étude
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Berlin, Allemagne, 10117
- Charité - Universitätsmedizin Berlin
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Berlin, Allemagne, 10115
- Charité Berlin, Division of Neuroimaging
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
Méthode d'échantillonnage
Population étudiée
La description
Inclusion Criteria:
- Alcohol dependence according to DSM-IV
- Minimum of 72 hours of abstinence, maximum of 21 days of abstinence
- Minimum of three years of alcohol dependence
- Low severity of withdrawal symptoms
- Ability to provide fully informed consent and to use self- rating scales
Exclusion Criteria:
- Lifetime history of DSM- IV bipolar or psychotic disorder
- Current threshold DSM-IV diagnosis of any following disorders: current major - depressive disorder, generalized anxiety disorder, PTSD, borderline personality disorder or obsessive- compulsive disorder
- History of substance dependence other than alcohol or nicotine dependence
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
Cohortes et interventions
Groupe / Cohorte |
Intervention / Traitement |
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Controls, highrisk for AD
Community-based ad-hoc participants, high risk for alcohol dependence, matched to inpatients by sociodemographics
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Controls, low risk for AD
Community-based ad-hoc participants, low risk for alcohol dependence, matched to inpatients by sociodemographics
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Alcohol detoxification
Inpatients with alcohol dependence from local psychiatric hospital wards (18-65 years old)
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Detoxified alcohol- dependent patients in an inpatient setting
Autres noms:
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Striatal D2-receptor availability (PET) and prefrontal glutamate concentration (MRS)
Délai: first assessment time point (alc. dependent pat. up to 21 days after detoxification)
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reduction in striatal D2-receptor availability and a increase in prefrontal glutamate concentration in alcohol-dependent patients compared to healthy controls
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first assessment time point (alc. dependent pat. up to 21 days after detoxification)
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
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behavioral data in reward-habit-learning paradigms
Délai: first assessment time point (alc. dependent pat. up to 21 days after detoxification)
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Reduced learning speed and PIT withdrawal score in the probabilistic reversal learning task
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first assessment time point (alc. dependent pat. up to 21 days after detoxification)
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Treatment response
Délai: 12-month follow-up period beginning after first assessment timepoint
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test the predictive effects of striatal D2-receptor availability and prefrontal glutamate availability for treatment outcome (relapse vs abstinence) in alcohol-dependent patients
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12-month follow-up period beginning after first assessment timepoint
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Autres mesures de résultats
Mesure des résultats |
Description de la mesure |
Délai |
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striatal-prefrontal connectivity (fMRI)
Délai: first assessment time point (alc. dependent pat. up to 21 days after detoxification)
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striatal-prefrontal connectivity (see other LeAD-projects) in the probabilistic reversal learning task
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first assessment time point (alc. dependent pat. up to 21 days after detoxification)
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Collaborateurs et enquêteurs
Parrainer
Collaborateurs
Les enquêteurs
- Chercheur principal: Jürgen Gallinat, Prof MD, Charite University, Berlin, Germany
Publications et liens utiles
Liens utiles
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
- Les troubles mentaux
- Troubles induits chimiquement
- Comportement de consommation
- Troubles liés à l'alcool
- Troubles liés à une substance
- Boire de l'alcool
- Alcoolisme
- Effets physiologiques des médicaments
- Agents anti-infectieux locaux
- Agents anti-infectieux
- Dépresseurs du système nerveux central
- Éthanol
Autres numéros d'identification d'étude
- GA707/6-1
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
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Essais cliniques sur Alcohol detoxification
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University of WashingtonNational Institute on Alcohol Abuse and Alcoholism (NIAAA)Actif, ne recrute pasAlcool; Utilisation, problèmeÉtats-Unis
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University of SevilleMaastricht University; Junta de AndalucíaComplétéBoire de l'alcool | Beuveries | Comportement des adolescentsEspagne
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University of MichiganNational Institute on Alcohol Abuse and Alcoholism (NIAAA)ComplétéMaladies du foie | Troubles liés à l'alcoolÉtats-Unis
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Centre Hospitalier Universitaire de NiceActif, ne recrute pasHyperplasie prostatique bénigneFrance