Norman Cousins Center for Psychoneuroimmunology, University of California, Los Angeles
Los Angeles, California, 90095, United States
NCT Number: NCT05363527
The purpose of this study is to use an experimental inflammatory challenge to examine whether older adults with symptoms of anxiety experience loss of pleasure or loss of motivation when they are exposed to inflammation. Loss of pleasure or loss of motivation will be evaluated using self-report questionnaires, computer tasks, and during a brain scan.
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Notify Me60 year–80 year
All sexes
Interventional
Phase 1
Los Angeles, California, 90095, United States
Participants will undergo phone screening, two in-person visits, and telephone follow-up. The first visit will last 4 hours and the second visit will last 10.5 hours. Phone screening and follow-up will take no longer than 30 minutes.
Phone Screening and Visit #1:
Following phone screening to determine potential eligibility, participants will have an in-person evaluation. Following informed consent in the first session, participants will undergo semi-structured clinical interviews and complete questionnaires to assess medical- and medication histories; current- and past history of psychiatric disorders, and evaluation of behavioral symptoms of anxiety and depression. They will also complete computer tasks that assess motivation and sensitivity to reward. As part of one of these tasks, they will be asked to provide a picture of a loved one, which they will later view during a fMRI scan.
Visit #2 and telephone follow-up:
The second session will be about two weeks later. It will begin at 7:30AM and will involve placement of two intravenous catheters (one in each arm), evaluation of heart rate and blood pressure, administration of endotoxin vs. placebo, repeated blood sampling along with questionnaires about mood and symptoms for approximately 10.5 hours. Two hours post-injection participants will complete a 1-hour brain scan that includes tasks to assess motivation and sensitivity to reward. Study staff will escort the participant to a nearby facility to complete the brain scan. 24 hrs and 2-weeks following this session, study staff will call the subject and ask about physical and mood symptoms, using the same set of items used during the experimental protocol.
Healthy volunteers accepted: Yes
Only the study team can determine whether someone qualifies for participation.
Inclusion criteria
Exclusion criteria
Endotoxin
Placebo
Time frame: approximately 2 hours post-injection for 7 minutes
Task-based functional magnetic resonance imaging (fMRI) will be used to assess reward motivation, as operationalized by ventral striatum (VS) activity during anticipation of monetary reward cue trials vs no-reward cue trials during the Monetary Incentive Delay Task.
Time frame: approximately 2 hours post-injection for 14 minutes
Task-based functional magnetic resonance imaging (fMRI) will be used to assess effort-based motivational processing, as assessed by VS, ventromedial prefrontal cortex (vmPFC), and pre-supplementary motor area (pre-SMA) activity with choice phase as event onset during an adapted version of the Effort Expenditure for Rewards Task (EEfRT).
Time frame: approximately 2 hours post-injection for 14 minutes
Task-based functional magnetic resonance imaging (fMRI) will be used to assess sensitivity for monetary reward, as operationalized by VS and VMPFC activity during receipt of monetary reward (vs. fixation) and during choice of low vs. high reward trials during the EEfRT.
Time frame: approximately 2 hours post-injection for 10 minutes
Sensitivity for non-monetary reward as assessed by VS and VMPFC activity when viewing positive non-social vs neutral images, and when viewing positive social vs. neutral images, in a positive picture viewing task.
Time frame: 2 hours post-injection for 7 minutes
Resting-state functional connectivity will be assessed over a 7-minute period, focusing on functional connectivity between the ventromedial prefrontal cortex and ventral striatum.
Time frame: approximately 2 hours post-injection for 7 minutes
Task-based functional magnetic resonance imaging (fMRI) will be used to assess social reward motivation, as operationalized by ventral striatum (VS) activity during anticipation of social reward cue trials vs no-reward cue trials on the Social Incentive Delay Task.
Time frame: approximately 2 hours post-injection for 7 minutes
Motivational processing for a close other social reward will be assessed with the Social Incentive Delay Task as VS activity during anticipation of viewing images of a close other (vs no-reward cue).
Time frame: 2 hours post-injection
Motivational processing for a close other social reward will be assessed as self-reported desire to be around the close other on a scale of 1 (not at all) to 7 (a lot).
Time frame: approximately 2 hours post-injection for 7 minutes
Sensitivity for monetary reward as assessed by VS and VMPFC activity during outcome (reward vs. no-reward) and anticipation (low vs. high reward cues) on the Monetary Incentive Delay task.
Time frame: approximately 2 hours post-injection for 7 minutes
Sensitivity for social reward as assessed by VS and VMPFC activity during outcomes (reward vs. no-reward) on the Social Incentive Delay Task.
Time frame: approximately 2 hours post-injection for 7 minutes
Reward sensitivity for a close other will be assessed as VS and VMPFC activity during the outcome phase (close other reward vs no-reward outcomes) and anticipation phase (general social reward vs. close other social reward cue anticipation) on the Social Incentive Delay Task.
Time frame: Pre-injection and approximately 2 hours post-injection
Motivation for monetary reward is assessed with an Effort Expenditure for Rewards Task (EEfRT); willingness to exert physical effort for monetary reward (i.e., selection of hard vs easy tasks) is the outcome measure with higher willingness indicative of higher motivation.
Time frame: Pre-injection and approximately 2 hours post-injection
Implicit reward learning and sensitivity to monetary reward is assessed with the probabilistic reward task (PRT); change in the magnitude of response bias from baseline to post-injection is the outcome measure. Higher response bias indicates higher reward sensitivity/learning.
Time frame: 10 hours
The Depressed Mood Subscale of the POMS is a self-reported assessment of depressed mood in which subjects rate severity of depressed mood using a visual analog scale from 1 to 10 (10 being most severe). Each timepoint is scored and analyses examine the temporal profile of change with assessment every hour
Time frame: 10 hours
This task will evaluate motivation for reward by subjective reports of interest in engaging in a variety of social and non-social activities on a 1 to 5 Likert scale on an hourly basis, with higher score indicating more interest. Each timepoint is scored and analyses examine the temporal profile of change with assessment at baseline and at 1 hour intervals post-injection.
Time frame: approximately 2 hours post-injection for 14 minutes
Behavioral performance on the Monetary and Social Incentive Delay Tasks is tested as reaction time for reward vs no- reward cue trials (an index of motivation) and reaction time for low vs. high reward trials (an index of sensitivity to changes in reward magnitude).
Time frame: approximately 2 hours post-injection for 10 minutes
Sensitivity for non-monetary reward assessed by self-report affect when viewing positive non-social vs neutral images, and when viewing positive social vs. neutral images, on a 1(extremely negative affect) to 4(extremely positive affect) scale.
Time frame: Pre-injection and 2 hours post-injection
Sensitivity for monetary reward assessed by the degree to which higher potential winnings predict hard task choice.
Time frame: Baseline and 3 hours post-injection for five minutes
This is a short computer-based task used to test emotion detection with a face morphing task. Faces morph from neutral to expressions of emotions (happy, sad, angry, or fearful) and participants indicate when and what emotion is presented; the dependent variables are reaction time and accuracy.
Time frame: Baseline and 3 hours post-injection for five minutes
This is a short computer-based task used to test attentional bias towards positive and negative valenced facial expressions (low arousal happy, high arousal happy, sad, angry) relative to neutral faces. Higher attentional bias scores indicate greater bias towards emotion.
Time frame: 10 hours
Systemic inflammation as measured by circulating levels of interleukin-6 in plasma in pg/ml. Each timepoint is assayed and analyses examine the temporal profile of change with assessment every hour
Time frame: baseline and .5, 1, and 2 hours post-injection
Transcriptional profile of inflammation as measured by Conserved Translational Response to Adversity in circulating peripheral blood mononuclear cells
Time frame: Baseline and 4 hours post-injection for 10 minutes.
The Antisaccade task is used to assess Inhibition. Participants are tasked with inhibiting a reflexive response towards a visual cue in order to correctly identify a target stimulus presented elsewhere. For each of 72 trials, participants view a centrally positioned fixation point (the letter X) on the computer screen for a variable amount of time (1500-3500ms). A visual cue (a black circle) is then presented on one side of the computer screen for 225ms. The target stimulus (a number from 1 to 9) is presented on the opposite side of the screen for 250, 233, or 200ms before being masked by gray cross-hatching. The participant verbally reports the target number to a trained research assistant or recording device or uses the keyboard to indicate the number. The participant does not receive feedback regarding accuracy, and there is no time limit for participant response for each trial.
Time frame: Baseline and 4 hours post-injection for 10 minutes.
The Spatial 2-Back task is used to assess Updating, the ability to monitor and replace information in working memory. For each of 120 trials, participants view an array of boxes, 11 white and 1 black. The location of the black box varies across trials. Participants are tasked with using one of two keys to indicate whether the black box is presented in the same location as it was two trials back. Participants do not receive feedback regarding accuracy, and trials proceed automatically if a response is not made within 2000ms. The task includes 20 practice trials
Time frame: Baseline and 4 hours post-injection for 10 minutes.
The Color-Shape task is used to assess Shifting, or the ability to switch between mental sets. For each of 104 trials, participants are presented with a circle or square that is of blue or red color. Participants are asked to use 1 of 2 keys to indicate whether the figure is red or blue (52 color trials) or square or triangle (52 shape trials). One key is paired with a color and a shape (e.g., red and square) and one key is paired with the other color and shape (e.g., blue and circle). For each trial, the letter C or S is presented above the figure to indicate color versus shape trials. The order of C/S trials is randomized, and there is no time limit for participant response for each trial. A quiet "ding" occurs following incorrect trials. The task includes 52 practice trials: 26 color followed by 26 shape trials.
Time frame: 10 hours
Depressed mood and depressive symptom severity by self-reported assessment using the Montgomery Asberg Depression Rating scale with a range from 0 to 54 with a higher score indicating more severe depressive symptoms. Each timepoint is scored and analyses examine the temporal profile of change with assessment at baseline and at 2 hour intervals post-injection.
University of California, Los Angeles
Other
Experimental Model of Depression in Aging: Anxiety, Inflammation, and Reward Mechanisms
Acronym: ARIA
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