Reward-Related Processes and Brain Function
| Status: | Completed |
|---|---|
| Conditions: | Depression |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 9 - 40 |
| Updated: | 10/8/2017 |
| Start Date: | January 11, 2002 |
| End Date: | July 24, 2017 |
This study will examine and compare brain changes during decision-making in healthy
adolescents and adolescents who are anxious or depressed. The findings may provide a better
understanding of mechanisms that lead to depression or anxiety.
Adolescents between 9 and 17 years of age and adults between 20 and 40 years of age in the
following categories will be enrolled in this study:
- Healthy adults
- Healthy adolescents
- Adolescents with major depression
- Adolescents with anxiety disorder (generalized anxiety disorder, social phobia, or/and
separation anxiety disorder)
The study involves three visits, as follows:
Visit 1
Visit 1 consists of three parts for both child and adult participants:
- Part 1: Staff will meet with participants for a standard psychiatric interview, which
will include questions about the participants feelings, experiences and behavior both
past and present. For adolescent participants, staff will meet with the child alone, the
parent alone, and the child and parent together.
- Part 2: Participants will perform a series of simple tasks involving shapes, letters,
and numbers. They will have a medical history, physical examination and blood draw. In
addition, adolescents will have a urine drug test.
- Part 3: Adults and those adolescents who will undergo magnetic resonance imaging (MRI)
in Visit 3 will receive training to familiarize them with the procedure.
Visit 2
- Adolescents will again be asked standardized questions regarding their feelings,
experiences and behavior, and will then perform a series of simple decision-making tasks
on a computer.
- Adults will undergo MRI scanning, as described below in Visit 3 for adolescents. This
concludes the participation of adults in the study.
Visit 3
Adolescents will have one of the following two procedures:
- Decision-making task using a computer. Small electrodes will be placed on the child s
wrists, face and fingers to monitor muscle tone and skin humidity during the task.
Or
- MRI, a test that uses a strong magnetic field and radio waves to show changes in brain
function. During the scan, the participant lies on a table in a space enclosed by a
metal cylinder (the MRI scanner). The procedure takes 60-90 minutes; subjects must lie
still for 10-15 minutes at a time. During imaging, the subject will be asked to perform
a decision-making task on a computer.
adolescents and adolescents who are anxious or depressed. The findings may provide a better
understanding of mechanisms that lead to depression or anxiety.
Adolescents between 9 and 17 years of age and adults between 20 and 40 years of age in the
following categories will be enrolled in this study:
- Healthy adults
- Healthy adolescents
- Adolescents with major depression
- Adolescents with anxiety disorder (generalized anxiety disorder, social phobia, or/and
separation anxiety disorder)
The study involves three visits, as follows:
Visit 1
Visit 1 consists of three parts for both child and adult participants:
- Part 1: Staff will meet with participants for a standard psychiatric interview, which
will include questions about the participants feelings, experiences and behavior both
past and present. For adolescent participants, staff will meet with the child alone, the
parent alone, and the child and parent together.
- Part 2: Participants will perform a series of simple tasks involving shapes, letters,
and numbers. They will have a medical history, physical examination and blood draw. In
addition, adolescents will have a urine drug test.
- Part 3: Adults and those adolescents who will undergo magnetic resonance imaging (MRI)
in Visit 3 will receive training to familiarize them with the procedure.
Visit 2
- Adolescents will again be asked standardized questions regarding their feelings,
experiences and behavior, and will then perform a series of simple decision-making tasks
on a computer.
- Adults will undergo MRI scanning, as described below in Visit 3 for adolescents. This
concludes the participation of adults in the study.
Visit 3
Adolescents will have one of the following two procedures:
- Decision-making task using a computer. Small electrodes will be placed on the child s
wrists, face and fingers to monitor muscle tone and skin humidity during the task.
Or
- MRI, a test that uses a strong magnetic field and radio waves to show changes in brain
function. During the scan, the participant lies on a table in a space enclosed by a
metal cylinder (the MRI scanner). The procedure takes 60-90 minutes; subjects must lie
still for 10-15 minutes at a time. During imaging, the subject will be asked to perform
a decision-making task on a computer.
Impaired motivated behaviors, including aspects of decision-making and reward-related
processes, lie at the root of maladaptive behavior in many psychiatric disorders, including
major depression (MD). Little is known of the cognitive and neural mechanisms that underlie
MD in adolescents. Adolescence is a key period during which many psychiatric disorders first
emerge, and studies during this developmental stage may provide a unique window to address
primary deficits associated with the disorders. In particular, major depression shows a
marked increase in prevalence at adolescence. Data from family-based and longitudinal studies
suggest that anxiety disorders (AD), often preceding MD, may index childhood vulnerabilities
for the development of MD. The concomitant examination of MD and AD can help interpret these
findings. We propose to examine, in adolescents, the manner in which the various elemental
emotional-cognitive processes are differentially affected in MD and AD compared to healthy
controls. This investigation will be done in two phases. In Phase I, using fMRI, we will test
two tasks in the decision-making model of gambling that have similarly been tested in adults
in a group of healthy adolescents and healthy adults. This phase will serve as a test of the
feasibility and validity of using these tasks in adolescents, and will provide normative
developmental data by comparing healthy adults with healthy adolescents. In addition to
showing the feasibility of using these tasks in normal adolescents, we will also test task
performance behaviorally in healthy, anxious and depressed adolescents. Measures will include
psychophysiological and eye tracking measures, and behavioral variables. Once task
performance is well characterized behaviorally, we will conduct in Phase II an fMRI study in
independent groups of depressed and anxious adolescents and compare the findings with those
obtained in healthy adolescents.
processes, lie at the root of maladaptive behavior in many psychiatric disorders, including
major depression (MD). Little is known of the cognitive and neural mechanisms that underlie
MD in adolescents. Adolescence is a key period during which many psychiatric disorders first
emerge, and studies during this developmental stage may provide a unique window to address
primary deficits associated with the disorders. In particular, major depression shows a
marked increase in prevalence at adolescence. Data from family-based and longitudinal studies
suggest that anxiety disorders (AD), often preceding MD, may index childhood vulnerabilities
for the development of MD. The concomitant examination of MD and AD can help interpret these
findings. We propose to examine, in adolescents, the manner in which the various elemental
emotional-cognitive processes are differentially affected in MD and AD compared to healthy
controls. This investigation will be done in two phases. In Phase I, using fMRI, we will test
two tasks in the decision-making model of gambling that have similarly been tested in adults
in a group of healthy adolescents and healthy adults. This phase will serve as a test of the
feasibility and validity of using these tasks in adolescents, and will provide normative
developmental data by comparing healthy adults with healthy adolescents. In addition to
showing the feasibility of using these tasks in normal adolescents, we will also test task
performance behaviorally in healthy, anxious and depressed adolescents. Measures will include
psychophysiological and eye tracking measures, and behavioral variables. Once task
performance is well characterized behaviorally, we will conduct in Phase II an fMRI study in
independent groups of depressed and anxious adolescents and compare the findings with those
obtained in healthy adolescents.
- INCLUSION CRITERIA:
1. Age: Subjects will be males and females, 9-17 and 20-40 years of age.
2. Psychiatric history: Subjects in Group 3, and 4 will be diagnosed with current
MD, and current AD (generalized anxiety disorder, social phobia, or/and
separation anxiety disorder) respectively, based on k-SADS interviews of parents
and adolescents for minors (<18 years old), and SCID for adults. History of
anxiety disorders in individuals with MD is acceptable, if current symptoms are
mild or absent (see exclusion criteria). Similarly, history of depression in
individuals with AD is acceptable, if current symptoms are mild or absent (see
exclusion criteria). AD and MD patients should have a CGAS< 70.
3. Medication status: No history of medication treatment or use of an SSRI > one
month prior to entering the study and fluoxetine > six months prior to entering
the study.
EXCLUSION CRITERIA:
Because factors such as psychiatric disease, or CNS disease, can influence functional brain
activity, and pregnancy precludes participation in fMRI studies, these factors are
exclusionary.
1. Psychiatric disease: Any current history of an axis I diagnosis other than adjustment
disorder, simple phobia, Social Phobia, Separation Anxiety, dysthymia, GAD and MD is
exclusionary. Subjects will be assessed using DSM-IV criteria via standardized
psychiatric interviews conducted by trained examiners (K-SADS in minors and SCID in
adults). Any current suicidal ideation, and severe ADHD requiring pharmacotherapy will
be exclusionary.
2. History of Drug Abuse: Axis I diagnoses of substance use disorders will be
exclusionary.
3. Severe acute and chronic medical illnesses
4. CNS disease: History of brain abnormalities (e.g., neoplasms, subarachnoid cysts),
cerebrovascular disease, infectious disease (e.g., abscess), or other neurological
disease, or history of head trauma (defined as loss of consciousness > 3 min).
5. IQ lower than 70.
6. Metal or electronic objects: Metal plates, certain types of dental braces, cardiac
pacemakers, etc., that are sensitive to electromagnetic fields contraindicate MRI
scans.
7. Claustrophobia: Subjects will be questioned about potential discomfort in being in an
enclosed space, such as an MRI scanner.
8. Pregnancy status: Because of the potential effects of hormonal changes on brain
function as well as the unknown effects of electromagnetic field on the fetus,
pregnancy is an exclusion criterion. Sexually mature female participants must have a
negative urine pregnancy test performed within 24 hours of the fMRI scan.
We found this trial at
2
sites
9000 Rockville Pike
Bethesda, Maryland 20892
Bethesda, Maryland 20892
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