ANZCTR - Registration

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Trial registered on ANZCTR

Registration number

ACTRN12617000008325p

Ethics application status

Submitted, not yet approved

Date submitted

4/11/2016

Date registered

3/01/2017

Date last updated

3/01/2017

Type of registration

Prospectively registered

Titles & IDs

Public title

Using brain rhythms to assess anti-anxiety drug action

Scientific title

Using brain rhythms to assess anti-anxiety drug action in healthy adult volunteers

Secondary ID [1]

None

Universal Trial Number (UTN)

Trial acronym

Linked study record

Health condition

Health condition(s) or problem(s) studied:

Anxiety

Condition category

Condition code

Mental Health

Anxiety

Intervention/exposure

Study type

Interventional

Description of intervention(s) / exposure

Single doses of one of the following anxiolytic medications: buspirone 5, 10 or 15mg, citalopram 10mg, clonidine 75mcg, pregabalin 25, 75 or 100mg, triazolam 0.125, 0.25 or 0.5mg, promethazine 10mg, quetiapine 25mg, venlafaxine 75mg. All medications will be encapsulated (i.e.administered as an oral capsule) to assist with blinding. Dosing will be directly observed by study staff.

Intervention code [1]

Treatment: Drugs

Comparator / control treatment

Encapsulated microcellulose placebo capsule

Control group

Placebo

Outcomes

Primary outcome [1]

Response inhibition, assessed using the Stop Signal Task.

Timepoint [1]

Approximately 1 hour after dosing

Primary outcome [2]

EEG frontal midline power,

Timepoint [2]

Approximately 1 hour after dosing

Primary outcome [3]

EEG left-right and frontal-posterior alpha asymmetry

Timepoint [3]

Approximately 1 hour after dosing

Secondary outcome [1]

Stop signal reaction time in the stop signal task

Timepoint [1]

Over the first hour post-dose

Secondary outcome [2]

Choice reaction time task; Subjects press mouse buttons in response to presented stimuli. The percent of left (outcome delivery) click responses out of left+right (no outcome) responses in the choice task are assessed separately for each condition (net gain, conflict, and net loss). This is a composite outcome for net gain, conflict and net loss conditions.

Timepoint [2]

Over the first hour post-dose

Eligibility

Key inclusion criteria

1. Capable of understanding and signing an informed consent.
2. Aged 18-65 years on the day of consent.
3. Good general health.

Minimum age

18 Years

Maximum age

65 Years

Sex

Both males and females

Can healthy volunteers participate?

Yes

Key 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 prior to testing.
5. Subjects with a prior history of seizures; susceptibility to photosensitivity; or a history of allergic skin reactions.

Study design

Purpose of the study

Treatment

Allocation to intervention

Randomised controlled trial

Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)

Prof Glue will create the random codes and encapsulate all treatments. All study personnel involved with recruitment, dosing, data collection and analysis will have no access to the random codes until the databases are locked. All medications will be provided in opaque labelled envelopes.

Methods used to generate the sequence in which subjects will be randomised (sequence generation)

Computer generated random code, with stratification based on gender.

Masking / blinding

Blinded (masking used)

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

Intervention assignment

Parallel

Other design features

There are four discrete dosing groups in this study, three of which are evaluating dose-response relationships in the study tasks for buspirone, triazolam and pregabalin. The fourth group will test single doses of other anxiolytic drugs not yet evaluated in the study task paradigm.
1. Placebo, buspirone (5, 10*, 15mg)
2. Placebo, triazolam (0.125, 0.25*, 0.375mg)
3. Placebo, pregabalin (25, 75*, 100 mg)
4. Placebo, buspirone (10*mg), citalopram (SSRI, 10mg), venlafaxine (SNRI, 75mg), clonidine (adrenergic agonist, 75mcg), quetiapine (atypical antipsychotic, 25mg), promethazine (antihistamine, 10mg)

Phase

Phase 1

Type of endpoint/s

Pharmacodynamics

Statistical methods / analysis

- Behaviour: Post-dosing behaviour changes will be compared between drug and placebo dosing using a mixed measures ANOVA with drug/dose as a between participants factor and, e.g., changes in measures across trials as repeated measures with polynomial contrasts extracted.
- Biomarker: Raw EEG will be converted to log Fourier power for an epoch centred on the 500ms after a stop signal. GCSR will be calculated as stop-go[linear] x delay[quadratic] for channel F8 and the resultant value submitted to ANOVA. Additional EEG analyses will assess polynomial components of anterior-posterior and left-right location of channels on the scalp. Significant results will be explored with post hoc split ANOVAs.
- Choice EEG: as for biomarker EEG analysis but with analysis centred on the trial start and GCSR calculated as payoff[quadratic].
- Resting EEG: log Fourier power will be calculated for eyes open and eyes closed periods separately for all electrodes. Frontal midline power, left-right alpha asymmetry, and frontal-posterior alpha asymmetry will be extracted as separate measures and each subjected to repeated measures ANOVA with effect of drug group and eyes open/closed as factors.

Recruitment

Recruitment status

Not yet recruiting

Date of first participant enrolment

Anticipated

1/02/2018

Actual

Date of last participant enrolment

Anticipated

Actual

Date of last data collection

Anticipated

Actual

Sample size

Target

190

Accrual to date

Final

Recruitment outside Australia

Country [1]

New Zealand

State/province [1]

Otago

Funding & Sponsors

Funding source category [1]

University

Name [1]

Otago University

Address [1]

PO Box 56
Dunedin, 9054

Country [1]

New Zealand

Primary sponsor type

University

Name

University of Otago

Address

PO Box 56
Dunedin, 9054

Country

New Zealand

Secondary sponsor category [1]

None

Name [1]

None

Address [1]

N/A

Country [1]

Ethics approval

Ethics application status

Submitted, not yet approved

Ethics committee name [1]

Southern HDEC

Ethics committee address [1]

Ministry of Health
Ethics Department
133 Molesworth Street
Thorndon
Wellington 6011

Ethics committee country [1]

New Zealand

Date submitted for ethics approval [1]

18/11/2016

Approval date [1]

Ethics approval number [1]

Summary

Brief summary

‘Anxiety disorders’ diagnosis is currently based on clinical symptom check lists and there are no biological markers to diagnose specific syndromal causes. We have described a detailed theory of the brain systems controlling anxiolytic-insensitive threat-avoidance and anxiolytic-sensitive threat-approach. This new biomarker should allow division of untreated ‘anxiety’ patients, with superficially similar clusters of symptoms, into distinct high scoring (syndromal) and low scoring groups with different treatment-responses. This would be the first theoretically-derived biomarker for any mental disorder and should: 1) predict treatment efficacy better than current symptom-based diagnoses; 2) provide a human single dose test of novel anxiolytics; 3) provide a starting point for developing biomarkers for other ‘anxiety’ syndromes; and so, 4) greatly improve treatment outcomes and cost-effectiveness.

Our previous work has shown that single doses of 3 types of anxiolytic drug all reduce goal-conflict-specific rhythmicity (GCSR) in a stop signal task despite sharing only anxiolytic and not panicolytic or antidepressant or other actions. Preliminary results indicate that this action is also seen in a variant of the stop signal task with targeted rather than speeded responses; but drug action has not been tested in the choice tasks, involving monetary gain and loss, in which GCSR was originally demonstrated and from which the money-free variant was developed. Generality of the results has also not been extended to other doses of the original anxiolytic drugs or to drugs with broader actions on panic and depression that share a capacity to reduce clinical anxiety.

There are several objectives in the proposed randomized double blind parallel group studies:
-To evaluate the dose-response relationship for drugs already known to affect an EEG biomarker of an anxiety-related process. 
-To evaluate the generalisation of effect on the EEG biomarker of the anxiety-related process to drugs with broader anxiolytic-antipanic-antidepressant-antipsychotic actions.
-To evaluate the dose-response relationship of anxiolytic drugs on behaviour and potential EEG biomarkers in behavioural tasks involving explicit approach-avoidance conflict generated by gain and loss of money.

Trial website

none

Trial related presentations / publications

Public notes

Contacts

Principal investigator

Name

Prof Neil McNaughton

Address

Department of Psychology
University of Otago
William James Building
275 Leith Walk
Dunedin 9016

Country

New Zealand

Phone

+64 3 479 7634

Fax

nmcn@psy.otago.ac.nz

Contact person for public queries

Name

Neil McNaugthon

Address

Department of Psychology
University of Otago
William James Building
275 Leith Walk
Dunedin 9016

Country

New Zealand

Phone

+64 3 479 7634

Fax

nmcn@psy.otago.ac.nz

Contact person for scientific queries

Name

Neil Mcnaughton

Address

Department of Psychology
University of Otago
William James Building
275 Leith Walk
Dunedin 9016

Country

New Zealand

Phone

+64 3 479 7634

Fax

nmcn@psy.otago.ac.nz

No information has been provided regarding IPD availability

What supporting documents are/will be available?

No Supporting Document Provided

Results publications and other study-related documents

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