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The investigators propose to use positron emission tomography (PET) imaging to determine whether nicotinic receptor availability at pretreatment predicts smoking cessation success. The investigators will recruit 30 smokers from those enrolled in the Pharmacogenetics of Nicotine Addiction Treatment clinical trial. The investigators will measure nicotinic receptor availability using the PET radioligand 2-[18F]FA, after overnight abstinence and prior to initiation of treatment.
Subjects will be asked to complete a short screening session, an orientation phone call, and two imaging sessions: one PET imaging session and one MRI session.
Intake Session. This session will familiarize subjects with the study procedures and risks, as well as determine initial eligibility for the study. Subjects will first complete an Imaging Screening Form with study personnel. Subjects will also complete a Magnet Safety Form to check for any metal in the body. Finally, subjects will complete a Scanning Registration Form.
Orientation Call. Dr. Dubroff (the Principal Investigator and study physician) will call subjects before the PET Scan Session to review the study procedures and risks and answer any questions subjects might have.
PET Scan Session. Subjects will receive a telephone call the day before the session to remind them to stop smoking at 9:00pm that night. At the session, they will provide a series of samples. These include:
After subjects arrive at the PET center, they will have two intravenous (I.V.) lines placed. A sterile solution will be dripped through the tubing to keep them open. Subjects will have blood pressure and heart rate taken prior to injection and three 10ml tubes of blood will be drawn to determine the baseline levels of radioactive tracer. After this, subjects will be injected with a radioactive tracer (a chemical that has a radioactive molecule attached to it) called 2-[18F]FA that will be pumped through one of the I.V. lines over an 8-hour period. During the waiting period subjects will complete two questionnaires, a brief IQ test, and five computer games. They will have repeated blood pressure and heart rate readings taken soon after the initial injection and every 45 minutes afterwards. The investigators will draw 3 ml (half a teaspoon) of blood from the second I.V. line every 15-30 minutes to measure radiotracer levels.
Just prior to beginning the scan, subjects will be asked two questions about cravings. These questions will be asked every 30 minutes during the scan and then once more after subjects have exited the scan. The investigators will draw one 3ml tube of blood at the beginning of the PET scan and every 30 min during the PET scan (total 5 teaspoons) from the second I.V. line to measure radiotracer levels.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Slow metabolizers | Individuals with an NMR <0.26 will be classified as slow metabolizers. | ||
| Normal metabolizers | Participants with an NMR >= 0.26 will be classified as normal metabolizers. |
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| Measure | Description | Time Frame |
|---|---|---|
| Acetylcholinergic Nicotine Receptor Availability as Determined by 2FA -PET Brain Imaging. | Acetylcholinergic Nicotine Receptor availability in the thalamus is decreased in smokers with slower rates of nicotine metabolism. | following overnight nicotine abstinence |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Cigarette Craving as Measured by the Questionnaire on Smoking Urges. | Measure is post-scan subtracted from pre-scan ratings. Rating is measured using the standardized, Questionnaire on Smoking Urges - Brief Version (QSU-Brief) is a standardized measure consisting of 10 statements, each rated on a Likert-like scale from 1 (Strongly Disagree) to 7 (Strongly Agree). Responses for each item are summed to produce an overall score with a range of 10-70. |
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Exclusion Criteria:
In addition to the exclusion criteria used for PNAT trial [NCT01314001], participants in this trial will be excluded if they meet the following criteria:
Imaging-Related Exclusion Criteria:
General Exclusion Criteria:
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Inclusion Criteria:
Participants will be male and female smokers between the ages of 18 and 65 and must be enrolled(consented and meet all eligibility requirements) in the ongoing PNAT trial [NCT01314001] in order to participate in this sub-study. They must be able to provide informed consent and weigh less than 300 lbs (due to limitations of the PET and MRI scanners).
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Center for Interdisciplinary Research on Nicotine Addiction, University of Pennsylvania | Philadelphia | Pennsylvania | 19104 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 16894067 | Background | Brody AL, Mandelkern MA, London ED, Olmstead RE, Farahi J, Scheibal D, Jou J, Allen V, Tiongson E, Chefer SI, Koren AO, Mukhin AG. Cigarette smoking saturates brain alpha 4 beta 2 nicotinic acetylcholine receptors. Arch Gen Psychiatry. 2006 Aug;63(8):907-15. doi: 10.1001/archpsyc.63.8.907. |
| Label | URL |
|---|---|
| Principal Investigator | View source |
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10/01/2012-03/28/2014 recruitment at the Center for Interdisciplinary Research on Nicotine Addiction at the University of Pennsylvania
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| ID | Title | Description |
|---|---|---|
| FG000 | Slow Metabolizers. | Participants with an NMR < 0.26 will be considered slow metabolizers. |
| FG001 | Normal Metabolizers | Participants with an NMR >= 0.26 will be considered normal metabolizers. |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
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| ID | Title | Description |
|---|---|---|
| BG000 | Normal Nicotine Metabolizers | Nicotine Metabolite Radio of > or = 0.26 |
| BG001 | Slow Nicotine Metabolizers | Nicotine Metabolite Radio of < 0.26. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Acetylcholinergic Nicotine Receptor Availability as Determined by 2FA -PET Brain Imaging. | Acetylcholinergic Nicotine Receptor availability in the thalamus is decreased in smokers with slower rates of nicotine metabolism. | Posted | Mean | Standard Deviation | Distribution Volume Ratio (Vt/fp) | following overnight nicotine abstinence |
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Adverse events will examine the day of and the day following PET scanning.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Slow Metabolizers (NMR < 0.26) | No serious adverse events were observed. | 0 |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Jacob Dubroff,M.D., Ph.D., Assistant Professor of Radiology | University of Pennsylvania | 215-662-3041 | jacob.dubroff@uphs.upenn.edu |
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| ID | Term |
|---|---|
| D016540 | Smoking Cessation |
| D014029 | Tobacco Use Disorder |
| ID | Term |
|---|---|
| D015438 | Health Behavior |
| D001519 | Behavior |
| D019966 | Substance-Related Disorders |
| D064419 | Chemically-Induced Disorders |
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| Before and immediately following the PET scan. |
| Center for Interdisplinary Research on Nicotine Addiction | View source |
| Position Emission Tomography (PET) Center at the University of Pennsylvania | View source |
| BG002 | Total | Total of all reporting groups |
| years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Race (NIH/OMB) | Count of Participants | Participants |
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| Region of Enrollment | Count of Participants | Participants |
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| Units |
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| Counts |
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| Participants |
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| Secondary | Change in Cigarette Craving as Measured by the Questionnaire on Smoking Urges. | Measure is post-scan subtracted from pre-scan ratings. Rating is measured using the standardized, Questionnaire on Smoking Urges - Brief Version (QSU-Brief) is a standardized measure consisting of 10 statements, each rated on a Likert-like scale from 1 (Strongly Disagree) to 7 (Strongly Agree). Responses for each item are summed to produce an overall score with a range of 10-70. | Posted | Mean | Standard Deviation | units on a scale | Before and immediately following the PET scan. |
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| 13 |
| 0 |
| 13 |
| 0 |
| 13 |
| EG001 | Normal Metabolizers (NMR > or + 0.26) | No serious adverse events were observed. | 0 | 12 | 0 | 12 | 0 | 12 |
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| D001523 |
| Mental Disorders |