| Condition or disease | Intervention/treatment | Phase |
|---|---|---|
| Healthy | Drug: Reboxetine Drug: Rivastigmine Drug: Placebo oral tablet | Not Applicable |
Background: Previous research has shown that human learners are able to encode the probabilities of positive and negative outcomes in parallel, and adjust their learning behaviour to the information content of positive and negative outcomes (Pulcu and Browning 2017). In reinforcement learning tasks, the volatility (also known as unexpected uncertainty arising when the environment changes suddenly) of outcomes directly influences how informative the outcomes are perceived to be (Behrens, Woolrich et al. 2007). Previous studies consistently shown that human participants use a higher learning rate while learning from outcomes with high volatility (Behrens, Woolrich et al. 2007, Browning, Behrens et al. 2015, Pulcu and Browning 2017). Another source of uncertainty is expected uncertainty, which arises from naturally varying outcomes (e.g. day to day changes in temperature). Different sources of uncertainty in the environment are argued to be associated with the activity of different neurotransmitter systems in the human brain (Yu and Dayan, 2005)(Angela and Dayan 2005). For example, outcome volatility (unexpected uncertainty) is thought to be associated with the activity of the central norepinephrine (NE) system, whereas outcome variation (expected uncertainty) has been linked to the cholinergic (ACY) system.
Studies using pupillometry (a non-invasive way of inferring central norepinephrine activity in the human brain) showed that pupil size is associated with the volatility of outcomes during reinforcement learning tasks (Browning, Behrens et al. 2015, Pulcu and Browning 2017). However, pupil size can also be influenced by the activity of other neurotransmitters including acetylcholine limiting the degree to which these results can be attributed to the NE system. Further, previous human studies have been associational in nature and thus the causal role of the NE and ACY systems in human learning under uncertainty have yet to be tested. The current study will address this knowledge gap by investigating how administering a single dose of the norepinephrine reuptake inhibitor reboxetine or cholinesterase inhibitor rivastigmine influence choice behaviour and pupillary correlates of human reinforcement learning.
Study Structure: All participants will be recruited via the recruitment pipeline described below. The randomisation procedure used will treat participants as if 2 parallel studies were running: a reboxetine vs. placebo and a rivastigmine vs. placebo study. Researchers will assign participants to either the reboxetine or rivastigmine arm (NB researchers will not be blind to this allocation although participants will be). Both studies will randomise participants in a 1:1 ratio, stratified by gender, to either the active drug or placebo (NB both researchers and participants will remain blind to this allocation). This will result in an overall group size for the reboxetine:rivastigmine:placebo groups of 30:30:60 (with participants randomised to placebo being specifically associated with the reboxetine or rivastigmine group). The rationale for this approach is that, while study procedures are identical for all participants, the investigators are addressing 2 separate questions in this study (the effect of NE manipulation and the effect of ACY manipulation on learning) which are more straightforwardly assessed using two, separate, placebo controlled comparisons rather than a larger three group study.
| Study Type : | Interventional (Clinical Trial) |
| Actual Enrollment : | 107 participants |
| Allocation: | Randomized |
| Intervention Model: | Parallel Assignment |
| Intervention Model Description: | Three group parallel design |
| Masking: | Triple (Participant, Investigator, Outcomes Assessor) |
| Masking Description: | Overencapsulated drug/placebo capsule used. Investigator and participant blind to allocation. Randomisation schedule drawn up by independent researcher and kept in locked cabinet. |
| Primary Purpose: | Basic Science |
| Official Title: | Noradrenaline, Acetylcholine and Dynamic Learning in Healthy Humans |
| Actual Study Start Date : | June 1, 2019 |
| Actual Primary Completion Date : | June 1, 2020 |
| Actual Study Completion Date : | June 1, 2020 |
| Arm | Intervention/treatment |
|---|---|
|
Experimental: Reboxetine
Single dose of 4mg
|
Drug: Reboxetine
Single dose used to increase central norepinepherine
|
|
Experimental: Rivastigmine
Single dose of 3mg
|
Drug: Rivastigmine
Single dose to increase central acetylcholine
|
|
Placebo Comparator: Placebo
Single dose of placebo
|
Drug: Placebo oral tablet
Single dose as control condition
|
| Ages Eligible for Study: | 18 Years to 45 Years (Adult) |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
Exclusion Criteria:
| United Kingdom | |
| Dept of Psychiatry, University of Oxford | |
| Oxford, Oxfordshire, United Kingdom, OX3 7JX | |
| Tracking Information | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| First Submitted Date ICMJE | May 10, 2019 | ||||||||||||
| First Posted Date ICMJE | May 21, 2019 | ||||||||||||
| Last Update Posted Date | June 16, 2020 | ||||||||||||
| Actual Study Start Date ICMJE | June 1, 2019 | ||||||||||||
| Actual Primary Completion Date | June 1, 2020 (Final data collection date for primary outcome measure) | ||||||||||||
| Current Primary Outcome Measures ICMJE |
Change in learning rates [ Time Frame: 2 hours after dosing (NB outcome is the change from the baseline measure to this time point) ] Learning rates from negative and positive outcomes received in a reinforcement learning task
|
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| Original Primary Outcome Measures ICMJE | Same as current | ||||||||||||
| Change History | |||||||||||||
| Current Secondary Outcome Measures ICMJE |
|
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| Original Secondary Outcome Measures ICMJE | Same as current | ||||||||||||
| Current Other Pre-specified Outcome Measures | Not Provided | ||||||||||||
| Original Other Pre-specified Outcome Measures | Not Provided | ||||||||||||
| Descriptive Information | |||||||||||||
| Brief Title ICMJE | Noradrenaline, Acetylcholine and Dynamic Learning in Healthy Humans | ||||||||||||
| Official Title ICMJE | Noradrenaline, Acetylcholine and Dynamic Learning in Healthy Humans | ||||||||||||
| Brief Summary | The aim of this study is to characterize the role of central norepinephrine and acetylcholine on reward and emotion related information processing in healthy volunteers using behavioural tasks and pupillometry (with eye tracking equipment). The pharmacological compounds used in the study (reboxetine and rivastigmine) are used as tools to manipulate these systems rather than to treat patients. The aim of the study is not to study the clinical effects, pharmacodynamics, adverse reactions, absorption, distribution, metabolism or excretion of the drugs. Further, the population studied is non-clinical, the drugs are not administered in a therapeutic dosing regimen (only a single dose of study drug will be administered) and the investigators do not measure clinically significant outcomes. | ||||||||||||
| Detailed Description |
Background: Previous research has shown that human learners are able to encode the probabilities of positive and negative outcomes in parallel, and adjust their learning behaviour to the information content of positive and negative outcomes (Pulcu and Browning 2017). In reinforcement learning tasks, the volatility (also known as unexpected uncertainty arising when the environment changes suddenly) of outcomes directly influences how informative the outcomes are perceived to be (Behrens, Woolrich et al. 2007). Previous studies consistently shown that human participants use a higher learning rate while learning from outcomes with high volatility (Behrens, Woolrich et al. 2007, Browning, Behrens et al. 2015, Pulcu and Browning 2017). Another source of uncertainty is expected uncertainty, which arises from naturally varying outcomes (e.g. day to day changes in temperature). Different sources of uncertainty in the environment are argued to be associated with the activity of different neurotransmitter systems in the human brain (Yu and Dayan, 2005)(Angela and Dayan 2005). For example, outcome volatility (unexpected uncertainty) is thought to be associated with the activity of the central norepinephrine (NE) system, whereas outcome variation (expected uncertainty) has been linked to the cholinergic (ACY) system. Studies using pupillometry (a non-invasive way of inferring central norepinephrine activity in the human brain) showed that pupil size is associated with the volatility of outcomes during reinforcement learning tasks (Browning, Behrens et al. 2015, Pulcu and Browning 2017). However, pupil size can also be influenced by the activity of other neurotransmitters including acetylcholine limiting the degree to which these results can be attributed to the NE system. Further, previous human studies have been associational in nature and thus the causal role of the NE and ACY systems in human learning under uncertainty have yet to be tested. The current study will address this knowledge gap by investigating how administering a single dose of the norepinephrine reuptake inhibitor reboxetine or cholinesterase inhibitor rivastigmine influence choice behaviour and pupillary correlates of human reinforcement learning. Study Structure: All participants will be recruited via the recruitment pipeline described below. The randomisation procedure used will treat participants as if 2 parallel studies were running: a reboxetine vs. placebo and a rivastigmine vs. placebo study. Researchers will assign participants to either the reboxetine or rivastigmine arm (NB researchers will not be blind to this allocation although participants will be). Both studies will randomise participants in a 1:1 ratio, stratified by gender, to either the active drug or placebo (NB both researchers and participants will remain blind to this allocation). This will result in an overall group size for the reboxetine:rivastigmine:placebo groups of 30:30:60 (with participants randomised to placebo being specifically associated with the reboxetine or rivastigmine group). The rationale for this approach is that, while study procedures are identical for all participants, the investigators are addressing 2 separate questions in this study (the effect of NE manipulation and the effect of ACY manipulation on learning) which are more straightforwardly assessed using two, separate, placebo controlled comparisons rather than a larger three group study. |
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| Study Type ICMJE | Interventional | ||||||||||||
| Study Phase ICMJE | Not Applicable | ||||||||||||
| Study Design ICMJE | Allocation: Randomized Intervention Model: Parallel Assignment Intervention Model Description: Three group parallel design Masking: Triple (Participant, Investigator, Outcomes Assessor)Masking Description: Overencapsulated drug/placebo capsule used. Investigator and participant blind to allocation. Randomisation schedule drawn up by independent researcher and kept in locked cabinet. Primary Purpose: Basic Science
|
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| Condition ICMJE | Healthy | ||||||||||||
| Intervention ICMJE |
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| Study Arms ICMJE |
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| Publications * | Not Provided | ||||||||||||
|
* Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline. |
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| Recruitment Information | |||||||||||||
| Recruitment Status ICMJE | Completed | ||||||||||||
| Actual Enrollment ICMJE |
107 | ||||||||||||
| Original Estimated Enrollment ICMJE |
120 | ||||||||||||
| Actual Study Completion Date ICMJE | June 1, 2020 | ||||||||||||
| Actual Primary Completion Date | June 1, 2020 (Final data collection date for primary outcome measure) | ||||||||||||
| Eligibility Criteria ICMJE |
Inclusion Criteria:
Exclusion Criteria:
|
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| Sex/Gender ICMJE |
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| Ages ICMJE | 18 Years to 45 Years (Adult) | ||||||||||||
| Accepts Healthy Volunteers ICMJE | Yes | ||||||||||||
| Contacts ICMJE | Contact information is only displayed when the study is recruiting subjects | ||||||||||||
| Listed Location Countries ICMJE | United Kingdom | ||||||||||||
| Removed Location Countries | |||||||||||||
| Administrative Information | |||||||||||||
| NCT Number ICMJE | NCT03957174 | ||||||||||||
| Other Study ID Numbers ICMJE | R62807/RE001 | ||||||||||||
| Has Data Monitoring Committee | No | ||||||||||||
| U.S. FDA-regulated Product |
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| IPD Sharing Statement ICMJE |
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| Responsible Party | University of Oxford | ||||||||||||
| Study Sponsor ICMJE | University of Oxford | ||||||||||||
| Collaborators ICMJE | Not Provided | ||||||||||||
| Investigators ICMJE | Not Provided | ||||||||||||
| PRS Account | University of Oxford | ||||||||||||
| Verification Date | March 2020 | ||||||||||||
|
ICMJE Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP |
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