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Remediation of Impaired Self-Regulation in Patients With Mild TBI

Not Applicable
Completed
Conditions
Mild Traumatic Brain Injury
Interventions
Drug: Placebo
Registration Number
NCT02260570
Lead Sponsor
VA Office of Research and Development
Brief Summary

The ability to regulate impulses enables us to plan for the future, to maintain focus in the face of distractions (i.e. to encode memories), and to manage emotions. This self regulation can be compromised in individuals who have a history of mild traumatic brain injury and co-occurring disorders. In this study the investigators are using functional MRI scanning to understand how memory and self regulation are expressed in the brains of people with a history of mild traumatic brain injury. The investigators are also testing whether the medication tolcapone may improve memory and self regulation.

Detailed Description

In this randomized, double-blind, placebo-controlled, crossover cognitive neuroscience study, the investigators are evaluating whether the COMT inhibitor tolcapone impacts memory and self regulation, as measured both behaviorally (via cognitive testing) and neurophysiologically (via functional MRI). A new study arm that does not include use of tolcapone, nominally equivalent to the placebo arm only, is now also included to address performance on cognitive testing alone.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
55
Inclusion Criteria
  • Veteran ages 18-50 and in general good health;
  • Able to read English at a 6th grade level;
  • Able to provide written informed consent;
  • Normal or corrected to normal visual acuity;
  • Stable doses of all medications (2 weeks or greater);
  • History of mild traumatic brain injury greater than 6 months prior to participation
Exclusion Criteria
  • Contraindications to MRI scanning;
  • Inability to complete basic fMRI requirements;
  • History of brain surgery or penetrating brain injury;
  • Uncontrolled blood pressure (low or high);
  • Contraindications to tolcapone use (not required for subjects who participate only in the study arm that does not include study medication);
  • Use of medications or drugs with dopamine-related actions within 30 days;
  • Active substance abuse or dependence;
  • Clinically severe medical illness requiring treatment;
  • History of psychiatric hospitalization (past 1 year) or suicide attempt (past 5 years);
  • Seizures greater than 4 weeks after TBI event or seizures requiring active treatment;
  • History of brain tumor, stroke, Alzheimer's disease, aneurysm rupture, or multiple sclerosis;
  • History of schizophrenia, ADHD or psychiatric diagnosis EXCEPT depression or PTSD

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
Functional MRI ArmPlaceboThis cognitive science study consists of a single "arm" in which all subjects receive both tolcapone and placebo in randomized, double-blind, counterbalanced, crossover fashion
Functional MRI ArmTolcaponeThis cognitive science study consists of a single "arm" in which all subjects receive both tolcapone and placebo in randomized, double-blind, counterbalanced, crossover fashion
Primary Outcome Measures
NameTimeMethod
Blood Oxygen Level Dependent (BOLD) brain signal measured using functional MRIApproximately 60-240 minutes following tolcapone/placebo administration

BOLD signal provides an indirect measure of brain activity during cognitive testing

Performance on Cognitive TestingApproximately 60-240 minutes following tolcapone/placebo administration

Tasks to assess cognition will be performed while subjects are in the MRI scanner

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

VA Northern California Health Care System, Mather, CA

🇺🇸

Sacramento, California, United States

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