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Investigating the Impact of Methylphenidate on Neural Response in Disruptive Behavioral Disorder

Primary Purpose

Conduct Disorder, Attention Defict Hyperactivity Disorder

Status
Withdrawn
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
Methylphenidate Hydrochloride
Sponsored by
National Institute of Mental Health (NIMH)
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional other trial for Conduct Disorder focused on measuring Conduct Disorder, Methylphenidate, Disruptive Behavior Disorders

Eligibility Criteria

10 Years - 17 Years (Child)All SexesDoes not accept healthy volunteers
  • INCLUSION CRITERIA

Youth with CD

  1. 10-17 years of age.
  2. A current diagnosis of CD as determined by the Kiddie-SADS, lifetime version.

    • Youth in the CD+comorbid ADHD group will also meet diagnostic criteria for ADHD.
    • Youth in the CD without comorbid ADHD group will specifically not meet diagnostic criteria for ADHD.
  3. Youth with CD shouldmust be na(SqrRoot) ve to psychoactive medication (such as: methylphenidate and amphetamine).

TD youth

  1. 10-17 years of age.
  2. No current psychiatric diagnosis, as determined by the Kiddie-SADS, lifetime version.

EXCLUSION CRITERIA

Exclusion criteria for youth with CD (with or without ADHD)

  1. Comorbid psychotic, major mood, tic, pervasive developmental, and substance abuse disorders.
  2. Presence of comorbid ADHD is exclusory for the group of patients with CD without ADHD
  3. History of known structural cardiac abnormalities, cardiomyopathy, serious heart rhythm abnormalities, coronary artery disease, or other serious cardiac problems
  4. Current weight less than 25kg or over 90kg

Exclusion criteria for all participants (CD with ADHD, CD without ADHD and TD)

  1. History of serious CNS disease disorder (examples aresuch as: history of seizure, epilepsy, brain tumor, brain hemorrhage, and major CNS infection such as meningitis or encephalitis)
  2. Previous history of known structural cardiac abnormalities, cardiomyopathy, serious heart rhythm abnormalities, coronary artery disease, or other serious cardiac problems
  3. Current use of any psychiatric medications and centrally acting medications (such as stimulants, non-stimulant ADHD medications, antidepressants, anxiolytics, antipsychotics and anti-epilepsy medications), and past history of use of psychoactive medication (such as methylphenidate and amphetamine)
  4. A positive urine pregnancy test
  5. A Positive urine toxicology, History/current diagnosis of substance abuse/dependence
  6. Suicidal or homicidal ideation within the past 6 months.
  7. Wechsler Abbreviated Scale of Intelligence (WASI) (D. Wechsler, 1999) scores <70
  8. Metal in body (i.e., hearing aid, cardiac pacemaker, bone plates, etc), claustrophobia, or any other condition that would preclude fMRI scanning.

Sites / Locations

    Outcomes

    Primary Outcome Measures

    Patients with CD will show an increase in the amygdala response to fearful expressions such that the difference between BOLD response in patients and TDs is reduced on MPH relative to placebo. ICU score will be a significant covariate of the inc...
    Patients with CD will show an increase in reward prediction errors and reward expected value signaling within striatum and ventromedial frontal cortex (vmPFC) such that the difference between BOLD response in patients and TDs is reduced on MPH r...
    Patients with CD will show an increase in conflict related signaling within dorsomedial, lateral and parietal cortices such that the difference between BOLD response in patients and TDs is reduced on MPH relative to placebo. Current ADHD sympto...

    Secondary Outcome Measures

    Symptom profiles measured by the clinical scales listed in the protocol (CBCL, the ICU, Connor s parent report on ADHD symptom) will be significantly related to the BOLD signal changes after methylphenidate administration.

    Full Information

    First Posted
    September 20, 2014
    Last Updated
    November 30, 2019
    Sponsor
    National Institute of Mental Health (NIMH)
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02247986
    Brief Title
    Investigating the Impact of Methylphenidate on Neural Response in Disruptive Behavioral Disorder
    Official Title
    Investigating the Impact of Methylphenidate on Neural Response in Disruptive Behavioral Disorder
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    May 18, 2015
    Overall Recruitment Status
    Withdrawn
    Study Start Date
    September 4, 2014 (undefined)
    Primary Completion Date
    May 18, 2015 (Actual)
    Study Completion Date
    May 18, 2015 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    National Institute of Mental Health (NIMH)

    4. Oversight

    5. Study Description

    Brief Summary
    Background: - Disruptive behavior is a common problem for children and adolescents. It can be treated with some success with stimulant medicine. Researchers want to learn more about how this works. Objective: - To learn how the brain changes when taking the medicine methylphenidate for behavior problems. Eligibility: Children ages 10 17 with conduct disorder and/or attention deficit disorder. Healthy volunteers the same age. Design: Participants will be screened under a separate protocol. Participants will have two 3-hour sessions at the clinic. Girls who are menstruating will have a pregnancy test before their scans. Visit 1: All participants will: Perform simple tests on a computer. Fill out a questionnaire along with their parent or guardian. Have an MRI scan. A magnetic field and radio waves take pictures of the brain. Participants will lie on a table that slides into a metal cylinder. A coil will be placed over their head. They will be in the scanner for 60 minutes, lying still or performing a simple task. They will practice the task before the scan. A computer screen will show them task information during the scan. The scanner makes loud knocking sounds. Participants will get earplugs. Their parent or guardian can stay with them during the scan. Only participants with behavior disorders will: Take a pill of the study medicine or placebo. Be monitored for any side effects. Visit 2 is a repeat of Visit 1, except participants who got a pill in Visit 1 will get the other pill in Visit 2. For healthy volunteers, the 2 visits are exactly the same.
    Detailed Description
    OBJECTIVE: To determine the impact, as indexed by BOLD response, of the administration of dopaminergic agonist (methylphenidate) on the pathophysiology of CD/ODD. STUDY POPULATION: Youth with CD/ODD and typically developing (TD) youth. DESIGN: The study will involve a 2 session design (methylphenidate [MPH] vs. placebo). Patients with CD/ODD will participate in both sessions. TD youth will be tested for 2 sessions (no medication) to provide an index of typical task response. Activity within regions of interest identified from the TD youth will be used to determine whether MPH reduces differences in BOLD response in CD/ODD relative to TD youth. ICU scores and current ADHD symptomatology will be used as covariates to determine whether these variables moderate the putative increase in BOLD response in target regions in the patients with CD. OUTCOME MEASURES: Principle dependent measures will be BOLD responses as measured through core tasks.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Conduct Disorder, Attention Defict Hyperactivity Disorder
    Keywords
    Conduct Disorder, Methylphenidate, Disruptive Behavior Disorders

    7. Study Design

    Primary Purpose
    Other
    Study Phase
    Phase 1, Phase 2
    Interventional Study Model
    Crossover Assignment
    Masking
    ParticipantInvestigator
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Intervention Type
    Drug
    Intervention Name(s)
    Methylphenidate Hydrochloride
    Intervention Description
    Bold signal changes by methylphenidate on DBD
    Primary Outcome Measure Information:
    Title
    Patients with CD will show an increase in the amygdala response to fearful expressions such that the difference between BOLD response in patients and TDs is reduced on MPH relative to placebo. ICU score will be a significant covariate of the inc...
    Time Frame
    2 years from the initiation of the protocol
    Title
    Patients with CD will show an increase in reward prediction errors and reward expected value signaling within striatum and ventromedial frontal cortex (vmPFC) such that the difference between BOLD response in patients and TDs is reduced on MPH r...
    Time Frame
    2 years from the initiation of the protocol
    Title
    Patients with CD will show an increase in conflict related signaling within dorsomedial, lateral and parietal cortices such that the difference between BOLD response in patients and TDs is reduced on MPH relative to placebo. Current ADHD sympto...
    Time Frame
    2 years from the initiation of the protocol
    Secondary Outcome Measure Information:
    Title
    Symptom profiles measured by the clinical scales listed in the protocol (CBCL, the ICU, Connor s parent report on ADHD symptom) will be significantly related to the BOLD signal changes after methylphenidate administration.
    Time Frame
    2 years from the initiation of the protocol

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    10 Years
    Maximum Age & Unit of Time
    17 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    INCLUSION CRITERIA Youth with CD 10-17 years of age. A current diagnosis of CD as determined by the Kiddie-SADS, lifetime version. Youth in the CD+comorbid ADHD group will also meet diagnostic criteria for ADHD. Youth in the CD without comorbid ADHD group will specifically not meet diagnostic criteria for ADHD. Youth with CD shouldmust be na(SqrRoot) ve to psychoactive medication (such as: methylphenidate and amphetamine). TD youth 10-17 years of age. No current psychiatric diagnosis, as determined by the Kiddie-SADS, lifetime version. EXCLUSION CRITERIA Exclusion criteria for youth with CD (with or without ADHD) Comorbid psychotic, major mood, tic, pervasive developmental, and substance abuse disorders. Presence of comorbid ADHD is exclusory for the group of patients with CD without ADHD History of known structural cardiac abnormalities, cardiomyopathy, serious heart rhythm abnormalities, coronary artery disease, or other serious cardiac problems Current weight less than 25kg or over 90kg Exclusion criteria for all participants (CD with ADHD, CD without ADHD and TD) History of serious CNS disease disorder (examples aresuch as: history of seizure, epilepsy, brain tumor, brain hemorrhage, and major CNS infection such as meningitis or encephalitis) Previous history of known structural cardiac abnormalities, cardiomyopathy, serious heart rhythm abnormalities, coronary artery disease, or other serious cardiac problems Current use of any psychiatric medications and centrally acting medications (such as stimulants, non-stimulant ADHD medications, antidepressants, anxiolytics, antipsychotics and anti-epilepsy medications), and past history of use of psychoactive medication (such as methylphenidate and amphetamine) A positive urine pregnancy test A Positive urine toxicology, History/current diagnosis of substance abuse/dependence Suicidal or homicidal ideation within the past 6 months. Wechsler Abbreviated Scale of Intelligence (WASI) (D. Wechsler, 1999) scores <70 Metal in body (i.e., hearing aid, cardiac pacemaker, bone plates, etc), claustrophobia, or any other condition that would preclude fMRI scanning.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    James J Blair, Ph.D.
    Organizational Affiliation
    National Institute of Mental Health (NIMH)
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Citations:
    PubMed Identifier
    18088220
    Citation
    Waschbusch DA, Carrey NJ, Willoughby MT, King S, Andrade BF. Effects of methylphenidate and behavior modification on the social and academic behavior of children with disruptive behavior disorders: the moderating role of callous/unemotional traits. J Clin Child Adolesc Psychol. 2007 Oct-Dec;36(4):629-44. doi: 10.1080/15374410701662766.
    Results Reference
    background
    PubMed Identifier
    11723191
    Citation
    Blair RJ. Neurocognitive models of aggression, the antisocial personality disorders, and psychopathy. J Neurol Neurosurg Psychiatry. 2001 Dec;71(6):727-31. doi: 10.1136/jnnp.71.6.727.
    Results Reference
    background
    PubMed Identifier
    23450288
    Citation
    White SF, Pope K, Sinclair S, Fowler KA, Brislin SJ, Williams WC, Pine DS, Blair RJ. Disrupted expected value and prediction error signaling in youths with disruptive behavior disorders during a passive avoidance task. Am J Psychiatry. 2013 Mar;170(3):315-23. doi: 10.1176/appi.ajp.2012.12060840.
    Results Reference
    background

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    Investigating the Impact of Methylphenidate on Neural Response in Disruptive Behavioral Disorder

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