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Trial registered on ANZCTR
Registration number
ACTRN12617001339347p
Ethics application status
Submitted, not yet approved
Date submitted
20/08/2017
Date registered
21/09/2017
Date last updated
25/07/2019
Date data sharing statement initially provided
20/11/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Effects of lithium and fampridine on electroencephalography profiles in healthy volunteers
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Scientific title
Effects of lithium and fampridine on electroencephalography profiles in healthy volunteers
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Secondary ID [1]
292588
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
Li 4AP EEG
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Bipolar Disorder
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Condition category
Condition code
Mental Health
303722
303722
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0
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Depression
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Mental Health
303729
303729
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0
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Other mental health disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Pilot study.
Participants will be assigned to one of 4 oral treatment groups: placebo, lithium (750mg), fampridine (1mg or 2mg).
Allocation to a treatment group will be carried out by a computer generated random code. Daily doses of one of the 4 treatments will be administered for 7 days.
On the first, second and last days of the study (before dosing, post single dose and post 1 week of dosing) participants will have a (10 minute) resting state EEG recorded.
Adherence will be monitored by checking participants' drug containers at the end of each dosing week, and also sending daily text messages to participants to remind them to take their study treatments.
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Intervention code [1]
298889
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Treatment: Drugs
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Comparator / control treatment
The placebo capsule will contain lactose.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Composite primary outcome.
Statistically significant differences in activity in infraslow (<1Hz), delta (1-4Hz), theta (4-7
Hz), alpha (8-13Hz), beta (13-30Hz) and gamma (>30Hz) bands in EEG data in response to drug treatments (versus placebo control and normative EEG database).
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Assessment method [1]
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Timepoint [1]
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Baseline and end of treatment period
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Primary outcome [2]
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Composite primary outcome.
Statistically significant differences in functional connectivity in infraslow (<1Hz), delta (1-4Hz), theta (4-7
Hz), alpha (8-13Hz), beta (13-30Hz) and gamma (>30Hz) bands in EEG data in response to drug treatments (versus placebo control and normative EEG database).
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Assessment method [2]
303250
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Timepoint [2]
303250
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Baseline and end of treatment period
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Secondary outcome [1]
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Changes in visual analogue mood scale scores.
Self rated mood (happy, sad, calm, tense, energetic, sleepy) rated from 0 (not at all) to 100 (extremely)
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Assessment method [1]
337864
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Timepoint [1]
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Immediately prior to EEG recording
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Secondary outcome [2]
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Safety and tolerability. Endpoints include: vital signs (blood pressure, heart rate), reported adverse events.
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Assessment method [2]
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Timepoint [2]
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Pre-dose to 3h post-dose (continuous) on clinic visit days.
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Secondary outcome [3]
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Pharmacokinetics of lithium and fampridine.
The pharmacokinetic parameter for lithium and fampridine is C2h (drug concentrations at the time the EEG is being recorded).
This is a composite secondary outcome.
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Assessment method [3]
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Timepoint [3]
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Two hours after dosing on treatment days when EEGs are performed (day 2 and day 8).
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Eligibility
Key inclusion criteria
To be included in the study, participants must meet all of the following inclusion criteria:
1. Capable of understanding and signing an informed consent.
2. Aged >18 years on the day of consent.
3. Good general health.
4. Suitable venous access.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
To be included in the study, participants must meet none of the following exclusion criteria:
1. Females who are or intend to become pregnant, or are lactating.
2. Participants who, in the opinion of the investigator, do not understand the information and procedures of the study, or would not be compliant with them (in particular the study restrictions and risks involved).
3. Any participant for whom the investigator believes, for any reason, that participation would not be an acceptable risk.
4. Regular use of any drug that alters mood or is used to treat mental disorder, including daily use of alcohol or use of alcohol within 24 hours of testing.
5. Subjects with a prior history of seizures; susceptibility to photosensitivity; or a history of allergic skin reactions.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Central randomisation by phone/fax/computer
Prof Glue will create the random codes. All study personnel involved with recruitment, dosing, data collection and analysis will have no access to the random codes until the databases are locked.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software (i.e. computerised sequence generation)
Allocation to blinded study treatment (placebo, lithium, fampridine) is by random code with administration sequence balanced, and includes gender as a stratification factor.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Crossover
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Other design features
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Phase
Phase 1
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Type of endpoint/s
Pharmacokinetics / pharmacodynamics
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/08/2019
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Actual
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Date of last participant enrolment
Anticipated
20/12/2019
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Actual
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Date of last data collection
Anticipated
27/12/2019
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Actual
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Sample size
Target
24
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
9146
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Otago
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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University of Otago
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Address [1]
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PO Box 56
Dunedin, 9054
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Country [1]
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New Zealand
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Primary sponsor type
University
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Name
University of Otago
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Address
PO Box 56
Dunedin, 9054
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
296183
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Address [1]
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Country [1]
296183
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
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Northern A HDEC
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Ethics committee address [1]
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Ministry of Health Health and Disability Ethics Committees PO Box 5013 Wellington 6140
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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01/03/2018
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Approval date [1]
298332
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Ethics approval number [1]
298332
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Summary
Brief summary
Lithium is the first line treatment for bipolar disorder (BD), a disorder characterised by cyclic perturbations in mood, correlated with aberrant patterns of brain connectivity and rhythmicity in distributed brain networks. These patterns of activity, reflecting the intrinsic electrophysiological properties of constituent neurons, are dependent upon membrane ion channel function. BD is strongly associated with disturbances in genes responsible for ion channel expression, localisation and structure and can be treated with some antiepileptic drugs, acting directly on ion channels. Thus, ion channel dysfunction is strongly implicated in BD, however, lithium has had no known effect on ion channels. Recently, we found that lithium selectively blocks a specific K+ current, the delay current (ID), found in several types of brain neuron. ID can influence action potential threshold and output timing, how inputs from different synaptic sources are integrated, and network synchrony and rhythmicity. Output timing (gating) and synchrony are important variables in brain network function, contributing to the formation and dissolution of functional brain networks over time. Modulation of ID, including by lithium, may influence patterns of connectivity and rhythmicity in the brain and could explain the effectiveness of lithium in BD. We have found, additionally, that Fampridine (4AP), a prescription treatment for multiple sclerosis, blocks ID in cortical projection neurons in vitro. We therefore hypothesise, that Fampridine may act as an adjunctive or replacement therapy for lithium in BD. In order to assess this hypothesis, we aim to examine activity and functional connectivity changes in EEG recordings of healthy volunteers in the presence of lithium, Fampridine and placebo control. The specific objectives of the study are: • To examine the early and late effects of dose (Fampridine) and dose timing of lithium and Fampridine on EEG changes in healthy volunteers. • To evaluate the magnitude and duration of affective changes following administration of lithium, Fampridine or placebo in healthy volunteers. Blood testing will also show any associations of cognitive changes with levels of Li+ / Fampridine and its metabolites in the participant’s bloodstream.
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Trial website
None
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Paul Glue
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Address
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Department of Psychological Medicine
Dunedin School of Medicine
University of Otago
PO Box 56
Dunedin 9054
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Country
76746
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New Zealand
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Phone
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+64 21 243 3372
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Fax
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Email
76746
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[email protected]
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Contact person for public queries
Name
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Paul Glue
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Address
76747
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Department of Psychological Medicine
Dunedin School of Medicine
University of Otago
PO Box 56
Dunedin 9054
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Country
76747
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New Zealand
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Phone
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+64 3 4709451
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Fax
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Email
76747
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[email protected]
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Contact person for scientific queries
Name
76748
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Paul Glue
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Address
76748
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Department of Psychological Medicine
Dunedin School of Medicine
University of Otago
PO Box 56
Dunedin 9054
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Country
76748
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New Zealand
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Phone
76748
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+64 21 243 3372
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Fax
76748
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Email
76748
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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