Role of the Blood-Brain Barrier in Stress Resilience: Investigating New Pathways Towards Pharmacological Augmentation of Stress Resilience

Summary

The goal of this clinical trial is to better understand the relationship between blood-brain barrier (BBB) function and stress resilience and to investigate a potential causal role for BBB function in stress resilience in humans. The researchers will look for particpants that are young adults to answer the following questions to reach our goal: * Is better BBB integrity, measured with neuroimaging, associated with better stress resilience in the short term and in the long term? * Does the administration of Metformin improve BBB integrity? * Is improved BBB integrity a possible link between Metformin and better short- and long-term stress resilience? The participants will do the following during our study: * Participants will fill in online surveys on stressor exposure and mental health once every four weeks over 36 weeks * Participants will visit the study site 4 times: * The first time for a screening process which includes questionnaires, a medical exam and a blood sample. * The next 2 visits will include a blood sample, a medical exam, an MRI scan and a list of questionnaires * The last visit will include another blood sample, a medical exam and a list of questionnaires. * Between visit 2 and 3, the participant will take either Metformin or Placebo

Timeline

Start

2025-06

Primary completion

2027-02

Completion

2027-02

Publications

• Background Kalisch R, Muller MB, Tuscher O. A conceptual framework for the neurobiological study of resilience. Behav Brain Sci. 2015;38:e92. doi: 10.1017/S0140525X1400082X. Epub 2014 Aug 27.
• Background Cathomas F, Holt LM, Parise EM, Liu J, Murrough JW, Casaccia P, Nestler EJ, Russo SJ. Beyond the neuron: Role of non-neuronal cells in stress disorders. Neuron. 2022 Apr 6;110(7):1116-1138. doi: 10.1016/j.neuron.2022.01.033. Epub 2022 Feb 18.
• Background Vennin C, Hewel C, Todorov H, Wendelmuth M, Radyushkin K, Heimbach A, Horenko I, Ayash S, Muller MB, Schweiger S, Gerber S, Lutz B. A Resilience Related Glial-Neurovascular Network Is Transcriptionally Activated after Chronic Social Defeat in Male Mice. Cells. 2022 Oct 27;11(21):3405. doi: 10.3390/cells11213405.
• Background Shao X, Ma SJ, Casey M, D'Orazio L, Ringman JM, Wang DJJ. Mapping water exchange across the blood-brain barrier using 3D diffusion-prepared arterial spin labeled perfusion MRI. Magn Reson Med. 2019 May;81(5):3065-3079. doi: 10.1002/mrm.27632. Epub 2018 Dec 18.
• Maas FM, Hachenberg S, Mituniewicz J, Kleim B, Schweiger S, Yuen KS, Cathomas F, Kobylinska D, Tuscher O, Kalisch R. Study protocol: role of the blood-brain barrier in stress resilience: investigating new pathways towards Pharmacological augmentation of stress resilience (a PHASR-PP project study). BMC Psychol. 2026 Mar 17;14(1):486. doi: 10.1186/s40359-026-04118-z.

Drugs

Indications