Clinical trial NCT03203954: Testing the Neuroscience of Guided Learning in Depression
Official title: Neural Substrates of Reinforcement Learning and Its Training in Major Depression
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Major Depressive Disorder
Lead sponsor: Virginia Polytechnic Institute and State University
Sponsor class: OTHER
Collaborators: name: National Institute of Mental Health (NIMH)
First posted: 2017-06-29
Enrollment: 216
Sex: ALL
Minimum age (years): 18
Maximum age (years): 55
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: OTHER

Brief summary: Major depression is a prevalent and impairing illness. To better understand the basic science and treatment of depression, the investigators study the behavioral and brain processes associated with learning in depression and how potential disruptions in learning may be repaired. Understanding different methods that change learning may lead to novel treatments that contribute to recovery in people with depression.

Detailed description: Major depressive disorder ranks among the most significant causes of mortality and disability in the world. Recent data from the investigators and others highlight that impairments in reward and loss learning are central to depression, have distinct neural substrates, and improve with successful treatment. Together, these findings suggest an urgent need to delineate the relationships among neural and behavioral learning impairments and depression. Equally important, these insights suggest new targets for treatment such that manipulating the neural and behavioral substrates of learning may facilitate symptom change in depression.

To address these issues, the investigators use functional neuroimaging and a computational psychiatry framework to i) systematically characterize the neural and behavioral substrates that attend reward- and loss- learning in depression and ii) assess the degree to which learning in depression responds to two behavioral methods that target learning in different ways. The investigators test the broad hypotheses that i) that depression may be characterized by distinct neural and behavioral disruptions of learning, and ii) these disruptions and associated symptoms may be ameliorated through different methods of guiding learning. Recent advances in computational psychiatry provide a mechanism-based framework within which to understand the nature and trajectory of potential learning impairments in depression and suggest new ways that disrupted learning and associated symptoms may be improved in depression

Eligibility criteria: Inclusion Criteria:

* males and females of all ethnicities
* meet diagnostic criteria for major depression or non-depressed control (assessed by study staff)
* ages 18-55
* fluent in English
* able to see computer display clearly
* able to provide informed consent
* able to follow verbal or written instructions
* for participants who are referred by a clinician, a letter from that clinician indicating that participation in the study does not constitute an elevated medical or behavioral risk to the participant will be requested.

Exclusion Criteria:

* current pregnancy or menopause
* claustrophobia
* MRI contraindications
* psychotic or bipolar disorder

Primary outcomes:
measure: Task performance
timeFrame: approximately 6 weeks (pre- post- learning task changes and interim time points)
Secondary outcomes:
measure: Neuroimaging measures
timeFrame: approximately 6 weeks (pre- post- learning task changes and interim time points)
measure: Symptoms
timeFrame: approximately 6 weeks (pre- post- learning task changes and interim time points)
Other outcomes:
Locations:
city: Roanoke
country: United States
facility: Virginia Tech Carilion Research Institute
state: Virginia
Study officials:
References: