Beyond Monoamines: The Role of the Nociceptin/Orphanin FQ Receptor in Major Depression

Mass General Brigham

Status

Enrolling

Conditions

Major Depressive Disorder

Treatments

Drug: PET radiotracer

Device: Aversive stimuli

Study type

Observational

Funder types

Other

NIH

Identifiers

NCT05630963

2018P000318

4R37MH068376-17 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

This study looks at the role of the Nociceptin/Orphanin FQ receptor system in the brain of individuals with current or past major depressive disorder (MDD). It also examines how individuals with a history of depression make certain decisions and which brain regions are involved in such decisions. Information collected through MRI, PET, biospecimens (i.e., blood, saliva) and behavioral tasks will be used to predict depressive symptoms in the future.

Full description

The overarching goals of this research are to investigate: (1) the activity of the Nociceptin/Orphanin FQ receptor system among individuals with current or remitted MDD; (2) neural foundations of approach/avoidance behaviors in current or remitted MDDs; (3) stress-induced inflammation in individuals with remitted MDD; (4) neural markers that predict future disease course.

This will be achieved through an innovative method of using functional magnetic resonance imaging (fMRI) during an approach/avoidance decision-making task, in addition to a resting positron emission tomography (PET) scan.

Enrollment

228 estimated patients

Sex

All

Ages

18 to 45 years old

Volunteers

Accepts Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria for all participants:

All genders, races, and ethnic origins, aged between 18 and 45
Capable of providing written informed consent, and fluent in English
Right-handed
Absence of any psychotropic medications for at least 2 weeks
Has a smartphone (iPhone or Android) (needed for Ecological Momentary Assessment)

Inclusion Criteria for "Remitted MDD" group:

Meets inclusion criteria for all subjects, plus:
History of MDD as defined by DSM-5
Absence of anxiety disorder for the past two months

Inclusion Criteria for "Current MDD" group:

Meets inclusion criteria for all subjects, plus:
Presence of MDD as defined by DSM-5
Absence of anxiety disorder for the past two months

Exclusion Criteria for all participants:

Subjects with suicidal ideation where outpatient treatment is determined unsafe by the study clinician. These patients will be immediately referred to appropriate clinical treatment
Pregnant women or women of childbearing potential who are not using a medically accepted means of contraception (defined as oral contraceptive pill or implant, condom, diaphragm, spermicide, IUD, s/p tubal ligation, or partner with vasectomy)
Serious or unstable medical illness, including cardiovascular, hepatic, renal, respiratory, endocrine, neurologic or hematologic disease
History of seizure disorder
History of psychiatric illnesses, other than depression or anxiety disorders among the Current MDD and Remitted MDD groups
History of substance use disorder or alcohol use disorder (as these terms are defined by DSM-5); except depressed subjects may have a history of 'Mild' substance/alcohol use disorder only if it ended as least 12 months ago
History of cocaine or stimulant use or dopaminergic drugs
History or current diagnosis of dementia, or a score of < 26 on the Mini Mental State Examination at the screening visit;
Patients with mood congruent or mood incongruent psychotic features
Current use of other psychotropic drugs
Clinical or laboratory evidence of hypothyroidism
Patients with a lifetime history of electroconvulsive therapy (ECT)
Failure to meet standard MRI safety requirements
Abnormal ECG and lab results
History of seizure disorder
Contraindications for arterial line (e.g., abnormal result on Allen test, Raynaud's syndrome, history of anemia or bleeding disorder, history of fainting from blood draws).