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Trial registered on ANZCTR
Registration number
ACTRN12620001222932
Ethics application status
Approved
Date submitted
3/08/2020
Date registered
16/11/2020
Date last updated
7/07/2021
Date data sharing statement initially provided
16/11/2020
Type of registration
Prospectively registered
Titles & IDs
Public title
Developing a biomarker for anxiety disorders
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Scientific title
Do hippocampus, insula and amygdala contribute to an anxiety syndrome biomarker in healthy participants and patients with anxiety disorder when given anxiolytic medications?
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Secondary ID [1]
301934
0
'None'
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Universal Trial Number (UTN)
U1111-1256-4071
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Anxiety
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Panic
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Simple Phobia
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Generalized Anxiety
318465
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Social Anxiety
318809
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Psychological Distress
318810
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Condition category
Condition code
Mental Health
316471
316471
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0
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Anxiety
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Mental Health
316472
316472
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0
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Studies of normal psychology, cognitive function and behaviour
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Mental Health
316822
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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
Benzodiazepine (Triazolam):
-The administered doses (0.25 mg),
-once only,
-Oral tablet,
Buspirone:
-the administered doses (10 mg)
-once only
-Oral tablet
Pregabalin:
- the administered doses (75 mg)
- once only
- Oral tablet
Prozac/Fluoxetine:
- the administered doses (20 mg)
- once only
- Oral tablet
Each participant will receive one of these drug or placebo. We will obtain questionnaire measures of current mood and personality; Administer blinded study treatment; Wait 0.5 hour; Record fMRI in the SST or in the AACT; Repeat questionnaire measures of current mood (to assess mood changes); Ask participant to remain until it is safe to leave. Each cohort will complete their allocated task either SST or AACT.
We will recruit healthy volunteers (who have not received any medical or psychological treatment for anxiety, depression or emotional disorder within the last 12 months) and will follow the same procedure described in item 3 above. Patients with DSM-5 generalized anxiety (GAD); and social anxiety disorder (SAD) will be recruited and will follow the same procedure described above.
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Intervention code [1]
318222
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Diagnosis / Prognosis
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Comparator / control treatment
Placebo (glucose oral capsule) in a tablet form.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Change in brain networks assessed using fMRI
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Assessment method [1]
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Timepoint [1]
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30 minutes after intervention
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Primary outcome [2]
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Compare the fMRI changes between healthy and diseased brains specially the task related changes in hippocampus and insula.
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Assessment method [2]
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Timepoint [2]
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30 minutes
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Primary outcome [3]
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Changes in HAM-A and STAI-T because of acute administration of anxiolytic drugs. (This is a composite outcome)
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Assessment method [3]
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Timepoint [3]
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2 hour after dosing.
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Secondary outcome [1]
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Use fMRI to investigate whether hippocampus is involved in anxiety processes,
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Assessment method [1]
385232
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Timepoint [1]
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2 hours after intervention
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Secondary outcome [2]
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Use fMRI to investigate whether amygdala is involved in panic.
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Assessment method [2]
387318
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Timepoint [2]
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2 hours
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Eligibility
Key inclusion criteria
We will recruit healthy participants.
Inclusion Criteria:
1. Capable of understanding and signing an informed consent
2. Aged 18-40 years on the day of consent.
3. Volunteers with no major illness in the previous 30 days
4. With no regular use of psychotropic medication in the last 12 months
5. No use of alcohol in the 24 hours before testing
For the clinical comparison, patients with DSM-5 generalized anxiety (GAD); and social anxiety disorder (SAD) will be recruited for our project
Inclusion Criteria:
1. 18-40 years old
2. suffering from ongoing symptoms of anxiety, fear, or panic and who are intending to seek treatment for this
3. otherwise be healthy (with no major illness in the previous 30 days)
4. with no regular use of psychotropic medication in the last 6 months and
5. no use of alcohol in the 24 hours before testing.
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Minimum age
18
Years
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Maximum age
40
Years
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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
Healthy Volunteers:
Exclusion Criteria:
- Susceptibility to photosensitivity
- A history of seizure
- Any metal in your body, e.g., cardiac pacemaker, cochlea implant, intracranial vessel clips, artificial heart valve or vascular stent; a history of metal fragments in the eye; shrapnel within the body
- Are either pregnant or think you might be
- A history of claustrophobia
- Have received any medical or psychological treatment for anxiety, depression or emotional disorder within the last 12 months.
- Have a prior history of drug abuse
- Are suffering from acute or chronic physical disease such as heart and lung disease, influenza, diabetes, acute infections
- Are recovering from an accident, injury or operation.
Patient Volunteers (GAD and SAD)
Exclusion Criteria:
- Susceptibility to photosensitivity
- A history of seizure
- Any metal in your body, e.g., cardiac pacemaker, cochlea implant, intracranial vessel clips, artificial heart valve or vascular stent; a history of metal fragments in the eye; shrapnel within the body
- Are either pregnant or think you might be
- A history of claustrophobia
- Have a prior history of drug abuse
- Are suffering from acute or chronic physical disease such as heart and lung disease, influenza, diabetes, acute infections
- Are recovering from an accident, injury or operation.
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Study design
Purpose of the study
Diagnosis
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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)
sealed opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Permuted block randomisation.
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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
Parallel
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Other design features
None
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
We will recruit 80 (20 in each intervention group) healthy volunteers for 4 different drugs. We will collect additional 160 healthy volunteers in fMRI to map the brain structures involved in anxiolytics and panicolytics response. We will recruit 60 patient volunteers to validate our findings. We will use ANOVA to investigate the differences in healthy and diseased brain and map the relevant brain areas responsible for anxiety and panic.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/12/2020
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Actual
15/03/2021
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Date of last participant enrolment
Anticipated
31/12/2023
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Actual
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Date of last data collection
Anticipated
31/12/2023
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Actual
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Sample size
Target
300
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Accrual to date
55
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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]
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Otago
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Health Research Council of New Zealand
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Address [1]
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Level 3 - ProCARE Building, Grafton Mews, at 110 Stanley Street (GPS: 50 Grafton Road), Grafton, Auckland 1010
Postal address:PO Box 5541, Victoria Street West, Auckland 1142
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Country [1]
306348
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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
362 Leith Street
Dunedin 9016
New Zealand
PO Box 56
Dunedin 9054
New Zealand
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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]
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Address [1]
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Country [1]
307692
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Other collaborator category [1]
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University
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Name [1]
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Professor Paul Glue
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Address [1]
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Department of Psychological Medicine
Otago Medical School
PO Box 56
Dunedin 9054
University of Otago
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Country [1]
281545
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
306558
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Northern B Health and Disability Ethics Committee
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Ethics committee address [1]
306558
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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]
306558
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New Zealand
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Date submitted for ethics approval [1]
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20/08/2020
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Approval date [1]
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06/11/2020
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Ethics approval number [1]
306558
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20/NTB/196
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Summary
Brief summary
Anxiety disorders” are the commonest mental disorders in New Zealand; but their diagnosis is still based on clinical symptom check lists not biological markers of specific causes. In our well-established neuropsychological theory, anxiety involves threat-approach controlled by specific brain structures in which hypersensitivity to input generates specific clinical syndromes. We have developed a specific non-invasive biomarker for threat-approach system activation in humans that shows hyperactivity in some clinical cases with source localisation to right inferior frontal regions. Our project will test this with fMRI and test for the involvement, predicted by our theory, of hippocampus, insula and amygdala. This should provide better understanding of the underlying causes of anxiety and ultimately provide targeted treatments; greatly improving treatment outcomes and cost-effectiveness.
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Trial website
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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 Neil McNaughton
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Address
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Department of Psychology
University of Otago
PO Box 56
Dunedin 9054
New Zealand
Department of Psychology
University of Otago
William James Building
Level 1
275 Leith Walk
Dunedin 9016
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Country
104282
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New Zealand
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Phone
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+64 34797634
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Shabah Shadli
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Address
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Department of Psychology
University of Otago
William James Building
Level 1
275 Leith Walk
Dunedin 9016
Department of Psychology
University of Otago
PO Box 56
Dunedin 9054
New Zealand
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Country
104283
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New Zealand
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Phone
104283
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+64 34795835
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Fax
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Email
104283
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[email protected]
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Contact person for scientific queries
Name
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Shabah Shadli
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Address
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Department of Psychology
University of Otago
William James Building
Level 1
275 Leith Walk
Dunedin 9016
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Country
104284
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New Zealand
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Phone
104284
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+64 34795835
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Fax
104284
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Email
104284
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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)?
Yes
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What data in particular will be shared?
All of the individual participant data collected during the trial, after de-identification will be shared.
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When will data be available (start and end dates)?
31/12/2023 to 31/12/2025
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Available to whom?
Only researchers who provide a methodologically sound proposal, case-by-case basis at the discretion of Primary Sponsor.
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Available for what types of analyses?
To achieve the aims in the approved proposal, or for IPD meta-analyses.
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How or where can data be obtained?
access subject to approvals by Principal Investigator (please contact Dr Shabah Shadli (
[email protected]
) or Professor Neil McNaughton (
[email protected]
)
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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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