Protocol Number: 03-M-0149

Title:

Functional MRI Study of Brain Mechanism Mediating Anhedonia in Major Depression

Number:

03-M-0149

Summary:

This study will use magnetic resonance imaging (MRI) to examine how the brain regulates emotions in healthy people and in patients who have major depression and anhedonia (loss of feeling of pleasure in things that normally give pleasure).

Healthy normal volunteers and patients between 18 and 50 years of age with major depression, with or without significant anhedonia, are eligible for this study. Candidates will be screened with a psychiatric interview, a physical examination that will include blood and urine samples, and an electrocardiogram, and a questionnaire about their emotions.

Participants will perform a monetary reward task while lying in an MRI scanner. The task is similar to playing a computer video game with the possibility of winning cash. The amount of cash is largely dependent on the subject's performance. The accumulated amount of cash earned in a session will fluctuate depending on the subject's continuing performance level. That is, during a single session, a subject could lose money earned early in the session if his or her performance later in the session is not as good as earlier.

MRI pictures will be taken during performance of the task. MRI uses a magnetic field and radio waves to produce images of body tissues and organs. The patient lies on a table that is moved into the scanner (a narrow cylinder) and wears earplugs to muffle loud knocking and thumping sounds that occur during the scanning process. The procedure will last about 1 to 1-1/2 hours.

Sponsoring Institute:

National Institute of Mental Health (NIMH)

Recruitment Detail

Type: Participants currently recruited/enrolled

Gender: Male & Female

Referral Letter Required: No

Population Exclusion(s): Children

Eligibility Criteria:

INCLUSION CRITERIA

For both patient and control groups:

Age 18 to 50 of any ethnicity without other significant medical conditions

Not in active use of illicit drugs and heavy consumption of alcohol

No metallic implants or onplants that are ferromagnetic

Competent to sign consent forms to participate in the study.

For patient groups:

For the group with significant anhedonia, current MDD, as defined by DSM-IV criteria, with significant anhedonia defined as having PAS and/or SAS scores at or above one standard deviation of appropriate norm. For the group without significant anhedonia, current MDD, as defined by DSM-IV criteria, without significant anhedonia defined as having PAS and/or SAS scores within or below one standard deviation of appropriate norm. The BPD subjects will meet DSM-IV criteria for bipolar I or II disorder, most recent episode depressed and will currently be in a major depressive episode. We will use the Young Mania Rating Scale to assess the severity of the disorder Subjects may be enrolled as either inpatients or outpatients at their entrance to the study.

For control group:

No prior history of any psychiatric conditions including substance dependence

No family history of MDD, bipolar disorder, or psychosis

PAS and/or SAS scores within or below one standard deviation of appropriate norm.

EXCLUSION CRITERIA:

Medical conditions or concomitant medications that are likely to influence cerebral blood flow or neurological function including cardiovascular, respiratory, endocrine and neurological diseases;

History of psychosis, current mania and substance dependence;

Exposure to psychiatric medications in the past 4 weeks;

History of repeated self-mutilation or homicidal attempts, current active suicidal / homicidal ideations;

Current or recent (within past six weeks) illicit drug use or heavy alcohol consumption (more than 2 six-packs of beer or equivalent alcoholic beverages per week);

Pathological gamblers as defined by DSM-IV.

Special Instructions:

Currently Not Provided

Keywords:

Reward

Cortex

Dopamine

Neuroimaging

Strirtum

Major Depressive Disorder (MDD)

Melancholic Features

Brain Imaging

Functional Magnetic Resonance Imaging (fMRI)

Dopaminergic Mechanisms

Anhedonia

Recruitment Keyword(s):

Depression

Major Depressive Disorder

MDD

Healthy Volunteer

HV

Condition(s):

Major Depressive Disorder

Investigational Drug(s):

Oral Tryptophan

Investigational Device(s):

None

Intervention(s):

None

Supporting Site:

National Institute of Mental Health

Contact(s):

Patient Recruitment and Public Liaison Office
Building 61
10 Cloister Court
Bethesda, Maryland 20892-4754
Toll Free: 1-800-411-1222
TTY: 301-594-9774 (local),1-866-411-1010 (toll free)
Fax: 301-480-9793

Electronic Mail:prpl@mail.cc.nih.gov

Citation(s):

Blanchard JJ, Horan WP, Brown SA. Diagnostic differences in social anhedonia: a longitudinal study of schizophrenia and major depressive disorder. J Abnorm Psychol. 2001 Aug;110(3):363-71.

Boyer P, Tassin JP, Falissart B, Troy S. Sequential improvement of anxiety, depression and anhedonia with sertraline treatment in patients with major depression. J Clin Pharm Ther. 2000 Oct;25(5):363-71.

Barbier EL, Silva AC, Kim SG, Koretsky AP. Perfusion imaging using dynamic arterial spin labeling (DASL). Magn Reson Med. 2001 Jun;45(6):1021-9.

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