Effect of Single Dose Intranasal Insulin On Cognitive Function - Full Text View

Purpose

The purpose of the study is to find out how a small dose of insulin might affect memory, the ability to concentrate, and improve your daily functioning in patients with schizophrenia and schizoaffective disorders. Insulin is not being used to treat diabetes in this study. The investigators propose a single dose, double-blinded, placebo-controlled trial of intranasal insulin in 40 subjects with schizophrenia or schizoaffective disorder to examine insulin's effect on cognition. The specific aims include:

Examine the effects of single doses of 40 IU intranasal insulin compared to placebo on cognitive functioning, including attention and memory.
Examine whether single dose of intranasal insulin administration will raise serum insulin level and decrease plasma glucose level

Insulin will be delivered through an air spray pump into your nose. The investigators will be comparing one dose of insulin (40 International Units) with placebo, an inactive liquid.

Condition	Intervention	Phase
Schizophrenia Schizoaffective Disorder	Drug: Placebo Drug: Insulin (Humulin)	Phase 4


Study Type:	Interventional
Study Design:	Allocation: Randomized Intervention Model: Parallel Assignment Masking: Double Blind (Participant, Care Provider, Investigator) Primary Purpose: Treatment
Official Title:	Effect of Single Dose Intranasal Insulin on Cognitive Function in Patients With Schizophrenia

Resource links provided by NLM:

Genetics Home Reference related topics: schizophrenia

MedlinePlus related topics: Schizophrenia

Drug Information available for: Insulin Insulin human

U.S. FDA Resources

Further study details as provided by Xiaoduo Fan, University of Massachusetts, Worcester:

Primary Outcome Measures:

Improvement in Cognitive Function- HVLT Immediate Recall Total (Number) [ Time Frame: pretreatment= in the morning; postreatment= in the afternoon, 30 minutes after intranasal spray administration ]
Subjects performed the HVLT Immediate Recall Task. For this task, participants were read aloud a list of 12 words from three taxonomic categories. Participants were read the list three separate times, and after each reading were immediately asked to recall as many words from the list as they could. The number of words recalled successfully was measured before and after intranasal treatment. Values below represent posttreatment performance minus pretreatment performance.
Improvement in Cognitive Function- HVLT-Delayed Recall (Number) [ Time Frame: pretreatment= in the morning; postreatment= in the afternoon, 30 minutes after intranasal spray administration ]
Subjects performed the HVLT word recall task after a 20-minute delay before and after intranasal treatment. In the HVLT delayed recall task, participants were asked to recall the same list of 12 words dictated in the immediate recall task 20 minutes after the completion of the immediate recall task. Words successfully recalled after the 20-minute delay were measured. Values below represent posttreatment performance minus pretreatment performance.
CPT d Score [ Time Frame: pretreatment= in the morning; postreatment= in the afternoon, 30 minutes after intranasal spray administration ]
Subjects performed a computer-based test designed to measure sustained attention (attention to a specific stimuli over a period of several minutes) before and after intranasal treatment. During this test, participants respond as quickly as possible to any consecutive presentation of identical stimuli on the computer screen. The stimuli (2, 3, and 4-digit targets) were presented with increasing cognitive load in successive blocks. Correct responses, responses made to the second of 2 identical stimuli presented in a row, were scored as hits. False alarms were also recorded. The "d prime score" is a score given to each participant on a scale of 0.0- 1.0 in which discrimination sensitivity is measured. A score of zero equates to no sensitivity, whereas a score of 1.0 equates to perfect sensitivity. Values below represent postreatment performance minus pretreatment performance.
Improvement in Cognitive Function- CPT Hits Rate (Proportion) [ Time Frame: pretreatment= in the morning; postreatment= in the afternoon, 30 minutes after intranasal spray administration ]
Subjects performed a computer-based test designed to measure sustained attention before and after intranasal treatment. The task is described in the previous outcome measure ("CPT d score"). Hits rate refers to each participant's ability to correctly respond to two consecutive target presentations (i.e. correct responses). Hits rate was measured as a proportion of overall attempts (0= no hits, 1.0= 100% accuracy on hits). Values below represent posttreatment performance minus pretreatment performance.
Improvement in Cognitive Function- CPT Reaction Time of Hits (Milliseconds) [ Time Frame: pretreatment= in the morning; postreatment= in the afternoon, 30 minutes after intranasal spray administration ]
Subjects performed a computer-based test designed to measure sustained attention before and after intranasal treatment. The task is described in detail in a previous outcome measure ("CPT d score"). Reaction time of hits refers to the average time each participant took to correctly respond to a stimuli in milliseconds. Values below represent posttreatment performance minus pretreatment performance.
Improvement in Cognitive Function- CPT False Alarm Rate (Proportion) [ Time Frame: pretreatment= in the morning; postreatment= in the afternoon, 30 minutes after intranasal spray administration ]
Subjects performed a computer-based test designed to measure sustained attention before and after intranasal treatment. The task is described in detail in a previous outcome measure ("CPT d score"). False alarm rate refers to the proportion of overall attempts that were characterized as incorrect responses (responses to two non-identical targets). Values below represent posttreatment performance minus pretreatment performance.


Enrollment:	30
Study Start Date:	October 2006
Study Completion Date:	January 2010
Primary Completion Date:	January 2010 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Placebo Comparator: Placebo (1) Subjects are given a one-time, single dose of placebo intranasal spray	Drug: Placebo Placebo
Experimental: Single-Dose Intranasal Insulin Subjects are given a one-time, single dose of intranasal insulin	Drug: Insulin (Humulin) 40 IU Intranasal Insulin will be administered once Other Name: Humulin

Detailed Description:

Insulin signaling in the brain is associated with improved cognitive function in both animal and human studies. Intranasal administration of insulin, which is non-invasive and minimizes the risk of hypoglycemia, may represent a new intervention approach with the potential to improve cognition and real life functioning in this patient with schizophrenia.

Eligibility


Ages Eligible for Study:	18 Years to 65 Years (Adult)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	Yes

Criteria

Inclusion Criteria:

Age 18-65 years
Diagnosis of schizophrenia, any subtype or schizoaffective disorder, any subtype
Male or female
Stable dose of the current antipsychotic drug for at least one month
Well established compliance with out-patient treatment per treating clinician's judgement.
Able to complete the cognitive assessment battery (must be English speaking)

Exclusion Criteria:

Inability to provide informed consent
Current substance abuse
On clozapine or olanzapine
Psychiatrically unstable per treating clinician's judgement.
Significant medical illnesses including uncontrolled hypertension, diabetes, seizure disorder, severe cardiovascular, cerebrovascular, pulmonary, or thyroid diseases etc.
Incapable to complete the cognitive battery assessment.

Contacts and Locations

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00646581

Locations


United States, Massachusetts
Freedom Trail Clinic
Boston, Massachusetts, United States, 02114

Sponsors and Collaborators

University of Massachusetts, Worcester

Investigators


Principal Investigator:	Xiaoduo Fan, MD, MPH, MS	UMass Medical School

More Information


Responsible Party:	Xiaoduo Fan, Principal Investigator, University of Massachusetts, Worcester
ClinicalTrials.gov Identifier:	NCT00646581 History of Changes
Other Study ID Numbers:	4-2006 CORRC tracking number: 4-2006
Study First Received:	January 31, 2008
Results First Received:	August 17, 2012
Last Updated:	February 12, 2013

Keywords provided by Xiaoduo Fan, University of Massachusetts, Worcester:


Schizophrenia Memory Concentration Insulin

Additional relevant MeSH terms:


Schizophrenia Psychotic Disorders Schizophrenia Spectrum and Other Psychotic Disorders Mental Disorders	Insulin, Globin Zinc Insulin Hypoglycemic Agents Physiological Effects of Drugs

ClinicalTrials.gov processed this record on June 21, 2017