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Pitolisant Effects on Affect and Cognition Exploratory Study (PEACE Study) (PEACE)

Primary Purpose

Anhedonia, Cognitive Function

Status
Recruiting
Phase
Not Applicable
Locations
United Kingdom
Study Type
Interventional
Intervention
Pitolisant 17.8 MG [Wakix]
Placebo
Sponsored by
University of Oxford
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Anhedonia focused on measuring Drug, fMRI, pharmaco-fMRI, Cognition, Histamine

Eligibility Criteria

18 Years - 45 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria: Participant is willing and able to give informed consent for participation in the research Not currently taking any medications which may interfere with pitolisant, including psychoactive medications Not currently using antihistaminergic medication Aged 18-45 years Male or female Sufficiently fluent English to understand and complete cognitive tasks and questionnaires Body Mass Index above or below 18-30 Right handed Exclusion Criteria: Current pregnancy (as determined by urine pregnancy test taken during screening visit), planning to become pregnant or breast feeding Any past or current history of severe and/or serious psychiatric disorder, including but not limited to schizophrenia, psychosis, bipolar affective disorder, major depressive disorder, obsessive compulsive disorder Clinically significant abnormal values for urine drug screen, blood pressure measurement ( in accordance with AP20 'non-invasive blood pressure') and ECG. A participant with a clinical abnormality or parameters outside the reference range for the population being studied may be included only if the Investigator considers that the finding is unlikely to introduce additional risk factors and will not interfere with the study procedures History of, or current medical conditions which, in the opinion of the investigator, may interfere with the safety of the participant or the scientific integrity of the study, including epilepsy/seizures, brain injury, hepatic or renal disease, acid-related gastro-intestinal problems, Central Nervous System (CNS) tumours, neurological conditions Current or past history of drug or alcohol dependency Severe lactose intolerance Use of recreational drugs (e.g. cannabis, cocaine, amphetamines) within past 3 months Participation in a study which uses the same computer tasks as those in the present study (determined by asking participants about previous studies participated in during screening) within past 3 months Participation in a study that involves the use of a medication within the last three months Smoking > 5 cigarettes per day Consumption of a high amount of caffeine per day (> 400ml caffeine) (e.g., 5 or more cups of coffee) Participant is unlikely to comply with the clinical study protocol or is unsuitable for any other reason, in the opinion of the Investigator Any contraindication to MRI scanning (e.g. metal objects inside the body, pacemakers, significant claustrophobia) Not right handed

Sites / Locations

  • Department of Psychiatry, University of OxfordRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Pitolisant

Placebo

Arm Description

Two film-coated tablets (18mg x 2 [36mg]) for oral administration will be encapsulated in an opaque capsule.

Two lactose film-coated tablets (2 x 65mg [125mg]) will be encapsulated in an opaque capsule (identical to the experimental arm drug).

Outcomes

Primary Outcome Measures

BOLD signal levels during resting state fMRI sequence
Blood Oxygenation Level Dependent (BOLD) signal level in prior regions of interest (striatum, hippocampus and anterior cingulate cortex) in pilosant group compared with the placebo group
BOLD signal levels during fMRI memory encoding task
BOLD signal level in prior regions of interest during the task (hippocampus; perirhinal cortex) in pilosant group compared with the placebo group
BOLD signal levels during fMRI n-back task
BOLD signal level in prior regions of interest during the task (dorsolateral prefrontal cortex; hippocampus; anterior cingulate cortex) in pilosant group compared with the placebo group

Secondary Outcome Measures

Optimal choice selection during loss and reward conditions in Probabilistic Instrumental Learning Task (PILT)
Optimal choice selection during loss and reward conditions in Probabilistic Instrumental Learning Task (PILT) in pilosant group compared with the placebo group
Number of inhibited 'no-go' responses during the affective Interference Go/No-Go Task performance
Number of inhibited 'no-go' responses during the affective Interference Go/No-Go Task in pilosant group compared with the placebo group
Accuracy of target selection on the Colour Change Detection Task
Accuracy of target selection on the Colour Change Detection Task in pilosant group compared with the placebo group
Accuracy of emotional labeling of facial expressions during the facial emotion recognition task
Accuracy of emotion labels (e.g. disgusted face) assigned by participants to expressive faces during the facial emotion recognition task in pilosant group compared with the placebo group
Accuracy of target selection during n-back fMRI task
Accuracy of target selection during n-back fMRI task in pilosant group compared with the placebo group
Accuracy of stimuli labeling (novel or familiar) during fMRI memory encoding task
Accuracy of stimuli labeling (novel or familiar) during fMRI memory encoding task in pilosant group compared with the placebo group

Full Information

First Posted
April 3, 2023
Last Updated
May 4, 2023
Sponsor
University of Oxford
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1. Study Identification

Unique Protocol Identification Number
NCT05849675
Brief Title
Pitolisant Effects on Affect and Cognition Exploratory Study (PEACE Study)
Acronym
PEACE
Official Title
An fMRI Investigation of the Effects of Selective Histamine-3 Receptor Antagonism on Cognitive and Emotional Processing in Healthy Individuals
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Recruiting
Study Start Date
April 1, 2023 (Actual)
Primary Completion Date
March 2024 (Anticipated)
Study Completion Date
March 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Oxford

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
Yes

5. Study Description

Brief Summary
The goal of this study is to investigate the effects of selective histamine 3 antagonist pitolisant on brain function and cognition in healthy individuals. The main questions it aims to answer are: Does pitolisant alter functional activity in brain regions linked to reward and cognitive processing during rest or cognitive task performance? Does pitolisant alter cognitive ability across a range of psychological domains, including working memory, executive functioning and emotional processing? Participants will undertake fMRI scanning in addition to a battery of tasks designed to measure cognitive and emotional processing after taking a single dose of pitolisant or placebo. Researchers will compare differences in functional activity, cognition and emotional processing across the pitolisant and placebo groups.
Detailed Description
Cognitive and affective processing are underpinned by monoaminergic neurotransmission and neurosteroid systems, yet there are many aspects of these systems that remain unknown in humans. In particular, monoaminergic histamine 3 (H3) receptors are abundant in CNS regions underpinning cognitive processing (prefrontal cortex, hippocampus, and striatum), yet the role of these receptors in humans remains unclear. Evidence from animal models suggests H3R antagonism improves cognitive functioning, however these specific effects are yet to be examined in humans. Similarly, the function of sigma-1 (σ-1) receptors in the brain is not well understood in humans despite strong evidence of pro-cognitive effects in animal models. The study will investigate the effect of pitolisant, a dual H3R antagonist and σ-1R agonist, on cognitive and affective processing, in addition to changes in functional connectivity. These effects will be measured with a battery of neuropsychological tasks (e.g., Affective Go/No-Go Task; Adaptive dual n-back task), self-rated measures of cognitive function (PDQ), and resting state fMRI and fMRI data acquisition during the verbal n-back and memory encoding tasks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Anhedonia, Cognitive Function
Keywords
Drug, fMRI, pharmaco-fMRI, Cognition, Histamine

7. Study Design

Primary Purpose
Other
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Participants will be randomly allocated to one of two groups (pitolisant or placebo). This study uses a novel procedure known as variance minimisation (described in Sella, Raz & Cohen Kadosh, 2021) to randomise participants allocation to the two intervention groups based on equalising baseline cognitive functioning and gender. Participants will receive a single dose of the drug (pitolisant, 36mg) or placebo, and undertake fMRI and cognitive/emotional assessment three hours after dose. The study is assessing the effect antagonising the H3 receptor on functional connectivity/cognitive ability, it is not an efficacy or safety study.
Masking
ParticipantInvestigatorOutcomes Assessor
Masking Description
Matched placebo capsule
Allocation
Randomized
Enrollment
56 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Pitolisant
Arm Type
Experimental
Arm Description
Two film-coated tablets (18mg x 2 [36mg]) for oral administration will be encapsulated in an opaque capsule.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Two lactose film-coated tablets (2 x 65mg [125mg]) will be encapsulated in an opaque capsule (identical to the experimental arm drug).
Intervention Type
Drug
Intervention Name(s)
Pitolisant 17.8 MG [Wakix]
Intervention Description
Single dose pitoliosant (36mg)
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Single dose placebo
Primary Outcome Measure Information:
Title
BOLD signal levels during resting state fMRI sequence
Description
Blood Oxygenation Level Dependent (BOLD) signal level in prior regions of interest (striatum, hippocampus and anterior cingulate cortex) in pilosant group compared with the placebo group
Time Frame
3-6 hours after single dose of drug or placebo.
Title
BOLD signal levels during fMRI memory encoding task
Description
BOLD signal level in prior regions of interest during the task (hippocampus; perirhinal cortex) in pilosant group compared with the placebo group
Time Frame
3-6 hours after single dose of drug or placebo.
Title
BOLD signal levels during fMRI n-back task
Description
BOLD signal level in prior regions of interest during the task (dorsolateral prefrontal cortex; hippocampus; anterior cingulate cortex) in pilosant group compared with the placebo group
Time Frame
3-6 hours after single dose of drug or placebo.
Secondary Outcome Measure Information:
Title
Optimal choice selection during loss and reward conditions in Probabilistic Instrumental Learning Task (PILT)
Description
Optimal choice selection during loss and reward conditions in Probabilistic Instrumental Learning Task (PILT) in pilosant group compared with the placebo group
Time Frame
3-6 hours after single dose of drug or placebo.
Title
Number of inhibited 'no-go' responses during the affective Interference Go/No-Go Task performance
Description
Number of inhibited 'no-go' responses during the affective Interference Go/No-Go Task in pilosant group compared with the placebo group
Time Frame
3-6 hours after single dose of drug or placebo.
Title
Accuracy of target selection on the Colour Change Detection Task
Description
Accuracy of target selection on the Colour Change Detection Task in pilosant group compared with the placebo group
Time Frame
3-6 hours after single dose of drug or placebo.
Title
Accuracy of emotional labeling of facial expressions during the facial emotion recognition task
Description
Accuracy of emotion labels (e.g. disgusted face) assigned by participants to expressive faces during the facial emotion recognition task in pilosant group compared with the placebo group
Time Frame
3-6 hours after single dose of drug or placebo.
Title
Accuracy of target selection during n-back fMRI task
Description
Accuracy of target selection during n-back fMRI task in pilosant group compared with the placebo group
Time Frame
3-6 hours after single dose of drug or placebo.
Title
Accuracy of stimuli labeling (novel or familiar) during fMRI memory encoding task
Description
Accuracy of stimuli labeling (novel or familiar) during fMRI memory encoding task in pilosant group compared with the placebo group
Time Frame
3-6 hours after single dose of drug or placebo.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Participant is willing and able to give informed consent for participation in the research Not currently taking any medications which may interfere with pitolisant, including psychoactive medications Not currently using antihistaminergic medication Aged 18-45 years Male or female Sufficiently fluent English to understand and complete cognitive tasks and questionnaires Body Mass Index above or below 18-30 Right handed Exclusion Criteria: Current pregnancy (as determined by urine pregnancy test taken during screening visit), planning to become pregnant or breast feeding Any past or current history of severe and/or serious psychiatric disorder, including but not limited to schizophrenia, psychosis, bipolar affective disorder, major depressive disorder, obsessive compulsive disorder Clinically significant abnormal values for urine drug screen, blood pressure measurement ( in accordance with AP20 'non-invasive blood pressure') and ECG. A participant with a clinical abnormality or parameters outside the reference range for the population being studied may be included only if the Investigator considers that the finding is unlikely to introduce additional risk factors and will not interfere with the study procedures History of, or current medical conditions which, in the opinion of the investigator, may interfere with the safety of the participant or the scientific integrity of the study, including epilepsy/seizures, brain injury, hepatic or renal disease, acid-related gastro-intestinal problems, Central Nervous System (CNS) tumours, neurological conditions Current or past history of drug or alcohol dependency Severe lactose intolerance Use of recreational drugs (e.g. cannabis, cocaine, amphetamines) within past 3 months Participation in a study which uses the same computer tasks as those in the present study (determined by asking participants about previous studies participated in during screening) within past 3 months Participation in a study that involves the use of a medication within the last three months Smoking > 5 cigarettes per day Consumption of a high amount of caffeine per day (> 400ml caffeine) (e.g., 5 or more cups of coffee) Participant is unlikely to comply with the clinical study protocol or is unsuitable for any other reason, in the opinion of the Investigator Any contraindication to MRI scanning (e.g. metal objects inside the body, pacemakers, significant claustrophobia) Not right handed
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Michael J Colwell, M.Res
Phone
+44 (0)1865 618 303
Email
michael.colwell@psych.ox.ac.uk
First Name & Middle Initial & Last Name or Official Title & Degree
Susannah E Murphy, DPhil
Phone
+44 (0)1865 618313
Email
susannah.murphy@psych.ox.ac.uk
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Susannah E Murphy, DPhil
Organizational Affiliation
University of Oxford
Official's Role
Principal Investigator
Facility Information:
Facility Name
Department of Psychiatry, University of Oxford
City
Oxford
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Michael J Colwell, M.Res
Phone
+44 (0)1865 618 303
Email
michael.colwell@psych.ox.ac.uk
First Name & Middle Initial & Last Name & Degree
Susannah E Murphy, DPhil
Phone
+44 (0)1865 618313
Email
susannah.murphy@psych.ox.ac.uk
First Name & Middle Initial & Last Name & Degree
Susannah E Murphy, DPhil
First Name & Middle Initial & Last Name & Degree
Catherine J Harmer, DPhil

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Data which has been fully de-identified may be shared with other academic and commercial organisations in the future, including those outside of the UK and the EU. Participants will be informed of this and specific consent to this is obtained within the Informed Consent Form.
IPD Sharing Time Frame
A few months after all data has been completed (ETA July 2024), unblinding has occurred (ETA April 2024), and all data analyses has been completed (ETA May 2024).
IPD Sharing Access Criteria
The data will be made publicly available. Access requests will not be required.
IPD Sharing URL
https://osf.io/4ckdq/

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Pitolisant Effects on Affect and Cognition Exploratory Study (PEACE Study)

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