Functional Neuroimaging of Alcoholism Vulnerability (PIT) (CTNA)

Yale University

Status and phase: Completed; Phase 2

Conditions: Healthy

Treatments: Drug: Placebo; Drug: Memantine

Study type: Interventional

Funder types: Other

Identifiers

NCT01585168

1106008650

Details and patient eligibility

About

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.

Enrollment: 71 patients

Sex: All

Ages: 18 to 35 years old

Volunteers: Accepts Healthy Volunteers

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.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: Double Blind

---

71 participants in 4 patient groups, including a placebo group

Family history positive, Memantine first, then placebo

Experimental group

Description:

Memantine is a low-side-effect NMDA receptor antagonist usually administered therapeutically to elderly persons with moderately severe Alzheimer's disease in typical doses of 10-20 mg daily. In this study, single doses of 40 mg are administered.

Treatment:

Drug: Memantine

Drug: Placebo

Family history positive, placebo first, then Memantine

Placebo Comparator group

Description:

Memantine is a low-side-effect NMDA receptor antagonist usually administered therapeutically to elderly persons with moderately severe Alzheimer's disease in typical doses of 10-20 mg daily. In this study, single doses of 40 mg are administered.

Treatment:

Drug: Memantine

Drug: Placebo

Family history negative, Memantine first, then placebo

Experimental group

Description:

Memantine is a low-side-effect NMDA receptor antagonist usually administered therapeutically to elderly persons with moderately severe Alzheimer's disease in typical doses of 10-20 mg daily. In this study, single doses of 40 mg are administered.

Treatment:

Drug: Memantine

Drug: Placebo

Family history negative, placebo first, then Memantine

Placebo Comparator group

Description:

Memantine is a low-side-effect NMDA receptor antagonist usually administered therapeutically to elderly persons with moderately severe Alzheimer's disease in typical doses of 10-20 mg daily. In this study, single doses of 40 mg are administered.

Treatment:

Drug: Memantine

Drug: Placebo