A Phase 1 interventional study of Methylphenidate Pill and Oral Placebo in Normal Physiology, sponsored by National Institute on Alcohol Abuse and Alcoholism (NIAAA). Completed at 1 site in United States. Open to participants aged 18 Years to 55 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2024-05-28.
Sponsored by National Institute on Alcohol Abuse and Alcoholism (NIAAA) · Phase 1, Interventional, and Basic science
Background:
Dopamine (DA) is a chemical signal in the brain linked to learning, memory, and habits. Stimulant drugs like methylphenidate can increase DA in the brain. Researchers want to measure DA with and without this drug. They want to learn how methylphenidate and brain dopamine affect body responses, mood, and thinking.
Objective:
To better understand the role of dopamine in the brain and the effects of methylphenidate.
Eligibility:
Adults ages 18-55 who have used alcohol or stimulant drugs but have no drug dependence.
Design:
Participants will be screened with:
Participants will have 3 or 4 study visits. At each visit they will have:
Participants will wear an activity monitor on the wrist for one week.
Objectives: The overarching goal of this study is to assess the dynamic association between dopamine (DA) D2 receptor (D2R) occupancy measured by positron emission tomography (PET) with [11C]raclopride and brain activity inferred by pharmacological magnetic resonance imaging (phMRI) in the human brain, and to assess the relative sensitivity and specificity of the neurovascular coupling for slow (oral) versus rapid (intravenous, IV) stimulant methylphenidate (MP) delivery. Secondary objectives are to assess the associations between behavioral measures (heart and respiration rates and blood pressure, motor and sleep parameters, and neuropsychological testing variables), D2R occupancy and fMRI signals.
Study population: 10 healthy males and 10 healthy females 18-55 years old will be included. Test-retest reproducibility studies will be carried out in 5 participants.
Design: Double-blind. Participants will undergo simultaneous PET/phMRI, to evaluate dynamic changes in D2R occupancy by DA with [11C]raclopride and in blood-oxygenation-level dependent (BOLD) signals, under MP or placebo (PL). The participants will be scanned on 3 different occasions: 1) oral-MP (60 mg) and iv PL (3 cc saline), 2) oral-PL and iv-MP (0.25 mg/kg in 3 cc sterile water) and 3) oral PL and iv PL, which will be carried in different study days with at least 48 hours between them and their order will be randomized across subjects. Participants and researchers will be blind to the nature of the stimulant drug (MP/PL).
Outcome parameters: The scale factor between the distribution volume ratio (DVR) and the BOLD signal in the dorsal and ventral striatum for the slow and fast MP challenges.
National Institute on Alcohol Abuse and Alcoholism (NIAAA) is the lead sponsor of 102 studies on the registry; 15 are open to participants now.
Of its 13 completed or terminated interventional studies of FDA-regulated products, 9 (69%) have results posted.
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Healthy Volunteer Participants
EXCLUSION CRITERIA:
Subjects will not be excluded from enrollment in this study if their urine test is positive for drugs. However, if they test positive on scheduled study procedure days involving study imaging and neuropsychological testing, the procedures will be postponed and rescheduled. We will allow for up to 3 rescheduled study days that were the result of positive urine drug screens. If the drug test is positive on the third rescheduled visit, the participant will be withdrawn from the study. The intent of the research has no prospect of direct benefit to the subject. Therefore, we are excluding non-English speakers in this research study since it includes the administration of questionnaires, surveys and assessments that are validated for English, although some are available in Spanish. In addition,
our fMRI paradigms (particularly the Delay Discounting task) require that the subject be able to speak, read and comprehend English.
Healthy participants receive methylphenidate 60mg orally given 30 minutes prior to bolus \[11C\]raclopride injection followed by intravenous placebo (3ml saline) given 30 minutes post bolus injection of \[11C\]raclopride. PET/phMRI scan (MRI and PET scan) was initiated at the start of the \[11C\]raclopride injection. Participants were subsequently randomized across study arms B and C in different study days with at least 48 hours between visits.
Drug: Methylphenidate Pill · Drug: Intravenous Placebo
Healthy participants receive oral placebo given 30 minutes prior to bolus \[11C\]raclopride injection followed by intravenous methylphenidate 0.25 mg/kg in 3ml sterile water given 30 minutes post bolus injection of \[11C\]raclopride. PET/phMRI scan (MRI and PET scan) was initiated at the start of the \[11C\]raclopride injection. Participants were subsequently randomized across study arms A and C in different study days with at least 48 hours between visits.
Drug: Oral Placebo · Drug: Intravenous methylphenidate
Healthy participants receive oral placebo given 30 minutes prior to bolus \[11C\]raclopride injection followed by intravenous placebo (3ml saline) given 30 minutes post bolus injection of \[11C\]raclopride. PET/phMRI scan (MRI and PET scan) was initiated at the start of the \[11C\]raclopride injection. Participants were subsequently randomized across study arms A and B in different study days with at least 48 hours between visits.
Drug: Oral Placebo · Drug: Intravenous Placebo
Oral methylphenidate (60 mg) given 30 minutes prior to bolus \[11C\]raclopride
Also known as: Ritalin
Oral PL will be given 30 minutes prior to bolus \[11C\]raclopride injection
Intravenous Placebo given 30 minutes post bolus injection of \[11C\]raclopride.
Intravenous methylphenidate 0.25 mg/kg in 3ml sterile saline given 30 minutes post bolus injection of \[11C\]raclopride.
The Standardized Uptake Value Ratio (SUVR) for [11C]Raclopride in Putamen
Participants underwent brain positron emission tomography (PET) scan with \[11C\]raclopride. The SUVR is calculated by dividing the standardized uptake value in the putamen, target region, by the standardized uptake value in the cerebellum, the reference region. This ratio normalizes the uptake values and allows for comparisons between individuals or across different imaging sessions.
Time frame: 60 min after [11C]raclopride injection
Percent BOLD Signal Change in the Anterior Cingulum
The blood-oxygen-level-dependent (BOLD) signal was estimated as the fitted amplitude to the dynamic standardized uptake value ratio (SUVR) change in response to the methylphenidate challenges.
Time frame: From 0 to 90 minutes after [11C]raclopride injection
The Temporal Correlation Between BOLD(t) and SUVR(t) Change
The Pearson correlation between the temporal dynamics of the blood-oxygen-level-dependent (BOLD) signal in anterior cingulum and the standardized uptake value ratio (SUVR) change in putamen measures changes in the neurovascular coupling induced by methylphenidate.
Time frame: From 0 to 90 minutes after [11C]raclopride injection
| Milestone | Arm A: Oral Methylphenidate Followed by Intravenous Placebo | Arm B: Oral Placebo Followed by Intravenous Methylphenidate | Arm C: Oral Placebo Followed by Intravenous Placebo |
|---|---|---|---|
| Started | 8 | 7 | 7 |
| Completed | 8 | 7 | 7 |
| Not completed | 0 | 0 | 0 |
| Milestone | Arm A: Oral Methylphenidate Followed by Intravenous Placebo | Arm B: Oral Placebo Followed by Intravenous Methylphenidate | Arm C: Oral Placebo Followed by Intravenous Placebo |
|---|---|---|---|
| Started | 8 | 7 | 7 |
| Randomized to study arm a | 0 | 4 | 3 |
| Randomized to study arm b | 4 | 0 | 4 |
| Randomized to study arm c | 4 | 3 | 0 |
| Completed | 8 | 7 | 7 |
| Not completed | 0 | 0 | 0 |
| Milestone | Arm A: Oral Methylphenidate Followed by Intravenous Placebo | Arm B: Oral Placebo Followed by Intravenous Methylphenidate | Arm C: Oral Placebo Followed by Intravenous Placebo |
|---|---|---|---|
| Started | 8 | 7 | 5 |
| Randomized to study arm a | 0 | 3 | 4 |
| Randomized to study arm b | 4 | 0 | 1 |
| Randomized to study arm c | 4 | 4 | 0 |
| Completed | 8 | 7 | 5 |
| Not completed | 0 | 0 | 0 |
Participants underwent brain positron emission tomography (PET) scan with \[11C\]raclopride. The SUVR is calculated by dividing the standardized uptake value in the putamen, target region, by the standardized uptake value in the cerebellum, the reference region. This ratio normalizes the uptake values and allows for comparisons between individuals or across different imaging sessions.
| SUV Ratio (SUVR) | Arm A: Oral Methylphenidate Followed by Intravenous Placebo Placebo | Arm B: Oral Placebo Followed by Intravenous Methylphenidate | Arm C: Oral Placebo Followed by Intravenous Placebo |
|---|---|---|---|
| The Standardized Uptake Value Ratio (SUVR) for [11C]Raclopride in Putamen | 4.49 ± 0.39 | 4.39 ± 0.45 | 4.87 ± 0.46 |
The blood-oxygen-level-dependent (BOLD) signal was estimated as the fitted amplitude to the dynamic standardized uptake value ratio (SUVR) change in response to the methylphenidate challenges.
| percentage signal change | Arm A: Oral Methylphenidate Followed by Intravenous Placebo | Arm B: Oral Placebo Followed by Intravenous Methylphenidate | Arm C: Oral Placebo Followed by Intravenous Placebo |
|---|---|---|---|
| Percent BOLD Signal Change in the Anterior Cingulum | -0.13 ± 0.28 | 1.210 ± 0.620 | -0.001 ± 0.460 |
The Pearson correlation between the temporal dynamics of the blood-oxygen-level-dependent (BOLD) signal in anterior cingulum and the standardized uptake value ratio (SUVR) change in putamen measures changes in the neurovascular coupling induced by methylphenidate.
| correlation coefficient (r) | Arm A: Oral Methylphenidate Followed by Intravenous Placebo | Arm B: Oral Placebo Followed by Intravenous Methylphenidate |
|---|---|---|
| The Temporal Correlation Between BOLD(t) and SUVR(t) Change | .023 ± .376 | .556 ± .219 |
Collected over Participants were monitored over 4-6 clinic visits for up to 6 hours per clinic visit. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Arm A: Oral Methylphenidate Followed by Intravenous Placebo | 0/22 (0%) | 0/22 (0%) | 1/22 (4.5%) |
| Arm B: Oral Placebo Followed by Intravenous Methylphenidate | 0/22 (0%) | 0/22 (0%) | 10/22 (45.5%) |
| Arm C: Oral Placebo Followed by Intravenous Placebo | 0/22 (0%) | 0/22 (0%) | 1/22 (4.5%) |
| Event | Arm A: Oral Methylphenidate Followed by Intravenous Placebo | Arm B: Oral Placebo Followed by Intravenous Methylphenidate | Arm C: Oral Placebo Followed by Intravenous Placebo |
|---|---|---|---|
| AgitationNervous system disorders | 0/22 | 3/22 | 0/22 |
| NauseaGastrointestinal disorders | 0/22 | 2/22 | 0/22 |
| Feeling of relaxationGeneral disorders | 1/22 | 2/22 | 0/22 |
| PainGeneral disorders | 0/22 | 2/22 | 0/22 |
| AnxietyPsychiatric disorders | 0/22 | 2/22 | 1/22 |
| PalpitationsCardiac disorders | 0/22 | 1/22 | 0/22 |
| Disturbance in attentionNervous system disorders | 0/22 | 1/22 | 0/22 |
| DizzinessNervous system disorders | 0/22 | 1/22 | 0/22 |
| HeadacheNervous system disorders | 0/22 | 1/22 | 0/22 |
| LogorrhoeaNervous system disorders | 0/22 | 1/22 | 0/22 |
| Age, Categorical(Participants) | Arm A: Oral Methylphenidate Followed by Intravenous Placebo | Arm B: Oral Placebo Followed by Intravenous Methylphenidate | Arm C: Oral Placebo Followed by Intravenous Placebo | Total |
|---|---|---|---|---|
| <=18 years | 0 | 0 | 0 | 0 |
| Between 18 and 65 years | 8 | 7 | 7 | 22 |
| >=65 years | 0 | 0 | 0 | 0 |
| Sex: Female, Male(Participants) | Arm A: Oral Methylphenidate Followed by Intravenous Placebo | Arm B: Oral Placebo Followed by Intravenous Methylphenidate | Arm C: Oral Placebo Followed by Intravenous Placebo | Total |
|---|---|---|---|---|
| Female | 4 | 3 | 2 | 9 |
| Male | 4 | 4 | 5 | 13 |
| Ethnicity (NIH/OMB)(Participants) | Arm A: Oral Methylphenidate Followed by Intravenous Placebo | Arm B: Oral Placebo Followed by Intravenous Methylphenidate | Arm C: Oral Placebo Followed by Intravenous Placebo | Total |
|---|---|---|---|---|
| Hispanic or Latino | 0 | 0 | 1 | 1 |
| Not Hispanic or Latino | 7 | 7 | 6 | 20 |
| Unknown or Not Reported | 1 | 0 | 0 | 1 |
| Race (NIH/OMB)(Participants) | Arm A: Oral Methylphenidate Followed by Intravenous Placebo | Arm B: Oral Placebo Followed by Intravenous Methylphenidate | Arm C: Oral Placebo Followed by Intravenous Placebo | Total |
|---|---|---|---|---|
| American Indian or Alaska Native | 1 | 0 | 0 | 1 |
| Asian | 0 | 2 | 0 | 2 |
| Native Hawaiian or Other Pacific Islander | 0 | 0 | 0 | 0 |
| Black or African American | 2 | 5 | 3 | 10 |
| White | 4 | 0 | 3 | 7 |
| More than one race | 1 | 0 | 0 | 1 |
| Unknown or Not Reported | 0 | 0 | 1 | 1 |
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Studies of the drug tested here: Methylphenidate
National Institute on Alcohol Abuse and Alcoholism (NIAAA) →