Dopamine Modulation of Motivation and Motor Function in Major Depression & Inflammation

Charite University, Berlin, Germany165 enrolled

Overview

A large body of evidence on depression heterogeneity point to an "immunometabolic" subtype characterized by the clustering of immunometabolic dysregulations with atypical behavioral symptoms related to energy homeostasis. Motivational and motor impairments reflected by symptoms of anhedonia and psychomotor retardation in major depression are closely related to alterations in energy homeostasis, are associated with increased inflammation, and may be a direct consequence of the impact of inflammatory cytokines on the dopamine system in the brain. In the proposed project, the investigators will examine the effect of dopamine stimulation on motivation and motor function in patients with major depression and healthy controls and the role of inflammation using a double-blind, randomized, placebo-controlled, cross-over design. If successful, this study would provide crucial evidence that pharmacologic strategies that increase dopamine may effectively treat inflammation-related symptoms of anhedonia and psychomotor retardation in major depression.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

BASIC_SCIENCE

Masking

TRIPLE

Enrollment

165

Conditions

Depressive Disorder, Major

Interventions

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: For patients with major depressive disorder: * diagnosis of major depressive disorder according to DSM-5 * free of antidepressant medication For healthy participants: * C-reactive protein (CRP): ≤ 1 mg/l * free of antidepressant medication * free of any current psychiatric disorder Exclusion Criteria: * diagnosis of schizophrenia, schizoaffective disorder, bipolar disorder, dementia, and current/past alcohol or drug dependence * central nervous system diseases * neurological diseases * suspicious undiagnosed skin lesions or a history of melanoma * narrow-angle or wide-angle glaucoma * bronchial asthma * history of peptic ulcer disease * history of seizures * any severe somatic disease * current infections or chronic inflammatory diseases (e.g., rheumatic diseases, inflammatory bowel disease) * pregnancy / breast-feeding * class 3 obesity (body mass index of 40 or higher) * Use of medication containing reserpine (certain antihypertensive agents), tricyclic antidepressants, bon-selective monoamine oxidase (MAO) inhibitors, antiparkinsonian drugs, sympathomimetic drugs, tetrabenazine.

Outcomes

Primary Outcomes

The change in response bias (logb) after L-dopa/Carbidopa compared to placebo in the Probabilistic Reward Task (PRT).

The PRT, which uses a signal detection paradigm, will be used to measure response bias, the propensity to select the more rewarded response ("rich").