First Episose Psychosis, Metabolic Disease, Psychosis; Episode
Conditions
Keywords
psychosis, cerebral metabolism, glucose, ketone, PET scan
Brief summary
The goal of this observational study is to the early impacts of psychosis and antipsychotic medications on brain metabolism in young adults recently diagnosed with a first episode of psychosis. The main question aims to evaluate the effect of 4 to 6 weeks of antipsychotic medication on brain metabolism measured by PET scan (cerebral uptake of 11C-Acetoacetate + 18 Fluorodeoxyglucose). Participants will undergo a multimodal imaging protocol with other measures of psychopathology (e.g., cognition, depressive symptoms, etc.) and (metabolic marker, inflammation, etc).
Interventions
Any Antipsychotic drugs prescripbe as standrd of care for this specific populaton
Sponsors
Baszucki Brain Research Fund
Université de Sherbrooke
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 35 Years
Healthy volunteers
No
Inclusion criteria
* Admission to the PEP clinic in Estrie, either outpatient or inpatient, according to the transdiagnostic PEP model. * Willingness to begin taking an AP (regardless of type and dose, or change in type and dose during the study). * Ability to read and express themselves in French or English. * Capable of understanding and signing consent.
Exclusion criteria
* Pregnancy, childbirth in the last 6 months, or breastfeeding. * Presence of a metallic object in the body that is incompatible with MRI. * Any use of APs for more than 2 continuous weeks in the past year and/or 6 weeks in a lifetime (except for aripiprazole if taken at less than 2.5 mg/day or quetiapine at less than 50 mg/day, regardless of duration or timing of the prescription). * The following comorbidities: psychosis + borderline or intellectual disability, autism spectrum disorder, substance use disorder with decompensation, psychosis induced by a medical condition, or psychosis induced by drug use or withdrawal. * Type 1 diabetes. * Uncontrolled acute suicidal ideation. * Other conditions that could interfere with participation according to the judgment of the qualified physician.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cerebral metabolic rate of glucose and acetotacetate | BEFORE introduction of antipsychotic medicationand AFTER 4 to 6 weeks | Cerebral metabolic rate of glucose and acetotacetate(μmol/100 g/min) quantified with PET scan with 18F-FDG tracer and 11C-AcAc |
| Net inflow of glucose and acetoacetate | BEFORE introduction of antipsychotic medicationand AFTER 4 to 6 weeks | Net inflow of glucose and acetoacetate (k) as measured by PET scan with 18F-FDG and 11C-AcAc traceur (Kglu and Kacac, min-1) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| % of change in Brief Psychiatric Rating Scale | BEFORE introduction of antipsychotic medicationand AFTER 4 to 6 weeks | % of change in the Brief psychiatric Rating Scale (raw score after/raw score before\*100) |
| Concentration of glucose | BEFORE introduction of antipsychotic medicationand AFTER 4 to 6 weeks | Concentration of glucose measure in fasting plasma |
| Concentration of insuline | BEFORE introduction of antipsychotic medicationand AFTER 4 to 6 weeks | Concentration of insulinemeasure in fasting plasma |
| Concentration of Hemoglobin A1C | BEFORE introduction of antipsychotic medicationand AFTER 4 to 6 weeks | Concentration of HbA1C measured in fasting plasma |
Other
| Measure | Time frame | Description |
|---|---|---|
| Drug consumption measured by the score of the Drug Use Disorders Identification Test -DUDIT | BEFORE introduction of antipsychotic medicationand AFTER 4 to 6 weeks | Drug consumption as measured by the score of the Drug Use Disorders Identification Test DUDIT. Min score 0, maximum score 40, with higher alcool consumption with higher value of the score |
| Global brain volume measured by MRI | BEFORE introduction of antipsychotic medicationand AFTER 4 to 6 weeks | Global brain volumes measured as global brain volumes (ml) measured by MRI |
| Average weekly hours of sport/exercise per day | BEFORE introduction of antipsychotic medicationand AFTER 4 to 6 weeks | Average weekly hours of sport/exercise per day as measured by question 4 of the Simple Physical Activity questionnaire SIMPAQ (hour) |
| Thicknesses of the cerebral cortex | BEFORE introduction of antipsychotic medicationand AFTER 4 to 6 weeks | Thicknesses of the cerebral cortex (mm) measured by MRI |
| Depression status measured by the score of Calgary Depression Scale for Schizophrenia | BEFORE introduction of antipsychotic medicationand AFTER 4 to 6 weeks | Score of Calgary Depression Scale for Schizophrenia (CDSS) . Min score 0, maximum score 27 with worsening of the patient condition with hight value |
| Functionning level measured by the score of the Global Assessment of functionning | BEFORE introduction of antipsychotic medicationand AFTER 4 to 6 weeks | Score of the Global Assessment of functionning (GAF). Min score 0, maximum score 100, with worsening of the patient condition with higher value |
| Side effet score measured by the Side Effect Rating Scale | BEFORE introduction of antipsychotic medicationand AFTER 4 to 6 weeks | Score on the Side Effect Rating Scale UKU. Min score 0, maximum score 135 (female) 129 (male), with worsening of the side effect with higher value |
| Alcohol consumption measured by the score of the Alcohol Use Disorders Identification Test -AUDIT | BEFORE introduction of antipsychotic medicationand AFTER 4 to 6 weeks | Alcoohol consumption as measured by the score of the Alcohol Use Disorders Identification Test AUDIT. Min score 0, maximum score 40, with higher alcool consumption with higher value of the score |
Countries
Canada
Contacts
Primary ContactMelanie Fortier, M.Sc
Backup ContactStephen Cunnane, Ph.D.
Outcome results
None listed