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Cortical Excitability: Phenotype and Biomarker in Attention-deficit, Hyperactivity Disorder (ADHD) Therapy

Primary Purpose

Attention Deficit Disorder With Hyperactivity

Status
Unknown status
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Atomoxetine
Sugar Pill
Sponsored by
University of Cincinnati
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Attention Deficit Disorder With Hyperactivity focused on measuring ADHD, Atomoxetine, Biomarker

Eligibility Criteria

7 Years - 12 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Signed informed consent and assent
  2. Meets DSM-IV criteria for ADHD, combined or inattentive subtype, based on K-SADS interview
  3. Scores at least 1.5 SD higher than age and gender mean on ADHD RS, keyed to ADHD subtype (i.e., combined score for the combined subtype, inattentive subscale only for inattentive subtype, etc.)
  4. Age: 7 - 12 years at study entry
  5. Findings on physical exam, laboratory studies and ECG are judged to be normal for age and gender, as determined by study physician at study entry
  6. There is not a co-existing medical condition for which TMS or ATX is contraindicated (for example pheochromocytoma).
  7. Pulse and blood pressure within 95% of age and gender mean
  8. Full scale IQ >75 (i.e., excluding mental retardation and the lower level of the borderline range)
  9. Able to complete study instruments and swallow capsules
  10. Willing to commit to the entire visit schedule for the study
  11. No previous treatment with Atomoxetine
  12. Must either be naive to ADHD study medication or not doing well on the current ADHD medication.

Exclusion Criteria:

  1. Has one of the following exclusionary diagnoses: autism/ pervasive developmental disorder, mental retardation, schizophrenia, a psychotic disorder, bipolar disorder, severe depressive or conduct disorder
  2. Has a comorbid disorder that is otherwise allowable, but which requires a treatment that is not being offered in the study, and should be the primary focus of treatment, in the opinion of the PI
  3. Has a medical or neurologic disorder that would preclude taking the ATX, or which would potentially confound the assessment of ADHD and/or TMS outcomes, in the opinion of the PI (for example pheochromocytoma, or for specific purposes of this study uncontrolled seizure disorder or organic brain syndrome).
  4. Taking a systemic medication which might interfere with the metabolism or efficacy assessment of ATX in this study
  5. History of allergic reactions to multiple medications
  6. History of alcohol or drug abuse in the past 3 months Has been in a medication treatment study in the past 30 days
  7. Females of childbearing age who are sexually active, do not use acceptable birth control (double barrier method), or are not abstinent. Abstinence is defined as no sexual activity for at least 3 months before the start of the study and the intention to abstain from sexual activity during the study period). Double barrier methods allowed include: condoms or diaphragms combined with spermicide use, intrauterine devices (IUD), and oral, transdermal, injectable or implantable hormonal medications (Ortho-Evra, Norplant, Depo-Provera, and similar prescription products) for at least one month before entering the study and continuing its use throughout the study. Birth control pills alone are not acceptable forms of birth control for this study.
  8. Has any prior neurological condition that might increase the risk of an adverse event with TMS. For the purpose of this study we are excluding children with a current or prior history of epilepsy.

Sites / Locations

  • University of Cincinnati
  • Cincinnati Children's Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

Atomoxetine

Placebo

Arm Description

Atomoxetine is FDA-approved for the treatment of ADHD symptoms in children

Sugar pill

Outcomes

Primary Outcome Measures

Efficacy outcome as change from baseline in ADHDRS total score
SICI as a marker of ADHD Behaviors
To evaluate pTMS-evoked Short Interval Cortical Inhibition (SICI) as a marker of the hyperactive-impulsive dimension in Attention Deficit Hyperactivity Disorder
Cognitive Correlates of SICI Change
To determine cognitive correlates of SICI change, the study will first measure SICI at at rest and concurrently during the Stop-task. This process will then be repeated 2 hours after a single dose (0.5 mg/kg) of atomoxetine (ATX) or placebo.

Secondary Outcome Measures

Full Information

First Posted
April 5, 2011
Last Updated
August 17, 2015
Sponsor
University of Cincinnati
Collaborators
National Institute of Mental Health (NIMH)
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1. Study Identification

Unique Protocol Identification Number
NCT01330693
Brief Title
Cortical Excitability: Phenotype and Biomarker in Attention-deficit, Hyperactivity Disorder (ADHD) Therapy
Official Title
Cortical Excitability: Phenotype and Biomarker in ADHD Therapy
Study Type
Interventional

2. Study Status

Record Verification Date
August 2015
Overall Recruitment Status
Unknown status
Study Start Date
September 2009 (undefined)
Primary Completion Date
November 2015 (Anticipated)
Study Completion Date
November 2015 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Cincinnati
Collaborators
National Institute of Mental Health (NIMH)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to find out if children with attention-deficit, hyperactivity disorder (ADHD) have a difference in how their brain cells "fire" or react. The investigators also want to find if brain cell "firing" can tell us how severe of symptoms a child has from ADHD. Finally, the investigators want to see if giving an ADHD medication called atomoxetine can make the ADHD symptoms in a child better and if the improvement shows a change in brain "firing".
Detailed Description
This study will evaluate Short Interval Intracortical Inhibition (SICI) measured by pTMS as a marker of the hyperactive-impulsive dimension in 120 ADHD 7-12 years, medication-free children. This study will characterize the effects of a single dose of atomoxetine compared to placebo on cognitive correlates of SICI change. Participants will be randomized 2:1 to either atomoxetine or placebo. The study will also characterize the effects of four weeks of atomoxetine treatment on cortical inhibition and will correlate SICI change with clinical outcomes.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Attention Deficit Disorder With Hyperactivity
Keywords
ADHD, Atomoxetine, Biomarker

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
120 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Atomoxetine
Arm Type
Active Comparator
Arm Description
Atomoxetine is FDA-approved for the treatment of ADHD symptoms in children
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Sugar pill
Intervention Type
Drug
Intervention Name(s)
Atomoxetine
Other Intervention Name(s)
Strattera
Intervention Description
Atomoxetine is FDA-approved for the treatment of ADHD symptoms in children. Single dose of 0.5 mg/kg at baseline visit. Then dose adjusted in an open-label design afterwards.
Intervention Type
Drug
Intervention Name(s)
Sugar Pill
Intervention Description
In-active sugar pill randomly assigned at baseline visit
Primary Outcome Measure Information:
Title
Efficacy outcome as change from baseline in ADHDRS total score
Time Frame
At 4 weeks
Title
SICI as a marker of ADHD Behaviors
Description
To evaluate pTMS-evoked Short Interval Cortical Inhibition (SICI) as a marker of the hyperactive-impulsive dimension in Attention Deficit Hyperactivity Disorder
Time Frame
Baseline visit
Title
Cognitive Correlates of SICI Change
Description
To determine cognitive correlates of SICI change, the study will first measure SICI at at rest and concurrently during the Stop-task. This process will then be repeated 2 hours after a single dose (0.5 mg/kg) of atomoxetine (ATX) or placebo.
Time Frame
2 hours (at baseline visit)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
7 Years
Maximum Age & Unit of Time
12 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed informed consent and assent Meets DSM-IV criteria for ADHD, combined or inattentive subtype, based on K-SADS interview Scores at least 1.5 SD higher than age and gender mean on ADHD RS, keyed to ADHD subtype (i.e., combined score for the combined subtype, inattentive subscale only for inattentive subtype, etc.) Age: 7 - 12 years at study entry Findings on physical exam, laboratory studies and ECG are judged to be normal for age and gender, as determined by study physician at study entry There is not a co-existing medical condition for which TMS or ATX is contraindicated (for example pheochromocytoma). Pulse and blood pressure within 95% of age and gender mean Full scale IQ >75 (i.e., excluding mental retardation and the lower level of the borderline range) Able to complete study instruments and swallow capsules Willing to commit to the entire visit schedule for the study No previous treatment with Atomoxetine Must either be naive to ADHD study medication or not doing well on the current ADHD medication. Exclusion Criteria: Has one of the following exclusionary diagnoses: autism/ pervasive developmental disorder, mental retardation, schizophrenia, a psychotic disorder, bipolar disorder, severe depressive or conduct disorder Has a comorbid disorder that is otherwise allowable, but which requires a treatment that is not being offered in the study, and should be the primary focus of treatment, in the opinion of the PI Has a medical or neurologic disorder that would preclude taking the ATX, or which would potentially confound the assessment of ADHD and/or TMS outcomes, in the opinion of the PI (for example pheochromocytoma, or for specific purposes of this study uncontrolled seizure disorder or organic brain syndrome). Taking a systemic medication which might interfere with the metabolism or efficacy assessment of ATX in this study History of allergic reactions to multiple medications History of alcohol or drug abuse in the past 3 months Has been in a medication treatment study in the past 30 days Females of childbearing age who are sexually active, do not use acceptable birth control (double barrier method), or are not abstinent. Abstinence is defined as no sexual activity for at least 3 months before the start of the study and the intention to abstain from sexual activity during the study period). Double barrier methods allowed include: condoms or diaphragms combined with spermicide use, intrauterine devices (IUD), and oral, transdermal, injectable or implantable hormonal medications (Ortho-Evra, Norplant, Depo-Provera, and similar prescription products) for at least one month before entering the study and continuing its use throughout the study. Birth control pills alone are not acceptable forms of birth control for this study. Has any prior neurological condition that might increase the risk of an adverse event with TMS. For the purpose of this study we are excluding children with a current or prior history of epilepsy.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Floyd R Sallee, MD
Organizational Affiliation
University of Cincinnati
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Cincinnati
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45219
Country
United States
Facility Name
Cincinnati Children's Hospital
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45229
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Cortical Excitability: Phenotype and Biomarker in Attention-deficit, Hyperactivity Disorder (ADHD) Therapy

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