Depression in the Elderly and Cerebral Amyloid Plaques: Characterization by [18F] AV-45 Affectives Symptoms and Amyloïd Plaques (ASAP)

Study Overview
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Brief Summary
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The primary objective of the study is to compare the brain amyloid load in fully, partially and non remitting depressed elderly patients at 8 weeks of antidepressant therapy, by using PET with [F18]AV45.

Detailed Description
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The main aim of this study is to assess the brain amyloid load in treated depressed elderly subjects using PET with [F18]AV45. The investigators hypothesize that the brain amyloid load will be higher in non or partially remitting depressed subjects treated with antidepressants than in fully remitting ones. An additional two years follow-up will allow comparing the brain amyloid load at baseline between those who will have evolved towards MCI or MA and those who will not, including ApoE genotype, the cognitive performances at baseline, the hippocampus volume as assessed by MRI, the type and profile of mood disorder (number of past episodes, age at first episode, vascular risk factor profile, response profile to antidepressants), as covariates.

Official Title
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Depression in the Elderly and Cerebral Amyloid Plaques: Characterization by [18F] AV-45 Affectives Symptoms and Amyloïd Plaques (ASAP)

Conditions
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Elderly, Major Depression

Intervention / Treatment
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* Drug: 18FAV45


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria Adult 55 years or older Native language : french Study period > 7 years Major depression defined on the DSM-IV criteria assessed by MINI and HDRS score of 10 or over Affiliation to the national health insurance system Signed informed consent Exclusion Criteria History of alcoholism or drug addiction MMSE less than or equal to 17 Major depression with psychotic features Depressive episode resistant, patient who received two different antidepressants well conducted without significant therapeutic response Any current or past episode of mania, schizophrenia or any other psychotic disorder Any past history of stroke or Parkinson's disease Any current significant unstable illness Any past diagnosis of Alzheimer's disease Any current treatment by AcethylCholinesterae inhibitor, memantine or antidepressant therapy. Contraindications to MRI in patients with: Metallic foreign body eye. Any implanted electronic medical irremovably (pacemaker, neurostimulator, cochlear implants ...) Metal heart valve, Vascular clips formerly located on cranial aneurysm. Contraindications to antidepressants History of progressive disease that can affect the central nervous system such as uncontrolled diabetes, blood pressure greater than or equal to 180/100; chronic lung disease with hypoxia, head trauma with loss of consciousness greater than or equal to 15 minutes; brain surgery, encephalitis, recently treated cancer (<1 year), altered cerebral metabolism including subjects with stroke sequelae extended. Patients with lacunar stroke without thalamic or striatal may be included.

Ages Eligible for Study
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Minimum Age: 55 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: 18FAV45<br> | Drug: 18FAV45<br>* Admnistration of 18FAV45 if patient is compliant with one of those treatment: Seroplex, Zoloft, Deroxat, Venlafaxine, Mirtazapine, Moclamine,<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| standards uptakes values (SUVr) |  | 2 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Residual cognitive deficits | The residual cognitive deficits (presence/absence) will be considered as a categorical variable. The ApoE genotype will also be considered as categorical variables, as well as vascular risk factor profile, WMH at MRI. MADRS, NPI and IA scores as well as the hippocampus volume will be considered as continuous variables. | 2 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Affective symptoms as prodromal stage of Alzheimer