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Brain Mechanisms in Young Adults (MHP)

Primary Purpose

Cocaine-Related Disorders

Status

Completed

Phase

Early Phase 1

Locations

United States

Study Type

Interventional

Intervention

d-amphetamine

[C-11]NPA

About this trial

This is an interventional basic science trial for Cocaine-Related Disorders focused on measuring prenatal exposure

Eligibility Criteria

25 Years - 30 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

Prenatal cocaine exposed subjects (PCE): Offspring exposed to prenatal cocaine (concurrent exposure to prenatal alcohol and tobacco are not exclusionary) as determined by detailed interviewing during pregnancy
Comparison group (COMP): Offspring NOT exposed to prenatal cocaine (exposure to prenatal alcohol and tobacco are not exclusionary) as determined by detailed interviewing during pregnancy.

Exclusion criteria for both PCE and COMP groups:

No current mania or psychosis based on current mental status exam and SCID-IV modules A (pages A18-A37) and B (pages B1-B8);
No current cocaine, heroin, opioid, methadone, benzodiazepine, methamphetamine use (negative urine drug screen at both day of screening and the day of PET scan);
No current use of cannabis (a negative urine drug screen on day of PET scan; Note: a positive cannabis urine on the day of screening will not be exclusionary because cannabis tends to be used for recreation; and it takes a long time for it turn negative because it is released from fat cells in body long after subject has quit; and it has been shown to not impact amphetamine-induced dopamine release in prior studies);
Not currently taking prescription or over the counter medications that can alter monoamine transmission in the brain or interact with the d-amphetamine challenge or alter amphetamine concentrations (major CYP2D6 inhibitors such as fluoxetine, thioridazine, terbinafine etc., as well as pseudo-ephedrine, atomoxetine, SSRIs, etc.);
No use of acidifying (fruit juice; beverages; ascorbic acid) and alkalinizing agents (such as sodium bicarbonate) that alter amphetamine concentrations at least 12 hrs before PET scan day;
No current or past severe medical or neurological illnesses such as seizure disorders, head injury with prolonged loss of consciousness, hypertension, prior MI, CAD etc., (determined by physician investigator's elicited medical history, physical exam, review of labs, and EKG results);
Not currently pregnant (serum pregnancy test at screening) or breastfeeding;
No history of radioactivity exposure via prior nuclear medicine studies or occupational exposure in past 12 months;
No metallic objects in the body that are contraindicated for MRI;
SBP > 135, DBP > 85, and/or HR ≤ 50 or ≥ 100 (documented before the PET scans; Note: it is not unusual to have to repeat screening vital signs in subjects' because some subjects tend to have white coat syndrome and present with elevated vitals at screening, which later normalizes);
No first-degree relative with an MI or stroke or TIA prior to 50 years of age;
No first-degree relative with psychosis or mania.

Sites / Locations

University of Pittsburgh

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Arm Label

Prenatal cocaine exposed subjects

Comparison subjects

Arm Description

[C-11]NPA PET at baseline and post d-amphetamine

Outcomes

Primary Outcome Measures

Percent change in Binding potential (BPnd)

DELTA BPND

Secondary Outcome Measures

Full Information

NCT ID

NCT03606473

First Posted

July 20, 2018

Last Updated

September 2, 2020

Sponsor

Gale Richardson

Collaborators

National Institute on Drug Abuse (NIDA)

1. Study Identification

Unique Protocol Identification Number

NCT03606473

Brief Title

Brain Mechanisms in Young Adults

Acronym

MHP

Official Title

Exploration of Mechanisms of Effects of Prenatal Cocaine Exposure in Young Adults

Study Type

Interventional

2. Study Status

Record Verification Date

September 2020

Overall Recruitment Status

Completed

Study Start Date

January 24, 2018 (Actual)

Primary Completion Date

August 31, 2020 (Actual)

Study Completion Date

August 31, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title

Sponsor-Investigator

Name of the Sponsor

Gale Richardson

Collaborators

National Institute on Drug Abuse (NIDA)

4. Oversight

Studies a U.S. FDA-regulated Drug Product

Yes

Studies a U.S. FDA-regulated Device Product

Product Manufactured in and Exported from the U.S.

Data Monitoring Committee

5. Study Description

Brief Summary

The goal of this study is to use [C-11]NPA and amphetamine (oral, 0.5 mg/kg) to measure striatal dopamine transmission in prenatal cocaine exposed subjects (PCE) and comparison subjects (COMP)

Detailed Description

Prenatal cocaine exposure (PCE) has consistently been associated with behavioral deficits through childhood, adolescence, and young adulthood in our ongoing study (PRO15080516 - Effects of Prenatal Cocaine Use: 25-Year Follow-Up). Further, 21-year-olds with PCE in our study were twice as likely to have been arrested as non-exposed offspring, were more likely to be diagnosed with Conduct Disorder, had higher disinhibition scores, were significantly more likely to use alcohol and marijuana earlier, and to have earlier sexual intercourse. The effects of PCE on the developing nervous system may cause changes in brain function that underlie these behavioral outcomes. This study seeks to examine dopamine (DA) transmission in vivo, using positron emission tomography (PET) with [C-11]NPA, in striatal regions of interest in subjects who have a history of exposure to prenatal cocaine (PCE). We hypothesize that PCE is associated with increases in dopamine in the striatum relative to COMP. This may explain the impulsivity and high risk behaviors in PCE subjects

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study

Cocaine-Related Disorders

Keywords

prenatal exposure

7. Study Design

Primary Purpose

Basic Science

Study Phase

Early Phase 1

Interventional Study Model

Parallel Assignment

Model Description

[C-11]NPA d-amphetamine

Masking

None (Open Label)

Allocation

Non-Randomized

Enrollment

13 (Actual)

8. Arms, Groups, and Interventions

Arm Title

Prenatal cocaine exposed subjects

Arm Type

Experimental

Arm Description

[C-11]NPA PET at baseline and post d-amphetamine

Arm Title

Comparison subjects

Arm Type

Experimental

Arm Description

[C-11]NPA PET at baseline and post d-amphetamine

Intervention Type

Drug

Intervention Name(s)

d-amphetamine

Intervention Description

is used to stimulate dopamine release in the brain

Intervention Type

Radiation

Intervention Name(s)

[C-11]NPA

Intervention Description

PET radiotracer

Primary Outcome Measure Information:

Title

Percent change in Binding potential (BPnd)

Description

DELTA BPND

Time Frame

Baseline BPnd (time 0) and Post-amphetamine BPnd (time 3 hours

10. Eligibility

Sex

All

Minimum Age & Unit of Time

25 Years

Maximum Age & Unit of Time

30 Years

Accepts Healthy Volunteers

Eligibility Criteria

All potential subjects are current participants in the larger parent study entitled "Effects of Prenatal Cocaine Exposure: 25-Year Follow-Up", IRB PRO15080516. Participants are between 25 and 30 years of age. Inclusion Criteria: Prenatal cocaine exposed subjects (PCE): Offspring exposed to prenatal cocaine (concurrent exposure to prenatal alcohol and tobacco are not exclusionary) as determined by detailed interviewing during pregnancy Comparison group (COMP): Offspring NOT exposed to prenatal cocaine (exposure to prenatal alcohol and tobacco are not exclusionary) as determined by detailed interviewing during pregnancy. Exclusion criteria for both PCE and COMP groups: No current mania or psychosis based on current mental status exam and SCID-IV modules A (pages A18-A37) and B (pages B1-B8); No current cocaine, heroin, opioid, methadone, benzodiazepine, methamphetamine use (negative urine drug screen at both day of screening and the day of PET scan); No current use of cannabis (a negative urine drug screen on day of PET scan; Note: a positive cannabis urine on the day of screening will not be exclusionary because cannabis tends to be used for recreation; and it takes a long time for it turn negative because it is released from fat cells in body long after subject has quit; and it has been shown to not impact amphetamine-induced dopamine release in prior studies); Not currently taking prescription or over the counter medications that can alter monoamine transmission in the brain or interact with the d-amphetamine challenge or alter amphetamine concentrations (major CYP2D6 inhibitors such as fluoxetine, thioridazine, terbinafine etc., as well as pseudo-ephedrine, atomoxetine, SSRIs, etc.); No use of acidifying (fruit juice; beverages; ascorbic acid) and alkalinizing agents (such as sodium bicarbonate) that alter amphetamine concentrations at least 12 hrs before PET scan day; No current or past severe medical or neurological illnesses such as seizure disorders, head injury with prolonged loss of consciousness, hypertension, prior MI, CAD etc., (determined by physician investigator's elicited medical history, physical exam, review of labs, and EKG results); Not currently pregnant (serum pregnancy test at screening) or breastfeeding; No history of radioactivity exposure via prior nuclear medicine studies or occupational exposure in past 12 months; No metallic objects in the body that are contraindicated for MRI; SBP > 135, DBP > 85, and/or HR ≤ 50 or ≥ 100 (documented before the PET scans; Note: it is not unusual to have to repeat screening vital signs in subjects' because some subjects tend to have white coat syndrome and present with elevated vitals at screening, which later normalizes); No first-degree relative with an MI or stroke or TIA prior to 50 years of age; No first-degree relative with psychosis or mania.

Facility Information:

Facility Name

University of Pittsburgh

City

Pittsburgh

State/Province

Pennsylvania

ZIP/Postal Code

15213

Country

United States

12. IPD Sharing Statement

Plan to Share IPD

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