Imaging mGluR5 and Synaptic Density in Psychiatric Disorders
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 79
- 试验地点
- 2
- 主要终点
- mGluR5 availability using [18F]FPEB
研究概览
简要总结
This research study is designed to look at the involvement of the glutamate system and synaptic density in depression and bipolar disorder. Each participant will undergo a screening appointment to determine study eligibility. Thereafter, the study will take 2 or 3 visits depending on schedule availability and will consist of a combination of one magnetic resonance imaging (MRI) or functional magnetic resonance imaging (fMRI) scan, one proton magnetic resonance spectroscopy (MRS) and/or one C13 MRS scans, and up to two positron emission tomography (PET) scans. Participants will also participate in cognitive testing. Depending on camera time, staff availability and subject schedule, total study participation may last 1-2 months.
详细描述
With the recent advancements in the positron emission tomography (PET) and radioligand development, the investigators are now able to image and quantify the metabotropic glutamatergic system (mGluR5) in vivo in human subjects. The investigators propose a novel investigation using [18F]FPEB in depression and bipolar disorder to obtain critical data to advance the understanding of the etiology of depression and bipolar disorder and its associated symptoms of cognitive dysfunction. The findings with mGluR5 by themselves are limited. Changes in mGluR5 availability could be due to changes in synaptic density. Recently, the Yale PET center synthesized a new radioligand [11C]UCB-J (referred to as [11C]APP311 at the Yale University PET Center) that binds to synaptic vesicle glycoproteins (SV2A), which represent the number of synapses in the brain. Thus, the investigators will also measure synaptic density in the brain and relate to mGluR5 availability.
Aim 1: To determine mGluR5 availability with mood disorders compared to healthy controls as measured with PET brain imaging using [18F]FPEB.
Hypothesis 1: decrease in mGluR5 availability in individuals with mood disorders in regions responsible for emotional and cognitive processes, including the amygdala, hippocampus, thalamus, anterior cingulate, and frontal cortices.
Aim 2: To determine if glutamate cycling in individuals with mood disorders is altered as compared to healthy controls as measured with [1H]MRS and [13C]MRS.
Hypothesis 2: increase in glutamate number in individuals with mood disorders as compared to controls.
研究设计
- 研究类型
- Observational
- 观察模型
- Other
- 时间视角
- Cross Sectional
入排标准
- 年龄范围
- 18 Years 至 80 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •General inclusion criteria:
- •18-80 years old English speaking
- •Inclusion criteria for healthy controls: no current, or history of any DSM-5 diagnosis
- •Inclusion criteria for MDD subjects clinical diagnosis of major depressive disorder
- •Inclusion criteria for bipolar subjects clinical diagnosis of bipolar disorder
排除标准
- •Current or past significant medical, neurological, or metabolic disorder
- •history of head injury that led to significant long term decline in cognitive abilities as seen by decline in grades or work performance
- •history of significant medical illness such that would contraindicate study participation based on above criteria and PI/MD history review
- •Active, significant suicidal ideation
- •Implanted metallic devices or any MR contraindications
- •women who are pregnant or breastfeeding
- •Met Diagnostic and Statistical Manual of Mental Disorders(DSM)-5 criteria for mild substance use disorder in the past 6 months or moderate to severe substance use disorder within the past year (except marijuana or nicotine)
- •history of prior radiation exposure for research purposes within the past year such that participation in this study would place them over FDA limits for annual radiation exposure. This guideline is an effective dose of 5 rem received per year
- •Current, past, or anticipated exposure to radiation in the work place within one year of proposed research PET scans
- •Blood donation within 8 weeks of the start of the study
- •History of a bleeding disorder or currently taking anticoagulants (such as Coumadin, Heparin, Pradaxa, Xarelto)
研究组 & 干预措施
Healthy control
60 psychiatrically-healthy subjects will be enrolled as controls may participate in MRI or fMRI, [1H]MRS and/or [13C]MRS, [18F]FPEB and/or [11C]APP311 PET scans, cognitive testing
干预措施: [18F]FPEB (Radiation)
Healthy control
60 psychiatrically-healthy subjects will be enrolled as controls may participate in MRI or fMRI, [1H]MRS and/or [13C]MRS, [18F]FPEB and/or [11C]APP311 PET scans, cognitive testing
干预措施: [11C]APP311 (Radiation)
MDD
30 subjects with major depressive disorder (MDD) may participate in MRI or fMRI, [1H]MRS and/or [13C]MRS, [18F]FPEB and/or [11C]APP311 PET scans, cognitive testing
干预措施: [11C]APP311 (Radiation)
Bipolar
30 subjects with bipolar disorder may participate in MRI or fMRI, [1H]MRS and/or [13C]MRS, [18F]FPEB and/or [11C]APP311 PET scans, cognitive testing
干预措施: [11C]APP311 (Radiation)
MDD
30 subjects with major depressive disorder (MDD) may participate in MRI or fMRI, [1H]MRS and/or [13C]MRS, [18F]FPEB and/or [11C]APP311 PET scans, cognitive testing
干预措施: [18F]FPEB (Radiation)
Bipolar
30 subjects with bipolar disorder may participate in MRI or fMRI, [1H]MRS and/or [13C]MRS, [18F]FPEB and/or [11C]APP311 PET scans, cognitive testing
干预措施: [18F]FPEB (Radiation)
结局指标
主要结局
mGluR5 availability using [18F]FPEB
时间窗: Through study completion date: 5 years
Glutamate (major excitatory neurotransmitter)is widespread throughout the brain \& likely modulates some symptoms present in individuals w/mood disorders. Glutamate neurotransmission is regulated by ionotropic \& the G-protein coupled metabotropic glutamate receptors (mGluR) which are divided into 3 groups: group I (mGluR1 and 5), group II (mGluR2 and 3) \& group III (mGluR4, 6, 8). The group I mGluRs couple to phospholipase C, \& stimulate cyclic AMP formation \& arachidonic acid release \& thus impact neuroplasticity, neuronal excitability, synaptic transmission \& gene expression. mGluR5 receptors are located post synaptically \& on glia,\& have highest density in hippocampus, intermediate in caudate/putamen, cerebral cortex, deep cerebellar nuclei, \& thalamus, \& lowest in the cerebellum. mGluR5 are considered to be pivotal in the functioning of the glutamatergic system especially as it pertains to cognitive performance. \[18F\]FPEB: high affinity radiotracer used to image mGluR5 receptor.
Synaptic density using [11C]APP311
时间窗: Through study completion date: 5 years
Synaptic density differences using \[11C\]APP311 between individuals with mood disorders compared to healthy controls. Synaptic density and \[11C\]APP311: There is strong preclinical evidence showing that chronic stress and depression lead to structural changes, which include neuronal atrophy, reduced synaptic density and cell loss. \[11C\]APP311 (also referred to as \[11C\]UCB-J) was developed at the Yale University PET Center as a novel PET radioligand for synaptic vesicle glycoprotein 2A (SV2A). SV2A is an integral membrane protein located in presynaptic vesicle membranes, similar to synaptophysin (SYN). SV2 has 3 isoforms, with SV2A being the only isoform which is ubiquitously located in synaptic vesicles across the brain. Thus, PET quantification of SV2A signal may be an excellent in vivo biomarker of synaptic density.
次要结局
- Cognitive Functioning Assessed with CogState Software(Through study completion date: 5 years)
- glutamate cycling using MRS(Through study completion date: 5 years)