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Understanding Prediction Error and Affective Salience Abnormalities to Guide the Selection of Reward Exposure Activities

Clinical Trial Details

This pilot study examines the interaction of reward and salience abnormalities in depression with the goal to inform a simple-to-administer, structured assessment that will sharpen the targeting of behavioral interventions. 

This pilot studies the interplay of reward expectancy and salience functions in mid- and late-life depression. Focusing on three levels of analysis (neural circuitry, performance of PVS-related tasks, self-report/clinical observations) will offer a view of the relationship of neural activation with clinical symptoms. 

Key Eligibility: 

Inclusion Criteria

  • Age: 45-85 years 
  • Diagnosis: Major depression, unipolar without psychotic features by DSM-V criteria (depressed participants only)
  • Severity of depression: Montgomery Asberg Depression Rating Scale (MADRS) greater than or equal to 20 at screening and scan (depressed participants only)
  • No current treatment with psychotherapy or an SSRI or SNRI or on a stable dosage of an SSRI or an SNRI (8 weeks prior to study entry)
  • No plan to change the dosage of the antidepressant prescribed by the participant's own physician
  • Capacity to provide informed consent

Exclusion Criteria

  • High suicide risk, i.e. intent or plan to attempt suicide in near future
  • Presence of any current Axis I psychiatric disorder (other than unipolar major depression, Generalized Anxiety Disorder, or specific phobias) including substance abuse (those with a history of substance abuse must be abstinent for at least 3 months prior to entry)
  • Axis II diagnosis of antisocial personality disorder, mental retardation and pervasive developmental disorder (DSM-V)
  • History of psychotic disorder or bipolar mood disorder
  • Cognition: Mini Mental State Examination (MMSE) scores below 24 at screening or diagnosis of dementia by DSM-V
  • Acute or severe medical illness, i.e., delirium, metastatic cancer, decompensated cardiac, liver or kidney failure, major surgery, stroke or myocardial infarction during the three months prior to entry; or drugs known to cause depression, e.g., reserpine, alpha-methyl-dopa, steroids, sympathomimetics withdrawal
  • Presence of a significant neurological disease such as Parkinson's disease, primary or secondary seizure disorders, intracranial tumors, multiple sclerosis, stroke, severe head trauma
  • Inability to perform any of the ADLs (MAI: ADL subscale) even with assistance, e.g. walking with a cane is not an exclusion criterion
  • Inability to speak English
  • Corrected visual acuity less than 20/70
  • Contraindications to MRI (e.g., cardiac pacemaker, heart valve, brain or aortic clips, electrodes in body, head, or brain, insulin pump, metal fragments removed from eyes, fractured bones treatment with metal rods, claustrophobia 

Study contact by location

Upper East Side - Manhattan

Contact(s)

Lila Abreu
212-746-3749
lia4002@med.cornell.edu

Primary Investigator(s)

Lindsay Victoria, PhD  (UES)

Protocol ID(s)

Weill Cornell Medicine IRB #:

1708018441

Sponsor:

P50 MH113838

Status

Open to Enrollment

Age Group

Adult

Sponsor