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Cerebrovascular Health and Resilience in Midlife (CHARM)

Primary Purpose

Psychological Stress, Cardiovascular Diseases, Cerebrovascular Disorders

Status
Recruiting
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Paced Auditory Serial Addition Task
Sponsored by
University of Pittsburgh
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Psychological Stress

Eligibility Criteria

40 Years - 59 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria: Able to attend 2 study visits at the University of Pittsburgh campus in Oakland (Pennsylvania) Able to read and speak English Exclusion Criteria: Uncontrolled hypertension (systolic blood pressure >160 or diastolic blood pressure >100 mmHg) Current use of anticonvulsant, anti-Parkinson, neuroleptic, or antipsychotic medications Current use of glucocorticoids (e.g., oral prednisone) or ephedrine Current chronic conditions of the lungs, liver and kidney, as well as cancer (chemotherapy and radiation) treatment in the past 12 months (allowances are made for non-melanoma skin cancer treatment, controlled asthma, and allergy inhalers) Self-reported major neurological disorders or brain injuries (e.g., multiple sclerosis, cerebral palsy, major head injury) Self-reported psychotic illnesses (mania, bipolar disorder, schizophrenia) Current pregnancy or childbirth within the past 6 months Suspected mild cognitive impairment or dementia Self reported sleep apnea Self-reported history of myocardial infarction, stroke, or revascularization procedures, as well as treatment for cardiac arrhythmias Self-reported lack of comfort to undergo MRI testing Presence of implants or objects that are unsafe for MRI (e.g., tattooed eyeliner), as well as any other contraindications that would prevent MRI testing Self-reported lack of comfort to undergo the laboratory math task

Sites / Locations

  • University of PittsburghRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Paced Auditory Serial Addition Task

Arm Description

For the Paced Auditory Serial Addition Task, volunteers are presented with single digit numbers (1-9), and are instructed to add any given number to the previously presented number, and call out the answer. Volunteers are told that their performance is being monitored by research assistants. Volunteers are provided with a signaling device that they can use to discontinue testing. Lastly, participants will be asked to complete brief questionnaires to assess their levels of experienced threat, challenge, valence, arousal, and sense of control.

Outcomes

Primary Outcome Measures

Change in systolic blood pressure (SBP) from baseline to task
The mean SBP from the baseline period will be subtracted from the mean of the task period.
White matter hyperintensity burden
White matter hyperintensity burden will be computed as the total sum of the voxels segmented as hyperintensities multiplied by voxel dimensions to yield a total score (units of mm-cubed).
Hippocampal volume
Total bilateral hippocampal volume will be computed as the total sum of voxels automatically segmented.
Perivascular space volume
Total perivascular space volume will be computed from segmented brain blood vessel-tissue interfaces.
Pulse wave velocity
Pulse wave velocity in m/s will be assessed by dual impedance cardiography as a non-invasive indicator of arterial stiffness. This measure will be derived from the 5 minute baseline period.
Spontaneous baroreflex sensitivity
Spontaneous baroreflex sensitivity in ms/mmHg will be computed by the sequence method applied to beat-to-beat blood pressure and electrocardiogram recordings.
Endothelial function
Endothelial-dependent vasodilation will be measured non-invasively in a reactive hyperemia protocol using digital thermal monitoring.

Secondary Outcome Measures

Full Information

First Posted
August 31, 2023
Last Updated
October 19, 2023
Sponsor
University of Pittsburgh
Collaborators
National Heart, Lung, and Blood Institute (NHLBI)
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1. Study Identification

Unique Protocol Identification Number
NCT06029348
Brief Title
Cerebrovascular Health and Resilience in Midlife
Acronym
CHARM
Official Title
Cerebrovascular Health and Resilience in Midlife
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
October 17, 2023 (Actual)
Primary Completion Date
June 30, 2029 (Anticipated)
Study Completion Date
June 30, 2029 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Pittsburgh
Collaborators
National Heart, Lung, and Blood Institute (NHLBI)

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study examines cardiovascular responses to a brief psychological challenge under laboratory conditions among adult volunteers. The study volunteers are asked to complete two study sessions. In one session, the volunteers are asked to provide demographic and health-related information via questionnaires and an interview. In that session, volunteers would then be asked to undergo evaluations of their body composition, blood pressure, heart rate, and other signs of cardiovascular function and health. Lastly, volunteers would be asked to take part in a brief and challenging psychological task after a period of rest while cardiovascular activity is measured. In the other session, volunteers are asked to undergo magnetic resonance imaging and to complete neuropsychological tests of memory, attention, and processing speed. In addition to these two sessions, volunteers are asked to complete online questionnaires. The study is designed to examine associations between transient changes in cardiovascular activity induced by the psychological task, measures of overall cardiovascular health, and measures of cerebrovascular health measured by magnetic resonance imaging. Study results are expected to provide new information about the relationships between cardiovascular activity changes to psychological challenges and cardiovascular and cerebrovascular health in adults.
Detailed Description
This cross-sectional study examines the extent to which cardiovascular responses to the acute experience of psychological stress relate to signs of cerebrovascular health detected on magnetic resonance imaging. Study volunteers will include midlife adults who do not report having a history of clinical cardiovascular disease or dementia. Study volunteers will be asked to complete protocols to assess: behavioral, social, and biological correlates of cardiovascular and cerebrovascular health; arterial stiffness, endothelial function, and beat-to-beat blood pressure; cardiovascular changes to acute psychological stress; signs of cerebrovascular health; and, neuropsychological test performance. Cardiovascular responses to acute psychological stress will be examined in relation to indicators of brain function and structure, as well as indicators of cardiac and vascular function. Study results may help to increase knowledge about stress-related factors and cardiovascular sources of brain health.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Psychological Stress, Cardiovascular Diseases, Cerebrovascular Disorders

7. Study Design

Primary Purpose
Basic Science
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Model Description
The study is designed to measure cardiovascular responses to brief (~4 minute) mental arithmetic task (a psychological challenge) under laboratory conditions. Cardiovascular activity will be measured during (1) a resting period prior to the task (~5min), then (2) during the task(~4 min), and then (3) after the task is complete (~10min) for all study volunteers. Cardiovascular responses will be examine in relation to other study outcome measures.
Masking
None (Open Label)
Allocation
N/A
Enrollment
450 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Paced Auditory Serial Addition Task
Arm Type
Experimental
Arm Description
For the Paced Auditory Serial Addition Task, volunteers are presented with single digit numbers (1-9), and are instructed to add any given number to the previously presented number, and call out the answer. Volunteers are told that their performance is being monitored by research assistants. Volunteers are provided with a signaling device that they can use to discontinue testing. Lastly, participants will be asked to complete brief questionnaires to assess their levels of experienced threat, challenge, valence, arousal, and sense of control.
Intervention Type
Behavioral
Intervention Name(s)
Paced Auditory Serial Addition Task
Intervention Description
Study volunteers will be asked to complete a 4-minute Paced Auditory Serial Addition Task, which is a standardized task that is widely used to study cardiovascular responses to acute psychological challenges (or stressors) in a laboratory setting.
Primary Outcome Measure Information:
Title
Change in systolic blood pressure (SBP) from baseline to task
Description
The mean SBP from the baseline period will be subtracted from the mean of the task period.
Time Frame
Mean SBPs for the computation of change scores will be computed from the average of the 5 min baseline period and average of the 4 min task period
Title
White matter hyperintensity burden
Description
White matter hyperintensity burden will be computed as the total sum of the voxels segmented as hyperintensities multiplied by voxel dimensions to yield a total score (units of mm-cubed).
Time Frame
Derived from one acquisition sequence within in a 50 min multimodal MRI protocol
Title
Hippocampal volume
Description
Total bilateral hippocampal volume will be computed as the total sum of voxels automatically segmented.
Time Frame
Derived from one acquisition sequence within a 50 min multimodal MRI protocol
Title
Perivascular space volume
Description
Total perivascular space volume will be computed from segmented brain blood vessel-tissue interfaces.
Time Frame
Derived from one acquisition sequence in a 50 min multimodal MRI protocol
Title
Pulse wave velocity
Description
Pulse wave velocity in m/s will be assessed by dual impedance cardiography as a non-invasive indicator of arterial stiffness. This measure will be derived from the 5 minute baseline period.
Time Frame
5 minutes
Title
Spontaneous baroreflex sensitivity
Description
Spontaneous baroreflex sensitivity in ms/mmHg will be computed by the sequence method applied to beat-to-beat blood pressure and electrocardiogram recordings.
Time Frame
5 minutes
Title
Endothelial function
Description
Endothelial-dependent vasodilation will be measured non-invasively in a reactive hyperemia protocol using digital thermal monitoring.
Time Frame
15 minutes

10. Eligibility

Sex
All
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
59 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Able to attend 2 study visits at the University of Pittsburgh campus in Oakland (Pennsylvania) Able to read and speak English Exclusion Criteria: Uncontrolled hypertension (systolic blood pressure >160 or diastolic blood pressure >100 mmHg) Current use of anticonvulsant, anti-Parkinson, neuroleptic, or antipsychotic medications Current use of glucocorticoids (e.g., oral prednisone) or ephedrine Current chronic conditions of the lungs, liver and kidney, as well as cancer (chemotherapy and radiation) treatment in the past 12 months (allowances are made for non-melanoma skin cancer treatment, controlled asthma, and allergy inhalers) Self-reported major neurological disorders or brain injuries (e.g., multiple sclerosis, cerebral palsy, major head injury) Self-reported psychotic illnesses (mania, bipolar disorder, schizophrenia) Current pregnancy or childbirth within the past 6 months Suspected mild cognitive impairment or dementia Self reported sleep apnea Self-reported history of myocardial infarction, stroke, or revascularization procedures, as well as treatment for cardiac arrhythmias Self-reported lack of comfort to undergo MRI testing Presence of implants or objects that are unsafe for MRI (e.g., tattooed eyeliner), as well as any other contraindications that would prevent MRI testing Self-reported lack of comfort to undergo the laboratory math task
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Peter J Gianaros, PhD
Phone
412-624-4500
Email
bnl@pitt.edu
First Name & Middle Initial & Last Name or Official Title & Degree
Sara Boyko, BS
Phone
412-648-9047
Email
bnl@pitt.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Peter J Gianaros, PhD
Organizational Affiliation
University of Pittsburgh
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Pittsburgh
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15213
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Sara Boyko, BS

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
De-identified individual participant data that comprise primary and secondary study outcomes will be made available with data dictionaries via the University of Pittsburgh's repository, D-Scholarship@Pitt. This repository provides indefinite storage and accessibility. Along with de-identified data, other shared resources will include a description of data collection methods and study code book; a description of the data files; and descriptions of data use conditions. Statistical scripts will be deposited as appropriate following publication of manuscripts bearing on the aims of the study. All publications will include information on the location of study data and accessibility. Requests by researchers for other de-identified data will be facilitated by completion of a Data Use Agreement, as well as provision of a methodologically sound proposal and approval from their institution.
IPD Sharing Time Frame
Data are anticipated to become available within 12 months after the publication of findings bearing on the Specific Aims of R01HL169990
IPD Sharing Access Criteria
All presentations and publications will include information on the location of study data and its public accessibility for research use. The criteria for certain requests of de-identified data will involve the completion of a Data Use Agreement, https://www.osp.pitt.edu/osp-teams/clinical-corporate-contract-services/negotiations/data-use-agreements-duas
IPD Sharing URL
https://d-scholarship.pitt.edu/

Learn more about this trial

Cerebrovascular Health and Resilience in Midlife

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