Status:

TERMINATED

Brain Circuitry Analysis in Bipolar Disorder

Lead Sponsor:

Jennifer Sweet

Collaborating Sponsors:

National Institute of Mental Health (NIMH)

University Hospitals Cleveland Medical Center

Conditions:

Bipolar Disorder

Eligibility:

All Genders

18+ years

Brief Summary

The goal of this cross-sectional study is to use diffusion-weighted imaging based tractography (DWT) to assess white matter (WM) pathways in treatment-refractory bipolar disorder (REF-BD) and treatmen...

Eligibility Criteria

Inclusion

  • Group 1: Healthy Volunteers
  • Inclusion Criteria for Group 1:
  • Male or female ≥18 years of age
  • Capable of understanding/complying with protocol requirements
  • Has competency to understand and sign informed consent form
  • Physically healthy with no acute medical condition and ≤3 stable, chronic medical conditions
  • Without current and/or lifetime psychiatric disorders as assessed by the Mini International Neuropsychiatric Interview for DSM-5 (MINI)
  • Exclusion Criteria for Group 1:
  • Acute medical condition or \>3 stable, chronic health conditions
  • Significant structural brain lesion
  • Progressive neurological disease
  • Preexisting implanted electrical device
  • Currently pregnant or planning to become pregnant
  • Contraindications to MR imaging
  • Tests positive for cannabis, illegal substances, or prescription medications without valid prescription
  • Currently taking steroids, opioids, or other agents that might affect brain circuitry per research team discretion
  • Use of cigarettes or other nicotine products within 12 hours of imaging visit
  • Use of stimulants 24 hours prior MRI visit
  • Presents an immediate danger to self or others as judged by research psychiatrist
  • Has psychiatric disorder, including alcohol/drug use disorder or personality disorder
  • Group 2: Treatment-Responsive BDI
  • Inclusion Criteria for Group 2:
  • Male or female ≥18 years of age
  • Capable of understanding/complying with protocol requirements
  • Has competency to understand and sign informed consent form
  • Physically healthy with no acute medical condition and ≤3 stable, chronic medical conditions
  • Meets diagnostic criteria for BDI or BDII according to the DSM-5 criteria
  • Must be stable on current BD medications with no dosing changes in the last 30 days or not currently taking any BD medications.
  • Recent mood episode must currently be in remission for \> 8 weeks
  • Montgomery-Asberg Depression Rating Scale (MADRS) ≤10 total score during the psychiatric assessments portion and at the MRI visit (if repeated at MRI visit)
  • Young Mania Rating Scale (YMRS) ≤12 total score during the psychiatric assessments portion and at the MRI visit (if repeated at MRI visit)
  • Clinical Global Impression-Severity for Bipolar Disorder (CGI-S-BD) ≤2 during the psychiatric assessments visit
  • Must be adherent (≥ 80%) with BD medication(s)
  • Exclusion Criteria for Group 2:
  • Acute medical condition or \>3 stable, chronic health conditions
  • Significant structural brain lesion
  • Progressive neurological disease
  • Preexisting implanted electrical device
  • Currently pregnant or planning to become pregnant
  • Contraindications to MR imaging
  • Tests positive for cannabis, illegal substances, or prescription medications without valid prescription
  • Currently taking steroids, opioids, or other agents that might affect brain circuitry per research team discretion
  • Use of cigarettes or other nicotine products within 12 hours of imaging visit
  • Use of stimulants within 24 hours of imaging visit
  • Presents an immediate danger to self or others as judged by research psychiatrist
  • Has had changes in medications within 30 days
  • Contribution of any co-occurring psychiatric comorbidity disproportionate to contribution of BDI or BDII
  • Meets DSM-5 criteria for current borderline or antisocial personality disorder
  • Meets DSM-5 criteria for alcohol and/or drug use disorder within 6 months, excluding caffeine and/or nicotine
  • Group 3: Treatment-Refractory BDI
  • Inclusion Criteria for Group 3:
  • Male or female ≥18 years of age
  • Capable of understanding/complying with protocol requirements
  • Has competency to understand and sign informed consent form
  • Physically healthy with no acute medical condition and ≤3 stable, chronic medical conditions
  • Meets diagnostic criteria for BDI or BDII according to the DSM-5 criteria
  • Must be stable on drugs, including at least 1 mood stabilizer, with no dosing changes in the last 30 days
  • GCI-S-BD \>3 at the psychiatric assessments visit
  • MADRS ≥20 total score or YMRS ≥18 total score during the psychiatric assessments portion and at the MRI visit (if repeated at MRI visit)
  • BD-associated mood episodes are primary source of disability, according to both subject and psychiatrist
  • Current depressive episode lasting ≥6 months despite ≥ 2 adequate evidence-based first-line treatment \> 8 weeks, current manic/hypomanic episode lasting ≥2 months despite ≥ 2 adequate evidence-based first-line treatment \> 4 weeks, or meeting rapid cycling criteria in last 12 months despite ≥2 evidence-based first-line treatments for BDI or BDII assessed with assistance of Modified Antidepressant Treatment History Form (MATHF)
  • Severe impairment with score of ≥7 on at least one of three subscales of Sheehan Disability Scale (SDS), which includes assessment of work-life, family-life, and social life during the psychiatric assessments portion
  • Exclusion Criteria for Group 3:
  • Acute medical condition or \>3 stable, chronic health conditions
  • Significant structural brain lesion
  • Progressive neurological disease
  • Preexisting implanted electrical device
  • Currently pregnant or planning to become pregnant
  • Contraindications to MR imaging
  • Tests positive for cannabis, illegal substances, or prescription medications without valid prescription
  • Currently taking steroids, opioids, or other agents that might affect brain circuitry per research team discretion
  • Use of cigarettes or other nicotine products within 12 hours of imaging visit
  • Use of stimulants within 24 hours of imaging visit
  • Presents an immediate danger to self or others as judged by research psychiatrist
  • Has had changes in medications within 30 days
  • Contribution of any co-occurring psychiatric comorbidity disproportionate to contribution of BDI or BDII
  • Meets DSM-5 criteria for current borderline or antisocial personality disorder
  • Meets DSM-5 criteria for alcohol and/or drug use disorder within 6 months, excluding caffeine and/or nicotine

Exclusion

    Key Trial Info

    Start Date :

    October 15 2020

    Trial Type :

    OBSERVATIONAL

    Allocation :

    ACTUAL

    End Date :

    July 31 2025

    Estimated Enrollment :

    26 Patients enrolled

    Trial Details

    Trial ID

    NCT05186077

    Start Date

    October 15 2020

    End Date

    July 31 2025

    Last Update

    October 9 2025

    Active Locations (1)

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    University Hospitals Cleveland Medical Center

    Cleveland, Ohio, United States, 44106