Multimodal Neuroimaging of Stress and Reward Cues to Assess Alcoholism Risk and Relapse

Yale University

Status: Completed

Conditions: Alcohol Dependence

Treatments: Device: Multi-method Neuroendocrine and Neuroimaging Procedure Scan 1; Device: Multi-method Neuroendocrine and Neuroimaging Procedure Scan 2

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT02616094

1501015225

2R01AA013892-11 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

Extending previous findings, and applying a novel multi-method translational approach, this project hypothesizes that there are alcohol-related neuroendocrine and neural changes observable in acute and protracted abstinence, and which can accurately classify future relapse and treatment outcome in separate alcohol dependent (AD) patient samples, thereby validating them as biomarkers of relapse, with potential clinical utility as prognostic markers in identifying and treating those most susceptible to relapse.

Enrollment: 224 patients

Sex: All

Ages: 18 to 60 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Male and females, aged 18-60 years;
• Good health as verified by screening examination;
• Able to read English and complete study evaluations;
• Able to provide informed written and verbal consent;
• AD sample must meet DSM-5 criteria for AUD as assessed using SCID-I and have positive alcohol urine toxicology screens on admission to study; while HC group must never have met criteria for AUD, with non-binging and nonhazardous alcohol intake levels( men: below15 drinks/week; women: less than 8 drinks/week); and with negative alcohol urine toxicology screens; Page

Exclusion criteria

• Meet current criteria for dependence on another psychoactive substance, excluding nicotine; (ii) Current use of opiates or past history of opiate abuse/dependence;
• Regular use of anticonvulsants, sedatives/hypnotics, prescription analgesics, other antihypertensives, anti-arrhythmics, antiretroviral medications, SSRI's naltrexone, antabuse;
• Psychotic or otherwise severely psychiatrically disabled (i.e., suicidal, homicidal, current mania);
• Significant underlying medical conditions such as a history of seizure disorder, cerebral, renal, thyroid or cardiac pathology which in the opinion of study physician would preclude subjects from fully cooperating or be of potential harm during the course of the study;
• Any psychotic disorder or current Axis I psychiatric symptoms (excluding anxiety disorders) requiring specific attention, including need for psychiatric medications;
• hypotensive individuals with sitting blood pressure below 90/50 mmHG;
• Women who are pregnant, nursing or refuse to use a reliable form of birth control (as assessed by pregnancy tests during initial medical evaluation, and assessed every two weeks during the course of the study); and
• those with metal in their body excluded from MRI due to safety.

Trial design

Primary purpose: Diagnostic

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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224 participants in 3 patient groups

Treatment Seeking Alcohol Dependent Adults

Experimental group

Description:

Group consists of 100 treatment seeking alcohol dependent (AD) men and women (ages 18-60). AD subjects will complete either 8 weeks of outpatient treatment at the Yale Stress Center, or the first 4 weeks as inpatient treatment at the CNRU, followed by 4 weeks of outpatient treatment at the Yale Stress Center. While in outpatient treatment, AD subjects may be admitted to the CNRU or HRU for the 1-5 days prior to one or both of their scans, to ensure abstinence for their scans.

Treatment:

Device: Multi-method Neuroendocrine and Neuroimaging Procedure Scan 1

Device: Multi-method Neuroendocrine and Neuroimaging Procedure Scan 2

Social Drinking Controls

Active Comparator group

Description:

Group consists of demographically and handedness matched 50 socially drinking controls. Healthy controls will be moderate and binge/heavy social drinkers who will participate in a single MRI session after baseline assessments. Healthy controls may be admitted to the HRU overnight prior to their scan.

Treatment:

Device: Multi-method Neuroendocrine and Neuroimaging Procedure Scan 1

Prazosin/Placebo Group

Active Comparator group

Description:

This is a separate group of 60 treatment seeking AD subjects in a NIAAA-funded RCT of Prazosin vs placebo for alcohol dependence ( PI: Sinha, Hic protocol 0705002691, NCT00585780) to assess target primary and secondary predictors of alcohol treatment outcomes in the context of a currently ongoing RCT. AD subjects enrolled in the PZ/PL RCT will NOT be given drugs as part of this study. That study and intervention is listed elsewhere (NCT00585780). Subjects will participate in a baseline scan and a second scan between weeks 10-12 of the 12-week RCT with follow-ups. PZ/PL is only given to subjects enrolled in 0705002691, not the current protocol.

Treatment:

Device: Multi-method Neuroendocrine and Neuroimaging Procedure Scan 1

Device: Multi-method Neuroendocrine and Neuroimaging Procedure Scan 2