The Effect of Cortisol Administration on Neural Correlates of Emotion in Depression

Study Overview
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Brief Summary
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There is good evidence to suggest that the pathological version of sadness that people with Major Depression experience could be caused by the failure of the hormone cortisol to properly inhibit sadness-related brain activity in the subgenual cingulate cortex. This project investigates if the subgenual cingulate cortex has become insensitive to cortisol in patients with depression and tests for variants of the cortisol receptor genes that could predispose individuals to develop cortisol insensitivity.

Official Title
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The Effect of Cortisol Administration on Neural Correlates of Emotion in Depression

Conditions
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Depression

Intervention / Treatment
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* Drug: Hydrocortisone acetate
* Drug: Placebo


Participation Criteria
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Eligibility Criteria
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https://redcap.stanford.edu/surveys/?s=3F7WCENPND Inclusion Criteria: Healthy Participants must have no Axis 1 mental disorder Participants with depression must meet minimum severity levels (Hamilton >7) All participants must weight less than 280 pounds for the purposes of MRI scanning Exclusion Criteria: In order to protect against risk associated with taking Hydrocortisone, all participants must not have any of the following: Psychotropic medications Recent surgery Endocrine disorders Liver disease Kidney disease Thyroid disorder History of malaria Tuberculosis Osteoporosis Glaucoma/cataracts Chronic expressed infections (herpes --including ocular herpes, HIV, etc.) History of congestive heart failure History of recurring seizures Stomach Ulcers Comorbid psychosis Current use of illicit drugs High Blood pressure In order to protect against risks associated with MRI scanning participants must not be/have any of the following: >280 lbs In-dwelling ferrous metals Left Handed Abnormal Hearing Claustrophobic Head injury with loss of consciousness

Ages Eligible for Study
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Minimum Age: 21 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Healthy<br>Healthy individuals will receive both the placebo and hydrocortisone interventions in a randomized order | Drug: Hydrocortisone acetate<br> <br> * Other names: Cortef;Drug: Placebo<br> <br> |
| Other: Depression<br>Individuals with depression will receive both the placebo and hydrocortisone interventions in a randomized order | Drug: Hydrocortisone acetate<br> <br> * Other names: Cortef;Drug: Placebo<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Sadness-induced subgenual cingulate activity as measured by functional magnetic resonance imaging. |  | 2 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Genetics, Depression, Cortisol, Sadness, Stress