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Patients with schizophrenia show enhanced dopamine synthesis capacity and release, an effect that can be evoked in healthy subjects by repeated amphetamine administration. Therefore for the first time the relationship between dopamine synthesis and release will be studied in healthy subjects before and after amphetamine sensitization in order to better understand adaptive mechanisms of the dopamine system.
Positron emission tomography (PET) studies have consistently shown increased brain dopamine (DA) synthesis and enhanced d-amphetamine-induced DA release in patients with schizophrenia. Repeated administration of d-amphetamine leads to an increased subjective and behavioral drug-response. This effect, termed "sensitization", is paralleled by an increase in dopamine release to levels akin to those observed in schizophrenia. Schizophrenia thus goes along with a state of 'natural sensitization' towards amphetamines. However, while it is known that DA synthesis and release are both enhanced in schizophrenia, it is unknown whether sensitization changes indices of presynaptic DA synthesis in the striatum of healthy subjects. Thus, for the first time, this project will study the effects of repeated d-amphetamine on uptake of the DA precursor [18F]FDOPA and on d-amphetamine-induced changes in binding of the D2/3 receptor agonist radioligand [11C]-(+)PHNO in a within-subject design. Before and after amphetamine sensitization by repeated intermittent administration subjects will receive an [18F]FDOPA and and a [11C]-(+)PHNO PET scan. For the investigation of the influence of functional and structural cortical properties on dopamine synthesis and release, functional and structural magnet resonance imaging will be performed before and after sensitization.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Healthy subjects | Experimental | Measurement of Dextroamphetamine Sulfate-induced dopamine release and synthesis before and after amphetamine sensitization. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Dextroamphetamine Sulfate | Drug | Repeated oral administration of dexamphetamine 0.4mg/KG bodyweight four times. |
|
| Measure | Description | Time Frame |
|---|---|---|
| [18F]FDOPA Ki values | Relative change in regional [18F]FDOPA Ki values after AMPH sensitization | Baseline and 2 weeks after amphetamine sensitization, Week 1 and Week 4 |
| Measure | Description | Time Frame |
|---|---|---|
| [11C]-(+)-PHNO BPND values | Relative change in regional [11C]-(+)-PHNO BPND values after AMPH administration before and after sensitization | Baseline and 2 weeks after amphetamine sensitization, Week 1 and Week 4 |
| Subjective ratings of amphetamine effects (Drug Effects Questionnaire) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Ana Weidenauer, MD | Contact | +43140400 | 38370 | ana.weidenauer@meduniwien.ac.at |
| Matthaeus Willeit, MD | Contact | +43140400 | 35690 | matthaeus.willeit@meduniwien.ac.at |
| Name | Affiliation | Role |
|---|---|---|
| Ana Weidenauer, MD | Medical University of Vienna | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Medical University of Vienna | Recruiting | Vienna | 1090 | Austria |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27613293 | Background | Weidenauer A, Bauer M, Sauerzopf U, Bartova L, Praschak-Rieder N, Sitte HH, Kasper S, Willeit M. Making Sense of: Sensitization in Schizophrenia. Int J Neuropsychopharmacol. 2016 Dec 31;20(1):1-10. doi: 10.1093/ijnp/pyw081. Print 2017 Jan. | |
| 27690184 | Background | Sauerzopf U, Sacco R, Novarino G, Niello M, Weidenauer A, Praschak-Rieder N, Sitte H, Willeit M. Are reprogrammed cells a useful tool for studying dopamine dysfunction in psychotic disorders? A review of the current evidence. Eur J Neurosci. 2017 Jan;45(1):45-57. doi: 10.1111/ejn.13418. Epub 2016 Oct 19. |
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| ID | Term |
|---|---|
| D012559 | Schizophrenia |
| D011618 | Psychotic Disorders |
| ID | Term |
|---|---|
| D019967 | Schizophrenia Spectrum and Other Psychotic Disorders |
| D001523 | Mental Disorders |
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| ID | Term |
|---|---|
| D003913 | Dextroamphetamine |
| ID | Term |
|---|---|
| D000661 | Amphetamine |
| D000662 | Amphetamines |
| D010627 | Phenethylamines |
| D005021 | Ethylamines |
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Subjective ratings will be assessed via questionnaire (Drug Effects Questionnaire) four times throughout the study. |
| Baseline, after i.v. amphetamine during PHNO PET, on each of the two sensitization visits and 2 weeks after amphetamine sensitization during PHNO PET scanning over the course of 4 weeks. Time points: Week 1 Week 2 Week 4 |
| Subjective ratings of amphetamine effects (Subjective States Questionnaire) | Subjective ratings will be assessed via questionnaire (Subjective States Questionnaire) four times throughout the study. | Baseline, after i.v. amphetamine during PHNO PET, on each of the two sensitization visits and 2 weeks after amphetamine sensitization during PHNO PET scanning over the course of 4 weeks. Time points: Week 1 Week 2 Week 4 |
| Cognitive measures | Working memory, reward processing and impulsivity will be assessed via a computerized test battery four times throughout the study | At baseline, on each of the two sensitization visits after amphetamine administration and 2 weeks after amphetamine sensitization before FDOPA scanning, total timeframe 4 weeks, Time points: Week 1 Week 2 Week 4 |
| Impulsiveness | The personality traits impulsiveness will be assessed once during study participation by the questionnaire Barrat Impulsiveness Scale (BIS). | Baseline, Week 1 |
| Personality-related markers | Personality traits like novelty seeking will be assessed once during study participation using the Temperament and Character Inventory (TCI). | Baseline, Week 1 |
| Peripheral markers of sensitization | Plasma concentration of the dopamine metabolite HVA, glucose and insulin metabolism related parameters (glucose, glucagon, insulin, c-peptide, somatostatin), plasma cocaine and AMPH-regulated transcript (CART) levels will be measured at each PET study day. | Baseline FDOPA scan, baseline PHNO + amphetamine scan, post-sensitization PHNO+ amphetamine scan, post-sensitization FDOPA scan, Time points: Week 1 Week 2 Week 4 |
| Salivary cortisol | Salivary cortisol will be assessed using Salivettes ®. | Salivary cortisol will be assessed each time amphetamine is administered: At baseline and 30, 60, 90, 145 and 210 minutes after i.v. or oral amphetamine administration. |
| Fractional anisotropy (diffusion-weighted tensor imaging) of white matter | Fractional anisotropy of white matter will be measured by means of magnet resonance imaging. | Before and after amphetamine sensitization, Week 1, Week 5 |
| Gray matter volume | Gray matter volume will be measured by means of magnet resonance imaging. T1 and PD sequences will be recorded. | Before and after amphetamine sensitization, Week 1, Week 5 |
| Functional connectivity | Functional connectivity between brain regions will be measured by means of magnet resonance imaging during a resting state of the subject. | Before and after amphetamine sensitization, Week 1, Week 5 |
| D000588 |
| Amines |
| D009930 | Organic Chemicals |