Clinical trial NCT03822910: Hippocampal Memory Circuits in Delusions
Official title: Hippocampal Memory Circuits in Delusions
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Psychosis
Lead sponsor: NYU Langone Health
Sponsor class: OTHER
Collaborators: name: National Institutes of Health (NIH)
First posted: 2019-01-30
Enrollment: 212
Sex: ALL
Minimum age (years): 16
Maximum age (years): 35
Standard ages: CHILD
ADULT
Accepts healthy volunteers: no
Observational model: CASE_CONTROL
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Males and females with First Episode Psychosis

Brief summary: This study will investigate dentate gyrus (DG) and hippocampal CA3 sub field function, using the pattern separation paradigm, as reflected by the difference in brain activation in response to same-as-previously- seen (OLD) vs. similar-to-previously-seen (SIM) objects in first episode psychosis (FEP) subjects before and after anti psychotic treatment and in matched healthy controls (HC). The current study uses three novel high-resolution task-based and post-encoding resting fMRI measures to probe hippocampal circuitry in delusions. It will also study CA1 function, using a sequential associative mismatch paradigm, as reflected by activation of CA1 in response to mismatching information compared to memory of that stimulus in FEP subjects before and after antipsychotic treatment and in matched HC. Finally, this study will evaluate plasticity of hippocampal intrinsic functional connectivity (IFC) in response to memory consolidation, using an encoding-plasticity paradigm, in FEP subjects before and after anti psychotic treatment and in matched HC. For each of the three imaging projects, a total of 50 FEP subjects and 50 matched healthy controls (HC) will be studied; hence, 300 subjects will be studied over 5 years. Within each paradigm, medication-naive FEP subjects will be studied at baseline and 8 weeks after starting anti psychotic medication. HC participants will be studied at baseline and 8 weeks later but will not receive any treatment.


Eligibility criteria: Inclusion Criteria:

* Males and females 16 to 35 years of age, inclusive, at the time of informed consent
* Right-handed
* Must have experienced a first episode of non-affective psychosis over the past five years
* Must exhibit a persistence of delusions for at least 4 days per week for at least 4 weeks in the absence of psychotomimetic substance use or other potential organic etiologies, including epilepsy or significant head trauma.
* Must score at least a 2 (mild to moderate) on the "Amount of preoccupation with delusions" and "Conviction" items on the Psychotic Symptom Rating Scale (PSYRATS).

Exclusion Criteria:

* Diagnosis of major mood disorder or other Axis I disorder other than Schizophrenia, Schizoaffective Disorder or Schizophreniform Disorder.
* Significant medical or neurological illness by history or physical exam including seizure disorder, history of loss of consciousness related to head trauma or developmental disorder including mental retardation.
* Metal implants, pacemaker, or other metal in the body or medicinal patch.
* History of claustrophobia.
* Currently taking any anti psychotic medication (within 4 weeks).

Primary outcomes:
measure: The difference in CA1 activation between a mismatch and an intact trial in FEP subjects after 8 weeks of antipsychotic treatment and the correlation of this change with change in delusions as measured by the Psyrats-D total score.
timeFrame: 8 Weeks
measure: Change in hippocampus-to-VTA (hip-VTA) IFC and hip-to-lateral occipital complex (hip-LO) IFC, from pre- to post- encoding during the encoding-plasticity paradigm, between FEP and HC.
timeFrame: 8 Weeks
measure: Change in (a) hip-VTA IFC and (b) hip-LO IFC, from pre- to post- encoding during the encoding-plasticity paradigm
timeFrame: 8 Weeks
measure: correlation of change (a) hip-VTA IFC and (b) hip-LO IFC with change in delusional severity measured by the Psyrats-D total score.
timeFrame: 8 Weeks
Secondary outcomes:
Other outcomes:
Locations:
city: New York
country: United States
facility: New York Langone Health
state: New York
city: Shanghai
country: China
facility: Shanghai Mental Health Center
city: Suzhou
country: China
facility: Suzhou Guangji Hospital
Study officials:
affiliation: NYU Langone Health
name: Donald Goff, MD
role: PRINCIPAL_INVESTIGATOR
References: