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Brain Imaging Biomarkers of Pathological Brain Aging in Late-life Depression

Recruiting
Conditions
Depression
Interventions
Other: ECT
Registration Number
NCT03849417
Lead Sponsor
Universitaire Ziekenhuizen KU Leuven
Brief Summary

This study investigates the relationships and differences in PET-MRI brain imaging biomarkers of abnormal aging and behavioral measures in late life depression compared to healthy controls, and evaluates relationships and differences in the same imaging and behavioral measures following electroconvulsive therapy. The study tests the hypotheses that late-life depression will be associated with higher levels of accelerated aging and brain disease biomarkers, and that electroconvulsive therapy works by stimulating the reorganization of brain tissue.The data collected with contribute to improved knowledge about the neurobiology of late-life psychopathology and its treatment.

Detailed Description

This clinical study is a combined single-center, cohort study with a (1) cross-sectional arm evaluating relationships and differences in PET-MR imaging and behavioral measures in 64 patients with late life depression (LLD) compared to 64 healthy controls, and (2) a longitudinal arm evaluating relationships and differences in imaging and behavioral measures in 20 patients receiving ECT as part of their normal clinical management. The study will utilise three PET tracers: (1) \[11C\]UCB-J, which targets the Synaptic Vesicle Glycoprotein 2A receptor, to estimate synaptic density (2) \[18F\]MK-6240, which targets tau associated with neurofibrillary tangles, to assess the presence of tau pathology and (3) \[18F\]-Flutemetamol, which targets beta-amyloid neuritic plaques in the brain, to assess the presence of cerebral amyloidosis. The main aim of the study is to clarify how hippocampal synaptic density, tau, amyloid and white matter lesions, relate to neuropsychological function, stress and ECT in late life depression.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
128
Inclusion Criteria
  • Diagnosis of late-life depression according to DSM 5 (patients only)
  • Age over 60 years old
  • Judged to be in good physical health by the investigator on the basis of medical history
Exclusion Criteria
  • history or evidence of psychiatric disease, as assessed by clinical interview (healthy controls only).
  • history of major other neurological disorder, or major internal pathology that may make him/her unfit for participation according to the interpretation by the investigator (including cardiac, lung, haematological, gastro-intestinal disorders or cancer);
  • current user (including ''recreational use'') of any illicit drugs,including cannabis, or has a history of drug or alcohol abuse;
  • had exposure to ionizing radiation (> 1 mSv) in other research studies within the last 12 months;
  • has a contra-indication for MRI scanning;
  • suffers from claustrophobia or cannot tolerate confinement during PET-MRI scanning procedures; cannot lie still for 60 minutes inside the scanner;
  • does not understand the study procedures
  • unwilling or unable to perform all of the study procedures, or is considered unsuitable in any way by the principal investigator;
  • underwent ECT within the last 3 months before enrollment (patients)

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Late-life Depression (ECT)ECTPatients aged over 60 years old with severe depression who are referred for treatment with electroconvulsive therapy
Primary Outcome Measures
NameTimeMethod
Relationship between synaptic density and hippocampal volume in LLD1 day

Cross-sectional association between \[11C\]UCB-J binding (SUVR) and MRI-based assessment of hippocampal volume

Relationship between tau and hippocampal volume in LLD1 day

Cross-sectional association between \[18F\]MK-6240 binding (SUVR) and MRI-based assessment of hippocampal volume

Effect of tau on medial temporal neural responses to emotional stimuli and functional connectivity in LLD1 day

Cross-sectional association between \[18F\]MK-6240 binding (SUVR), fMRI based assessment of the emotion positivity effect, and fMRI derived resting state brain networks.

Relationship between medial temporal pathology and stress1 week

Association between \[18F\]MK-6240 binding (SUVR), hippocampal volume (MRI) and reactivity to stress (EMA) and wristband monitoring of heart rate and skin conductance.

Relationship between tau and white matter (wm) pathology in LLD1 day

Cross-sectional association between \[18F\]MK-6240 binding (SUVR) and MRI measures of white matter pathology (T2-FLAIR WMH/lesions, diffusion MRI measures in temporal lobe tracts)

Relationship between hippocampal volume increase following ECT and changes in synaptic density and tau8 weeks

Association between change in \[11C\]UCB-J and \[18F\]MK-6240 binding (SUVR) and MRI-based assessment of hippocampal volume one week following last ECT

Amyloid changes following ECT8 weeks

Change in \[18F\] Flutemetamol one week following the last ECT treatment

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

UZ Leuven

🇧🇪

Leuven, Belgium

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