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Spectroscopy in Children and Adolescents With Bipolar Disorder

This study has been completed.
Sponsor:
ClinicalTrials.gov Identifier:
NCT00181831
First Posted: September 16, 2005
Last Update Posted: June 13, 2013
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
Collaborator:
Janssen Pharmaceutica
Information provided by (Responsible Party):
Joseph Biederman, MD, Massachusetts General Hospital
  Purpose
The primary aim of this study is to use proton magnetic resonance spectroscopy to look at myo-Inositol containing compounds (Ino) and creatine + phosphocreatine (Cr) in the anterior cingulate of 20 children with bipolar disorder between the ages of 6-17 years old free of risperidone treatment and 20 children with bipolar disorder after an eight-week or longer treatment with risperidone. For comparison, results will also be obtained from 20 controls (without bipolar disorder or ADHD) of the same age and gender as well as from 20 children or adolescents with a diagnosis of Attention Deficit Hyperactivity Disorder. We hypothesize that Ino/Cr levels in the anterior cingulate will correlate positively with manic symptoms using the Young mania rating scale (YMRS). Ino/Cr levels in the anterior cingulate in the anterior cingular gyrus will be lower in subjects who have received eight weeks or longer of risperidone

Condition Intervention
Bipolar Disorder ADHD Device: Proton Magnetic Resonance Spectroscopy

Study Type: Observational
Study Design: Observational Model: Cohort
Time Perspective: Prospective
Official Title: Proton Magnetic Resonance Spectroscopy in Children and Adolescents With Bipolar Disorder

Resource links provided by NLM:


Further study details as provided by Joseph Biederman, MD, Massachusetts General Hospital:

Estimated Enrollment: 80
Study Start Date: December 2002
Study Completion Date: November 2005
Primary Completion Date: November 2005 (Final data collection date for primary outcome measure)
Detailed Description:

Choline containing compound (Cho) and creatine + phosphocreatine (Cr) have been found to be greater in the orbitofrontal cortex of depressed adolescents. In addition, Cho/Cr has been found to increase in the anterior cingulate in depressed patients with bipolar affective disorder (BPD) compared with comparison subjects. Also, BPD subjects not taking antidepressants had a significantly higher anterior cingulate Cho/Cr compared with subjects taking antidepressants or comparison subjects. Therefore it would appear the frontal lobe Cho/Cr is increased in depression. Given these findings, we are interested in looking at subjects with mania to investigate if there may also be a biological marker for mania and drug response. Mania measured using the YMRS have been associated with an increase in the anterior cingulate Ino/Cr in manic children, adolescents, and adults with bipolar affective disorder. In addition, children and adolescents who were responsive to lithium showed a decrease in Ino/Cr levels after acute lithium treatment. We will test whether Ino/Cr levels will correlate positively with manic symptoms using the YMRS, as well as whether overall Ino/Cr levels will be lower for children and adolescents receiving risperidone.

The primary aim of this study is to use proton magnetic resonance spectroscopy to look at myo-Inositol containing compounds (Ino) and creatine + phosphocreatine (Cr) in the anterior cingulate of 20 children with bipolar disorder between the ages of 6-17 years old free of risperidone treatment and 20 children with bipolar disorder after an eight-week or longer treatment with risperidone. For comparison, results will also be obtained from 20 controls (without bipolar disorder or ADHD) of the same age and gender as well as from 20 children or adolescents with a diagnosis of Attention Deficit Hyperactivity Disorder. We hypothesize that Ino/Cr levels in the anterior cingulate will correlate positively with manic symptoms using the Young mania rating scale (YMRS). Ino/Cr levels in the anterior cingulate in the anterior cingular gyrus will be lower in subjects who have received eight weeks or longer of risperidone

  Eligibility

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Ages Eligible for Study:   6 Years to 17 Years   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population
20 children with bipolar disorder between the ages of 6-17 years old free of risperidone treatment and 20 children with bipolar disorder after an eight-week or longer treatment with risperidone.
Criteria

Inclusion Criteria:

  1. Male or female subjects, 6-17 years of age
  2. Subject and parent must have a level of understanding sufficient to communicate intelligently with the investigator and study coordinator, and to cooperate with all tests and examinations required by the protocol
  3. Subjects and their legal representatives must be considered reliable
  4. Each subject and his/her authorized legal representative must understand the nature of the study. The subject's authorized legal representative must sign an informed consent document and the subject must sign an informed assent document.
  5. Bipolar subjects must have a diagnosis of bipolar I or bipolar II disorder with a lifetime manic or mixed episode (with or without psychotic features) according to the DSM-IV confirmed by structured diagnostic interview (KSADS)
  6. ADHD subjects must meet full criteria for ADHD (with or without hyperactivity) according to the DSM-IV confirmed by structured diagnostic interview (KSADS)

Exclusion Criteria:

  1. Investigator and his/her immediate family; defined as the investigator's spouse, parent, child, grandparent, or grandchild.
  2. Pregnant of nursing females
  3. Presence of metal or surgical devices (aneurysm clips, metal plates, cochlear implants, neurostimulators, braces, and other items) in vital areas.
  4. Severe phobia of being in small, enclosed spaces (claustrophobic)
  5. Bipolar subjects must either have been free of antipsychotic medication (including risperidone) for 3 months of longer OR be currently treated with risperidone for 8 weeks or longer.
  6. ADHD subjects must not meet criteria for bipolar disorder by structured interview (KSADS). These subjects must be free of antipsychotic medication for 3 months or longer).
  7. Control subjects must not meet criteria for ADHD or bipolar disorder by structured interview (KSADS). These subjects must be free of antipsychotic medication treatment for 3 months or longer.
  8. Left hand dominant subjects will be excluded
  Contacts and Locations
Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00181831


Locations
United States, Massachusetts
Massachusetts General Hospital
Boston, Massachusetts, United States, 02114
Sponsors and Collaborators
Massachusetts General Hospital
Janssen Pharmaceutica
Investigators
Principal Investigator: Joseph Biederman, MD Massachusetts General Hospital
  More Information

Responsible Party: Joseph Biederman, MD, Principal Investigator, Massachusetts General Hospital
ClinicalTrials.gov Identifier: NCT00181831     History of Changes
Other Study ID Numbers: 2002-P-000661
First Submitted: September 13, 2005
First Posted: September 16, 2005
Last Update Posted: June 13, 2013
Last Verified: June 2013

Keywords provided by Joseph Biederman, MD, Massachusetts General Hospital:
SPECT
bipolar disorder
ADHD
children

Additional relevant MeSH terms:
Disease
Bipolar Disorder
Pathologic Processes
Bipolar and Related Disorders
Mental Disorders