Apathy in Late Life Depression: New Biomarkers Using Actimetry and Magnetic Resonance Imaging

NCT ID: NCT03807167

Last Updated: 2023-03-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

102 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-08-09

Study Completion Date

2023-02-09

Brief Summary

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Old age (\> 60 years) is at high risk to develop major depression disorders (MDD). MDD doubles the risk for subsequent cognitive disorders and dementia. Apathy (i.e. the lack of motivation) is a core problem in depression in older age and is frequently associated with cognitive decline in people who have mild cognitive disorders. The investigator propose here to combine actimetry (the measurement of motor activity using a simple device worn at the wrist) and brain imaging to show that it's possible to measure apathy using actimetry in a population of elders with MDD. Having shown that apathy can reliably be measured with actimetry and that it is associated with brain abnormalities, the investigator will be able to test whether actimetry can predict cognitive decline in elders with MDD and can be routinely used in a day-to-day medical practice.

Detailed Description

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Conditions

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Depression

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Patients

Group Type EXPERIMENTAL

Mattis Dementia Rating Scale

Intervention Type OTHER

This scale was developed to assess the cognitive status of patients with neurodegenerative diseases. There are 37 items that are presented in a fixed order and grouped into five sub-scales: attention, initiation, construction, conceptualization and memory. Patients and healthy subjects with a score below 125 are not included because of major cognitive impairment.

Unified Parkinson 's Disease Rating Scale-III

Intervention Type OTHER

This scale is used to rate the severity of extra-pyramidal symptoms (akinesia, rigidity and tremors). These symptoms may be the cause of reduction of motor activity apart from any reduction in motivation, they onstitute a confounding factor that it should be controlled.

Mini Neuropsychiatric Investigation

Intervention Type OTHER

This is a structured interview that allows rapid screening in about 20 minutes of troubles Psychiatric. It is based on short questions to which the patient must answer yes or no and on a decision tree. Patients must validate clinical diagnoses of depression.

Montgomery and Asberg depression Rating Scale

Intervention Type OTHER

This scale is composed of 10 items from 0 to 6 from a semi-structured interview, to obtain a total depression score of 0 to 60 (0 no depression, 60 maximum intensity of depression).

Clinical Global Impression

Intervention Type OTHER

heterosexual assessment that rates the severity of symptoms suicidal and changes in suicidal symptoms. Any subject with a score greater than 4 is not included.

Apathy diagnostic criteria

Intervention Type OTHER

The clinical criteria make it possible to make a diagnosis of apathy with a functional repercussion. It is based on a lack of motivation felt by the patient, causing a functional or social impact that is not the consequence of a disturbance of consciousness or a disability engine. The cognitive, emotional and behavioral dimensions are affected.

walking speed test

Intervention Type OTHER

The patient is timed to walk 10m. A speed \<1m / sec is a criterion exclusion because it shows severe sarcopenia and constitutes a bias.

accelerometer presentation

Intervention Type OTHER

accelerometer presentation and pose

data acquisition from the accelerometer

Intervention Type OTHER

withdrawal of the accelerometer and data acquisition from the accelerometer

Apathy Evaluation Scale,

Intervention Type OTHER

clinician version and near-helping version. It's a hetero rating scale from an interview semi structured by a trained clinician. It assesses cognitive, emotional and behavioral apathy than three items of various apathy. The total score ranges from 18 (total absence of apathy) to 72.

fatigue Visual Analog Scale

Intervention Type OTHER

To date, there is no valid fatigue scale in the depression of the elderly subject, a fortiori in French. The fatigue scale in adult depression includes has been validated with an EVA (Visual Analogue Scale) (38). We therefore propose to use this type of evaluation to control this aspect.

executive function

Intervention Type OTHER

* Modified Card Sorting Test MCST(Modified Card Sorting Test) (Wisconsin Test): This test assesses conceptualization, attention and mental flexibility using a deck of cards.
* Trail Making Test (TMT): This test is used to assess mental flexibility.
* Fluences verbal: This test tests the capacities of setting up search strategies in memory semantics and oral language.
* Stroop Paradigm: This test is used to evaluate the resistance to interference, ie the patient's ability to inhibit some over-learned and automated responses.

MRI

Intervention Type OTHER

An MRI lasting 30 minutes is programmed

Apathy Motivation Index

Intervention Type OTHER

This is a self-questionnaire of 18 items, each side on a 5-level Likert scale (0: not everything at 4: very often). It differentiates between "behavioral" apathy and "social" apathy.

"Emotional".

healthy controls

Group Type ACTIVE_COMPARATOR

Mini Neuropsychiatric Investigation

Intervention Type OTHER

This is a structured interview that allows rapid screening in about 20 minutes of troubles Psychiatric. It is based on short questions to which the patient must answer yes or no and on a decision tree. Patients must validate clinical diagnoses of depression.

Montgomery and Asberg depression Rating Scale

Intervention Type OTHER

This scale is composed of 10 items from 0 to 6 from a semi-structured interview, to obtain a total depression score of 0 to 60 (0 no depression, 60 maximum intensity of depression).

Clinical Global Impression

Intervention Type OTHER

heterosexual assessment that rates the severity of symptoms suicidal and changes in suicidal symptoms. Any subject with a score greater than 4 is not included.

accelerometer presentation

Intervention Type OTHER

accelerometer presentation and pose

data acquisition from the accelerometer

Intervention Type OTHER

withdrawal of the accelerometer and data acquisition from the accelerometer

executive function

Intervention Type OTHER

* Modified Card Sorting Test MCST(Modified Card Sorting Test) (Wisconsin Test): This test assesses conceptualization, attention and mental flexibility using a deck of cards.
* Trail Making Test (TMT): This test is used to assess mental flexibility.
* Fluences verbal: This test tests the capacities of setting up search strategies in memory semantics and oral language.
* Stroop Paradigm: This test is used to evaluate the resistance to interference, ie the patient's ability to inhibit some over-learned and automated responses.

MRI

Intervention Type OTHER

An MRI lasting 30 minutes is programmed

Interventions

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Mattis Dementia Rating Scale

This scale was developed to assess the cognitive status of patients with neurodegenerative diseases. There are 37 items that are presented in a fixed order and grouped into five sub-scales: attention, initiation, construction, conceptualization and memory. Patients and healthy subjects with a score below 125 are not included because of major cognitive impairment.

Intervention Type OTHER

Unified Parkinson 's Disease Rating Scale-III

This scale is used to rate the severity of extra-pyramidal symptoms (akinesia, rigidity and tremors). These symptoms may be the cause of reduction of motor activity apart from any reduction in motivation, they onstitute a confounding factor that it should be controlled.

Intervention Type OTHER

Mini Neuropsychiatric Investigation

This is a structured interview that allows rapid screening in about 20 minutes of troubles Psychiatric. It is based on short questions to which the patient must answer yes or no and on a decision tree. Patients must validate clinical diagnoses of depression.

Intervention Type OTHER

Montgomery and Asberg depression Rating Scale

This scale is composed of 10 items from 0 to 6 from a semi-structured interview, to obtain a total depression score of 0 to 60 (0 no depression, 60 maximum intensity of depression).

Intervention Type OTHER

Clinical Global Impression

heterosexual assessment that rates the severity of symptoms suicidal and changes in suicidal symptoms. Any subject with a score greater than 4 is not included.

Intervention Type OTHER

Apathy diagnostic criteria

The clinical criteria make it possible to make a diagnosis of apathy with a functional repercussion. It is based on a lack of motivation felt by the patient, causing a functional or social impact that is not the consequence of a disturbance of consciousness or a disability engine. The cognitive, emotional and behavioral dimensions are affected.

Intervention Type OTHER

walking speed test

The patient is timed to walk 10m. A speed \<1m / sec is a criterion exclusion because it shows severe sarcopenia and constitutes a bias.

Intervention Type OTHER

accelerometer presentation

accelerometer presentation and pose

Intervention Type OTHER

data acquisition from the accelerometer

withdrawal of the accelerometer and data acquisition from the accelerometer

Intervention Type OTHER

Apathy Evaluation Scale,

clinician version and near-helping version. It's a hetero rating scale from an interview semi structured by a trained clinician. It assesses cognitive, emotional and behavioral apathy than three items of various apathy. The total score ranges from 18 (total absence of apathy) to 72.

Intervention Type OTHER

fatigue Visual Analog Scale

To date, there is no valid fatigue scale in the depression of the elderly subject, a fortiori in French. The fatigue scale in adult depression includes has been validated with an EVA (Visual Analogue Scale) (38). We therefore propose to use this type of evaluation to control this aspect.

Intervention Type OTHER

executive function

* Modified Card Sorting Test MCST(Modified Card Sorting Test) (Wisconsin Test): This test assesses conceptualization, attention and mental flexibility using a deck of cards.
* Trail Making Test (TMT): This test is used to assess mental flexibility.
* Fluences verbal: This test tests the capacities of setting up search strategies in memory semantics and oral language.
* Stroop Paradigm: This test is used to evaluate the resistance to interference, ie the patient's ability to inhibit some over-learned and automated responses.

Intervention Type OTHER

MRI

An MRI lasting 30 minutes is programmed

Intervention Type OTHER

Apathy Motivation Index

This is a self-questionnaire of 18 items, each side on a 5-level Likert scale (0: not everything at 4: very often). It differentiates between "behavioral" apathy and "social" apathy.

"Emotional".

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

Patients:

* 60 years and above
* Major depressive disorder (either late-onset or early onset)
* Ambulatory settings
* Both uni and bipolar depression will be considered Healthy controls
* 60 years and above
* No psychiatric disorders, including no major depressive disorder

Exclusion Criteria

* Patients and healthy controls
* Major cognitive disorders (\< 125 on the Mattis dementia rating scale and a major cognitive disorders diagnostic according to the DSM5 (Diagnostic and Statistical Manual of Mental Disorders) criteria).
* Other neurological conditions (stroke, Parkinson's disease and seizures), severe and inflammatory disorders (ex: severe arthroses which limits movements, spondylarthritis)
* Severe sarcopenia: speed walk \< 1 meter/second
* Extrapyramidal syndrome
* High suicidal risk
* Anti-psychotic prescription
* Participant who are unable to provide clear consent, under legal protection
* MRI contra-indication
Minimum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Rennes University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Centre Mémoire de Ressources et de Recherche (CMRR),

Nice, , France

Site Status

CHU Pontchaillou, Département de Radiologie et d'Imagerie Médicale

Rennes, , France

Site Status

Centre Hospitalier Guillaume Régnier, Pôle Hospitalo-Universitaire de Psychiatrie Adulte

Rennes, , France

Site Status

CHU Bretonneau, Consultations Intersectorielles de Gérontopsychiatrie

Tours, , France

Site Status

CHU Bretonneau,CIC

Tours, , France

Site Status

Service de Radiologie- Neuroradiologie,CHU bretonneau

Tours, , France

Site Status

Countries

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France

Other Identifiers

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35RC18_8833_ACTIDEP

Identifier Type: -

Identifier Source: org_study_id

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