双相情感障碍的饮食干预
有针对性地改变 n-3 和 n-6 脂肪酸以管理双相情感障碍维持阶段的情绪变化
研究概览
详细说明
研究人员将进行一项 2 组、平行组、随机、对照的为期 24 周的饮食干预,以评估两种饮食干预对 BD 患者的治疗效果。 在两周的基线监测期后,研究人员将随机分配 84 名慢性 BD 患者,以通过实验改变的 omega-3、omega-6 干预或美国平均摄入 n-3 和 omega-6 的对照饮食来加强常规治疗。 n-6 脂肪酸。 两组中的受试者在整个试验期间都将由他们的医生照料。 在试验的第一阶段(12 周),干预将是强烈的,在第二阶段(12 周),将进行强度较低的干预,在两个阶段的干预之后,将进行为期 24 周的随访期。
本研究旨在实现以下具体目标,并获得对以下假设的支持:
具体目标 1(主要情绪结果):比较实验性饮食干预与对照饮食在减少情绪症状变异性和减少一般心理困扰方面的功效。
假设 1:与对照饮食相比,实验干预将在 (1a) 日常情绪症状、精力和冲动的可变性方面产生显着改善,使用视觉模拟量表使用生态瞬时分析 (1) 测量; (1b) 使用 PROMIS-29 的心理困扰和一般功能。
特定目标 2(次要情绪结果):比较实验性饮食干预与对照饮食在减少复发方面的功效。
假设 2:与对照饮食相比,实验干预将在 12 个月内显着减少情绪发作的复发。 为了充分支持这项研究的复发测量,研究人员需要的样本量是研究人员为这项研究估计的样本量的 2-3 倍,因此主要情绪结果不是发作的复发,而是情绪变异性的测量,这反过来预示复发。 研究人员将测量复发情况,为未来的研究收集数据。
具体目标 3(主要生化结果):评估实验性饮食干预是否可以改变 BD 患者的 n-6 AA 及其生物活性代谢物、n-3 DHA 及其生物活性代谢物。
假设 3:与对照饮食相比,实验干预将显着 (1a) 改变红细胞中的 n-6 AA 和 n-3 DHA; (1b) 改变 17-羟基 DHA 并减少血浆中的 PGE2。
探索性目标:以探索性方式,研究人员还将 (1) 比较实验性饮食干预与对照饮食在改善伴有偏头痛的 BP 患者亚群中头痛相关临床终点的疗效; (2) 测试饮食干预对 n-3 和 n-6 脂肪酸和其他炎症介质(例如 细胞因子、CRP); (3) 评估 n-3 DHA、n-6 AA 及其生物活性代谢物的生化变化是否与临床改善有关 (4) 比较实验性饮食干预与对照饮食在预防后续疾病复发方面的功效 -向上; (5) 储存样品用于探索性生物标志物分析。
研究类型
注册 (实际的)
阶段
- 不适用
联系人和位置
学习地点
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Pennsylvania
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Hershey、Pennsylvania、美国、17033
- Milton S. Hershey Medical Center Clinical Research Center
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
纳入标准:
- BD——至少有一次躁狂或混合发作史
- 有临床意义的轻躁狂或抑郁症
- 目前的精神治疗
- 年满18岁
排除标准:
- 目前因 BD 住院
- 活性物质依赖或进食障碍
- 积极的自杀/杀人意念
- 怀孕
- 重大内科疾病积极治疗
- 特定食物过敏史,例如但不限于鱼、麸质、乳制品
- 强烈厌恶鱼
- PI 认为会妨碍对研究的全面合作和承诺的任何条件或态度
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:四人间
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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实验性的:实验饮食
改变了 n-6 和 n-3 脂肪酸的摄入量。
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改变 n-6(亚油酸)和 n-3(二十碳五烯酸 (EPA) + 二十二碳六烯酸 (DHA))饮食。
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有源比较器:比较饮食
饮食标准化为通常的 n-6 和 n-3 摄入量。
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饮食标准化为美国通常的 n-6 (7%) 和 n-3 EPA+DHA(每天 150 毫克)分布。
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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情绪变异结果
大体时间:从第 1 阶段干预的 2 周基线期到 12 周期测量
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每个人都将获得 14 周的智能手机(2 周基线加上 12 周第 1 阶段干预)来测量情绪、睡眠和疼痛的各个方面。
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从第 1 阶段干预的 2 周基线期到 12 周期测量
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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情绪发作的复发
大体时间:1年
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复发率将通过电话访谈和医疗记录审查来衡量。
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1年
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其他结果措施
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Omega-6 脂肪酸的血浆水平
大体时间:从基线到第 4、8、12 周的比较
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将以探索性方式测量和分析脂肪酸、代谢物和脂质组学血浆水平相对于基线的平均变化的组比较。
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从基线到第 4、8、12 周的比较
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心理困扰和一般功能
大体时间:基线和第 0、4、8、12 周
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由 PROMIS-29 测量
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基线和第 0、4、8、12 周
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情绪症状
大体时间:基线和第 0、4、8、12、24、48 周
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情绪、睡眠、社会心理压力和疼痛问卷。
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基线和第 0、4、8、12、24、48 周
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Omega-3 脂肪酸的血浆水平
大体时间:基线和第 4、8、12 周
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将以探索性方式测量和分析脂肪酸、代谢物和脂质组学血浆水平相对于基线的平均变化的组比较。
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基线和第 4、8、12 周
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合作者和调查者
调查人员
- 首席研究员:Erika Saunders, M.D、Milton S. Hershey Medical Center
出版物和有用的链接
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- Modi HR, Taha AY, Kim HW, Chang L, Rapoport SI, Cheon Y. Chronic clozapine reduces rat brain arachidonic acid metabolism by reducing plasma arachidonic acid availability. J Neurochem. 2013 Feb;124(3):376-87. doi: 10.1111/jnc.12078. Epub 2012 Dec 6. Erratum In: J Neurochem. 2013 May;125(3):486.
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- Shimshoni JA, Basselin M, Li LO, Coleman RA, Rapoport SI, Modi HR. Valproate uncompetitively inhibits arachidonic acid acylation by rat acyl-CoA synthetase 4: relevance to valproate's efficacy against bipolar disorder. Biochim Biophys Acta. 2011 Mar;1811(3):163-9. doi: 10.1016/j.bbalip.2010.12.006. Epub 2010 Dec 22.
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