Clinical Trial: Dissociating Components of Anhedonia: A Pilot fMRI Study

Study Status: Recruiting
Recruit Status: Recruiting
Study Type: Interventional

Official Title: Dissociating Components of Anhedonia: Pilot Behavioral and fMRI Data for the Effort Expenditure for Rewards Task

Brief Summary: Anhedonia, decreased motivation for and sensitivity to rewarding experiences, is present in at least 1/3 of community dwelling older adults and is a feature of various psychiatric and neurological disorders, including late-life depression and Parkinson's disease. Anhedonia is associated with cognitive deficits, as well as poor clinical outcomes and increased mortality. Recent research suggests that anhedonia comprises motivational (reward "wanting") and consummatory (reward "liking") aspects. However, previous research on anhedonia has failed to dissociate these components, which may explain the contradictory findings in the literature. Recently, the Effort-Expenditure for Rewards Task (EEfRT) was developed in an effort to dissociate reward components in anhedonia. The EEfRT is an effort-based decision-making task that measures reward "wanting", in contrast to commonly used anhedonia questionnaires, which focus on reward "liking." This novel task may provide a useful measure of components of anhedonia in older adults and in different patient populations. Thus far no data is available on this task in elderly individuals, and the cognitive and neural correlates of components of the task have not been investigated. Given the paucity of research on the neurobiology of anhedonia, cognitive neuroscience studies using this task could fill a gap in the literature. The investigators are developing a line of cognitive neuroscience studies examining anhedonia in community-dwelling older adults and in late-life depression and Parkinson's disease. This study will involve gathering pilot behavioral and functional magnetic resonance imaging (fMRI) data in young and older adults performing the EEfRT task. Understanding the brain mechanisms underlying anhedonia in older adults and in different patient populations will have a translational impact by elucidating biological targets for treatment.

Detailed Summary: Twenty young adults (aged 18-38) and 20 older adults (aged 60-80) will perform the EEfRT while fMRI data are acquired. To quantify brain activity associated with reward "wanting," the fMRI activation will be measured while participants view information about reward probability and choose to perform the easy or hard task, with greater reward associated with the hard task. The investigators will measure activation during presentation of reward magnitude to capture brain activity associated with reward "liking." Participants will also complete a brief cognitive battery and anhedonia questionnaires.
Sponsor: University of Florida

Current Primary Outcome:

• fMRI Activity [ Time Frame: Approximately Day 14 (Visit 2) ]
  To quantify brain activity associated with reward "wanting," the investigators will contrast fMRI activation while participants view information about reward probability and choose to perform the easy or hard task with activity during fixation. The investigators will contrast activation during performance feedback and presentation of reward magnitude with activation during fixation to capture brain activity associated with reward "liking." Parameter estimates (ß) will be generated, which indicated relative strength of covariance between the data and the hemodynamic response function (HRF). The investigators will use a three-dimensional spatial contiguity threshold of 20 voxels and a statistical significance threshold of p ≤ .005 to decrease the likelihood of spurious findings.
• EEfRT Task Test [ Time Frame: Approximately Day 14 (Visit 2) ]
  The EEfRT is a computerized task in which participants are presented with a series of repeated trials during which they choose between performing a ''hard-task'' or an ''easy-task'' in order to earn varying amounts of monetary rewards.

Original Primary Outcome: Same as current

Current Secondary Outcome:

• Montreal Cognitive Assessment (MoCA) [ Time Frame: Baseline (Visit 1) ]
  Cognitive screening instrument. The highest possible score is 30. 18 - 26 = mild cognitive impairment, 10 - 17 = moderate cognitive impairment and less than 10 = severe cognitive impairment.
• Dementia Rating Scale-2 (DRS-2) [ Time Frame: Baseline (Visit 1) ]
  The scale includes 36 tasks which are grouped into five subscales assessing different cognitive domains, namely: Attention, Initiation/Perseveration (I/P), Construction, Conceptualization and Memory.
• Card Stroop Task [ Time Frame: Baseline (Visit 1) ]
  Participants must 1) read color words (red, green and blue) aloud, 2) name the ink color of a string of X's presented in rows on a page, and 3) name the ink color of color words (red, green, blue) written in either the same or a different color as the word meaning.
• Letter-Number Sequencing (Wechsler Adult Intelligence Scale, 4th Edition) [ Time Frame: Baseline (Visit 1) ]
  Subjects hear a string a numbers and letters and must repeat them with the numbers first, in order, followed by the letters in alphabetical order.
• Trail Making Test Parts A and B [ Time Frame: Baseline (Visit 1) ]
  The task requires a subject to 'connect-the-dots' of 25 consecutive targets on a sheet of paper or computer screen. There are two parts to the test: A, in which the targets are all numbers (1,2,3..) and the test taker needs to connect them in sequential order, and B, in which the subject alternates between numbers and letters (1, A, 2, B, etc.). The test should be finished as quickly as possible within 5 minutes. The poorer the performance the higher the impairment.
• Wisconsin Card Sorting Test [ Time Frame: Baseline (Visit 1) ]
  A number of stimulus cards are to be match within 20 minutes. Participants must figure out the sorting rule based on feedback from the examiner.
• Benton Facial Recognition Test [ Time Frame: Baseline (Visit 1) ]
  Subjects match faces presented in different orientations and lighting conditions.
• Judgment of Line Orientation [ Time Frame: Baseline (Visit 1) ]
  Subjects are asked to match two angled lines to a set of 11 lines that are arranged in a semicircle and separated 18 degrees from each other. A score of 17 or less is considered a sign of severe deficit.
• Controlled Oral Word Association/Category Fluency [ Time Frame: Baseline (Visit 1) ]
  Subjects are asked to name as many words as they can in 60 seconds based on either a letter (F, A, and S) or a category (animals) rule.
• Digit Span (Wechsler Adult Intelligence Scale, 4th Edition) [ Time Frame: Baseline (Visit 1) ]
  Subjects repeat a string of numbers in either the same order (digits forward) or in reverse order (digits backward).
• Test of Memory Malingering (TOMM) [ Time Frame: Baseline (Visit 1) ]
  The TOMM is a 50-item recognition test designed for adults to discriminate between true memory-impaired patients. The higher the score the better and the lower the score the higher the impairment.
• California Verbal Learning Test II (CVLT-II) [ Time Frame: Baseline (Visit 1) ]
  Subjects are asked to learn and remember a 16-item word list.
• Brief Visuospatial Memory Test-Revised (BVMT-R) [ Time Frame: Baseline (Visit 1) ]
  Subjects are asked to learn and remember the identity and location of 6 simple figures displayed on a page.
• Temporal Experience of Pleasure scale (TEPS) [ Time Frame: Baseline (Visit 1) ]
  18-item self-report questionnaire assessing anticipatory pleasure and consummatory pleasure
• Snaith-Hamilton Pleasure Scale (SHAPS) [ Time Frame: Baseline (Visit 1) ]
  The SHAPS measures hedonic capacity. A higher total SHAPS score will indicate a higher level of anhedonia or the inability to experience pleasure.
• Positive Affect Negative Affect Scale (PANAS) [ Time Frame: Baseline (Visit 1) ]
  Subjects are required to respond to a 20-item test using 5-point scale that ranges from very slightly or not at all (1) to extremely (5).
• Beck Depression Inventory, 2nd Edition (BDI-II) [ Time Frame: Baseline (Visit 1) ]
  21-item self-report questionnaire assessing symptoms of depression.
• Geriatric Depression Scale (GDS) [ Time Frame: Baseline (Visit 1)&n
  
  

  Original Secondary Outcome: Same as current
  
  Information By: University of Florida
  

  Dates:
  Date Received: October 2, 2015
  Date Started: February 2016
  Date Completion: March 2018
  Last Updated: April 27, 2017
  Last Verified: April 2017