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Trial registered on ANZCTR
Registration number
ACTRN12616000149460
Ethics application status
Approved
Date submitted
1/07/2015
Date registered
8/02/2016
Date last updated
18/08/2017
Type of registration
Retrospectively registered
Titles & IDs
Public title
Changes in brain activities seen on functional magnetic resonance imaging (fMRI) during autobiographical tasks in patients with borderline personality disorder.
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Scientific title
Differences in brain functioning with autobiographical task during fMRI between patients with borderline personality disorder and healthy controls.
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Secondary ID [1]
287032
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None
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Universal Trial Number (UTN)
U1111-1171-7620
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Borderline personality disorder
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Condition category
Condition code
Mental Health
295759
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0
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Psychosis and personality disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The objective of the present study is to investigate with fMRI the differences in brain functioning between BPD patients and healthy controls during a task of autobiographical memory. In particular, we evaluated brain functioning in patients with identity diffusion, a core psychopathological factor of BPD that had not been assessed in previous investigations. Based on recent findings about neural correlates involved in patients with BPD during autobiographical memories we hypothesised that BPD patients with a deficit in identity integration may present a higher brain activation in dorsolateral prefrontal cortex, insula, anterior cingulate cortex, and temporal parietal junction during the recall of significant life events, both resolved and unresolved, in comparison with controls.
Patients with a diagnosis of BPD and a group of healthy subjects will be enrolled.
Assessment will be performed only on one occasion (baseline).
Autobiographical Interview will be performed to all subjects a week before MRI by an expert clinician (psychiatrist). The duration of interview will be about 90 minutes. Autobiographical Interview will allow to obtain 2 unresolved life events and 2 resolved life events. For each event subjects will provide 4 key-words that will be used to trigger active recall during fMRI. All subjects will undergo a training session immediatly before fMRI. fMRI will be performed by a radiologist.
During assessment, patients and controls will choose 4 neutral events from a pool of brief reports/events (24-26 words).Each report/event has 4 key-words. This pool of reports was previously administered to 100 subjects, who indicated what reports were neutral. Only reports that > 80% of subjects considered neutral will use in the task as resting condition.
Study will be a bloch design characterized by the following conditions:
- activation condition: presentation with eye-glasses a brief summary of life event (24-26 words for each event) for 10 seconds, fixation cross for 10 seconds, key-word event-related for 10 seconds, fixation cross for 10 seconds.
- Resting condition: presentation of neutral report/event(24-26 words) for 10 seconds, fixation cross for 10 seconds, key-word report/event related for 10 seconds, fixation cross for 10 seconds.
This cycle will be repeated for 32 times.
Tasks will be projected from the computer to the specific MRI eye-glassess that patient will wear during fMRI.
Activation condition will immediately follow resting condition. MRI registration will continue for all 32 cycle repeats.
BPD patients and healthy controls will be undergone activation conditions and resting conditions. Each bloch will last 40 seconds.
Functional images will be aquired and compared between patients and controls.
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Intervention code [1]
292241
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Diagnosis / Prognosis
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Comparator / control treatment
Brain activity of BPD patients will be compared to healthy controls during fMRI
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Control group
Active
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Outcomes
Primary outcome [1]
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Identity Disturbance Questionnaire (IDQ) total score to assess the relation between identity disturbance and alterations of brain functioning, measured during fMRI.
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Assessment method [1]
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Timepoint [1]
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Identity Disturbance Questionnaire will be performed one week prior fMRI. During fMRI it will be done a continuous monitoring of brain activity for 30 seconds from time that each key-word is given and brain functioning will be also assessed during resting condition.
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Primary outcome [2]
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Difference of change in brain activity during autobiographical task between patients and controls who have undergone fMRI will be registered. These data will be inserted into the Statistical Parametrical Mapping (SPM), a specific program to elaborate fMRI data.
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Assessment method [2]
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Timepoint [2]
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fMRI assessment will be continuously done during active condition (for 30 seconds after the key-word presentation) and during resting condition (30 seconds after the fixation cross presentation).
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Secondary outcome [1]
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Global symptoms assessed with the Clinical Global Impression Scale-Severity (CGI-S)
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Assessment method [1]
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Timepoint [1]
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CGI-S will be performed one week before the fMRI
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Secondary outcome [2]
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Specific borderline symptomatology measured with the Borderline Personality Disorder Severity Index (BPDSI)
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Assessment method [2]
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Timepoint [2]
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BPDSI will be performed one week before the fMRI
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Secondary outcome [3]
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Affective symptoms measured with the Hamilton Scale for Depression (HAM-D)
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Assessment method [3]
315648
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Timepoint [3]
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HAM-D will be performed one week before the fMRI
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Secondary outcome [4]
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Interpersonal functioning measured with the Social and Occupational Functioning Assessing Scale (SOFAS)
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Assessment method [4]
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Timepoint [4]
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SOFAS will be performed one week before the fMRI
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Secondary outcome [5]
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Traumatic events assessed with The Childhood Trauma Questionnaire (CTQ)
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Assessment method [5]
315651
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Timepoint [5]
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CTQ will be performed one week before the fMRI
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Secondary outcome [6]
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Anxious symtoms measured with the Hamilton Scale for Anxiety (HAM-A)
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Assessment method [6]
315894
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Timepoint [6]
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HAM-A will be performed one week before the fMRI
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Eligibility
Key inclusion criteria
Patients: diagnosis of borderline personality disorder.
Controls: subjects mached for age and gender without psychiatric disorders and neurological diseases.
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Minimum age
18
Years
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Maximum age
55
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Dementia, delirium, and other cognitive disorders; brain injuries; schizophrenia and other psychotic disorders; bipolar disorders; concurrent major depressive episode; substance abuse in the last two months; pharmacological treatments in the last three weeks; pregnant women.
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Study design
Purpose of the study
Diagnosis
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
Statistical Parametric Mapping (SPM-12) and Analysis of Variance (ANOVA) to evaluate the differences between groups.
40 BPD patients and 40 healthy controls will be enrolled.
No sample size calculations were conducted.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
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Actual
1/10/2015
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Date of last participant enrolment
Anticipated
28/02/2018
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
80
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Accrual to date
45
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Final
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Recruitment outside Australia
Country [1]
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Italy
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State/province [1]
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Turin
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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Centre for Personality Disorders, Psychiatric Clinic, Department of Neuroscience, Univerisity of Turin, Italy
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Address [1]
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Centre for Personality Disorders, Psychiatric Clinic, Department of Neuroscience, Univerisity of Turin, Via Cherasco 11, 10126, Turin, Italy
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Country [1]
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Italy
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Primary sponsor type
University
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Name
Centre for Personality Disorders, Psychiatric Clinic, Department of Neuroscience, Univerisity of Turin, Italy
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Address
Centre for Personality Disorders, Psychiatric Clinic, Department of Neuroscience, Univerisity of Turin, Via Cherasco 11, 10126, Turin, Italy
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Country
Italy
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
290259
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Comitato Etico Interaziendale A.O.U. Citta della Salute e della Scienza di Torino, A.O. Ordine Mauriziano ASL TO1.
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Ethics committee address [1]
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Corso Bramante 88/90 10126, Turin
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Ethics committee country [1]
293116
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Italy
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Date submitted for ethics approval [1]
293116
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30/06/2015
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Approval date [1]
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30/09/2015
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Ethics approval number [1]
293116
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0094867
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Summary
Brief summary
The growing interest in the relationships between brain activity and psychopathology has recently produced an increasing number of neuroimaging studies aimed to register the changes of brain functioning in specific cerebral areas. The objective of the present study is to evaluate the relationships between identity disturbance in borderline personality disorder (BPD) and brain activity in specific areas involved in the mechanisms of self and identity. Cerebral regions of interest will be dorsolateral prefrontal cortex, insula, anterior cingulate cortex, and temporal parietal Junction. Patients with a diagnosis of BPD and a group of healthy subjects matched for age and gender will be enrolled and compared. All participants will be tested before fMRI with the following evaluation instruments: the Clinical Global Impression Scale (CGI-S); the Borderline Personality Disorder Severity Index (BPDSI); the Identity Disturbance Questionnaire (IDQ); the Hamilton for Anxiety and Depression (HAM-A and HAM-D); the Childhood Trauma Questionnaire (CTQ); the Social and Occupational Functioning Assessment Scale (SOFAS); and the Autobiographical Interview. Autobiographical Interview will allow to obtain 2 unresolved life events and 2 resolved life events. For each event subjects will provide 4 key-words that will be used to trigger active recall during fMRI. Study design will be a bloch design characterized by two conditions: life events/key-words (activation condition) and neutral events/key-words (resting state). Each bloch will be presented by fMRI glasses and will last 40 s. In response to each life-event and key-word, BPD patients and healthy controls will recall the event (resolved and unresolved). In response to the fixation cross, they will stop recall. Patients and controls will undergo neutral event and key-word as resting condition. Structural and functional images will be aquired and compared between patients and controls. Statistical analyses will be conducted with SPM-12 and ANOVA.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Silvio Bellino
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Address
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Department of Neuroscience, Psychiatric Clinic, University of Turin, Via Cherasco 11, 10126, Turin, Italy.
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Country
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Italy
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Phone
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+39 011-6634848
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Fax
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+39 011-673473
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Email
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[email protected]
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Contact person for public queries
Name
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Paola Bozzatello
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Address
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Department of Neuroscience, Psychiatric Clinic, University of Turin, Via Cherasco 11, 10126, Turin, Italy.
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Country
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Italy
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Phone
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+39 011-6634848
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Fax
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+39 011-673473
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Email
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[email protected]
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Contact person for scientific queries
Name
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Chiara Brunetti
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Address
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Department of Neuroscience, Psychiatric Clinic, University of Turin, Via Cherasco 11, 10126, Turin, Italy.
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Country
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Italy
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Phone
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+39 011-6634848
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Fax
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+39 011-673473
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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