Functional Neuroimaging of Alcoholism Vulnerability: Probing Glutamate and Reward, Using the mGluR5 Inhibitor Mavoglurant

Overview

The purpose of this study is to evaluate the role of Mavoglurant in clarifying the neurobiology of alcoholism risk. This is a one-site, randomized, within subjects, counterbalanced double-blind study of a single dose (200mg) of Mavoglurant and placebo.

Detailed description

This project explores the effects of 1 dose of Mavoglurant, an experimental non-competitive antagonist to metabotropic glutamate receptor-5 (mGlur5) developed by Novartis, in a double-blind, randomized, counterbalanced manner on alcoholism risk-relevant tasks. Drug/placebo will be administered on 2 separate visits separated by 1 week. More specifically, this project examines 4 functional MRI tasks related to different aspects of reward and/or impulsivity-related behavior in different contexts, compares the underlying neural circuitry across tasks, and uses a pharmacologic probe of the glutamatergic system to examine N-methyl-D-Aspartate and Dopamine (NMDA/DA) interactions. The combined measures provide the opportunity to advance our understanding of specific aspects of brain function related to familial alcoholism vulnerability in an already well characterized population as some members evolve into alcohol abuse. In addition, as well as conventional within-task analyses, functional network connectivity and allied approaches will be used to examine brain networks across the tasks.

Interventions

• Drug Mavoglurant (AFQ056)
  Two 100mg tablets of Mavoglurant will be administered on the morning of one of the two experimental days by a RN or the physician investigator.
• Drug Placebo
  Two matching tablets of placebo will be administered on the morning of one of the two experimental days by an RN or the physician investigator.

Primary outcome measures

• Change in Nucleus accumbens (Nacc)/Ventral striatum (VS) BOLD activation during A1 phase in FHP on study medication vs. placebo [Time frame: Mavoglurant and Placebo administration are 1 week apart]
• BOLD activation to alcohol vs. non-alcohol stimuli during ACR task alcohol versus non-alcohol stimuli [Time frame: Mavoglurant and Placebo administration are 1 week apart]

Secondary outcome measures (2)

• Dynamic Causal Modeling (DCM)-determined relationships between nucleus accumbens (NAcc) and -medial PFC BOLD signal during MSDM task [Time frame: Mavoglurant and Placebo administration are 1 week apart]
• Regional differences in BOLD signal [Time frame: Mavoglurant and Placebo administration are 1 week apart]

Eligibility criteria

Inclusion criteria

• Ages 18-45 years
• Estimated full-scale IQ>70
• Individual can cooperate with all study procedures
• No history of neurological disorder (e.g., epilepsy)
• No major medical condition (e.g., cancer)
• No history of significant head trauma
• Stable medication treatment 6 weeks prior to study enrollment
• Negative urine drug and breathe alcohol test at time of MRI scan
• Negative urine pregnancy test at time of MRI scan
• No MR contra-indications (e.g., in-body metal implant, severe claustrophobia)
• No contra-indications to study drug

Exclusion criteria

• A diagnosis of any psychotic disorder, or current mood or anxiety disorders under DSM-V, using the SCID-V-RV psychiatric interview
• A current diagnosis of: a) Alcohol use disorder, if severe (AUD, mild or moderate OK if no craving, tolerance, and withdrawal 3 months prior to interview) b) Substance use disorder
• Report of psychotic disorder in a 1º relative
• Auditory or visual impairment that interferes with test-taking
• Prenatal exposure to alcohol plus currently meeting criteria for features of fetal alcohol syndrome
• Not speaking English fluently or being a non-native English speaker, or being educated in a primary language other than English > grade 1
• Intellectual Disability (Full Scale IQ<70)
• Traumatic brain injury with loss of consciousness > 30 minutes or concussion in last 30 days
• Presence or history of neurosurgery or any neurologic illness that may affect brain physiology (e.g., epilepsy, Multiple Sclerosis), including focal brain lesion seen on structural MRI (all structural scans are read by a board certified radiologist)
• A current major medical condition (e.g. cancer, heart failure)
• Current pregnancy (all females will be tested with urine screens on the day of MRI)
• Women not on an effective form of birth control/contraception or abstinent during time of study visits to prevent exposure of the investigational drug to suspected fetus
• Current substance use with the exception of marijuana (THC), provided last use of THC was 24+ hours before visit (All participants will receive a urine screen for the presence of marijuana, cocaine, opiates and a breath screen to detect the presence of alcohol)
• Inability to comprehend the consent form appropriately
• Inability to cooperate with study procedures
• Other specific fMRI exclusions include metal devices, clips or fragments in body (orbital xray performed if needed)

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Allocation

Randomized

Model

Crossover

Masking

Double blind

Primary purpose

Prevention

Study locations

United States · 1 center

• Hartford Hospital — Hartford

Identifiers

NCT: NCT05203965 · HHC-2021-0006 · 2P50AA012870-21 · 2000032425

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗