Reward-Related Processes and Brain Function
Condition: Depression
MeSH terms: Depression
Study type: Observational

Summary: 
      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.
    

Detailed description: 
      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.
    

Observational model: Cohort
Time perspective: Cross-Sectional
Keywords: fMRI; Adolescents and Adults; Depression; Anxiety; Anxiety Disorder; GAD; Adolescents; Healthy Volunteer; HV; Normal Control