Clinical trial NCT01585168: Functional Neuroimaging of Alcoholism Vulnerability (PIT)
Official title: Functional Neuroimaging of Alcoholism Vulnerability: Glutamate, Reward, Impulsivity and Pavlovian-to-Instrumental Transfer (PIT)
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE2
Conditions: Healthy
Keywords: Reward Circuitry
Impulsivity
Family History of Alcoholism
NMDA/DA Interactions
Lead sponsor: Yale University
Sponsor class: OTHER
First posted: 2012-04-25
Enrollment: 71
Sex: ALL
Minimum age (years): 18
Maximum age (years): 35
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Intervention model description: All subjects received both the study drug and placebo. Family history was the main variable of interest, and randomization was stratified by this variable.
Primary purpose: TREATMENT

Brief summary: This project compares Family History Positive (FHP) for alcoholism subjects to matched Family History Negative (FHN) subjects derived from the project Principal Investigator's National Institute on Alcohol Abuse and Alcoholism-funded longitudinal study of drinking behavior in a 2000 college freshman population (known as the Brain and Alcohol Research in College Students study (BARCS)). The age of these subjects is a valuable one at which to capture the transition from harmful use to abuse/dependence. This project explores the effects of memantine in a double-blind, randomized, counterbalanced manner on alcoholism risk-relevant tasks. More specifically, this project studies functional MRI tasks related to different aspects of reward and/or impulsivity-related behavior in different contexts, compares the underlying neural circuitry across tasks, and uses a pharmacologic probe of the glutamatergic system to examine NMDA/DA interactions. The combined measures provide the opportunity to advance our understanding of specific aspects of brain function related to familial alcoholism vulnerability in an already well-characterized population as some members evolve into alcohol abuse. In addition to conventional within-task analyses, functional network connectivity and allied approaches will be used to examine brain networks across tasks.

The investigators will study adult male and female subjects in equal numbers who are either offspring of an alcoholic parent or are FHN matched controls. The investigators will recruit and assess a total of 84 (42 FHP and 42 matched FHN) subjects between the ages of 18-21 years on initial BARCS contact. The investigators will use 4 cognitive tasks during the functional MRI (fMRI) which include: 1) a Monetary Incentive Delay Task that distinguishes networks engaged in motivational (anticipation) and consummatory (outcome) components of reward processing; 2) a Go/No-Go Task that measures the ability to inhibit response to a pre-potent stimulus; 3) an Alcohol Cue Reactivity Task that examines Nucleus Accumbens response to alcohol-related versus matched soft drink stimuli; and 4) a Pavlovian-to-Instrumental Transfer (PIT) Task that dissects a component of the Monetary Incentive Delay (MID) Task, and provides an imaging assay of a transfer-like process that can be related to real-world drinking behavior, thus informing upon and extending the key findings from CTNA-2.


Eligibility criteria: Inclusion Criteria:

* Biological father with a history of Alcoholism
* A least 1 other first- or second-degree relative with a history of Alcoholism.

Exclusion Criteria:

* Cannot be an only child
* A diagnosis of DSM-IV-TR Axis I psychotic disorders screened with the Mini International Neuropsychiatric Interview (MINI), done in the BARCS study (with the exception of Alcohol Abuse)
* Report of psychotic disorder in a 1º relative
* Prenatal exposure to alcohol (mother reported to drink 3 or more drinks on an occasion or more than 3 times per month during pregnancy
* Not speaking English fluently or being a non-native English speaker, or being educated in a primary language other than English \>grade 1
* Mental retardation (Full Scale IQ\<70)
* Traumatic brain injury with loss of consciousness \> 30 minutes or concussion in last 30 days
* Presence or history of any medical/neurologic illness that may affect brain physiology (e.g., epilepsy, Multiple Sclerosis), including focal brain lesion seen on structural MRI (all structural scans are read by a licensed radiologist)
* Current pregnancy (all females will be tested with urine screens on the day of MRI)
* Any positive alcohol screen will result in exclusion
* Inability to comprehend the consent form appropriately
* Other specific fMRI exclusions include metal devices, clips or fragments in body (orbital x-ray performed if needed)
* Female participants under 125 pounds will be excluded from participating due to the strength and side effects in this segment of the population.

Primary outcomes:
measure: Change in Blood Oxygenation Level Dependent (BOLD) Activation in the Amygdala During "Win" Monetary Incentive Delay (MID) Task Between Placebo and Study Medication
timeFrame: 4 hours post intervention on each study day, separated by 1 week to 1 month
measure: Change in Blood Oxygenation Level Dependent (BOLD) Activation in Anterior Cingulate Cortex During "Loss" Condition of Monetary Incentive Delay (MID) Task Between Placebo and Study Medication
timeFrame: 4 hours post intervention on each study day, separated by 1 week to 1 month
Secondary outcomes:
measure: Change in Impulsive Behavior as Measured on the Balloon Analog Risk Task (BART) Computerized Task Between Placebo and Study Medication
timeFrame: 3 hours post intervention on each study day, separated by 1 week to 1 month
measure: Change in Impulsive Behavior as Measured on the Experimental Discounting Delay (EDT) Computerized Task Between Placebo and Study Medication
timeFrame: 3 hours post intervention on each study day, separated by 1 week to 1 month
Other outcomes:
Locations:
city: Hartford
country: United States
facility: Olin Neuropsychiatry Research Center at the Institute of Living, Hartford Hospital
state: Connecticut
Study officials:
affiliation: Yale University
name: Godfrey D Pearlson, MD
role: PRINCIPAL_INVESTIGATOR
References: