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Phase 4 Completed N=40 Randomized Double-blind Treatment

Study to Evaluate Armodafinil Treatment in Improving Prefrontal Cortical Activation and Working Memory Performance

Excessive Sleepiness
Source: ClinicalTrials.gov NCT00711516 ↗
Enrolled (actual)
40
Serious AEs
0.0%
Results posted
Feb 2011
Primary outcomePrimary: Change From Baseline to Endpoint in Number of Contiguous Activated Voxels Meeting Predefined Threshold in Dorsolateral Prefrontal Cortex (DLPFC) on Functional Magnetic Resonance Imaging (fMRI) as a Measure of Prefrontal Cortical Activation — -1932.3; -2428.1 Activated voxels — p=0.7382

Summary

The primary objective of this study is to determine whether treatment with armodafinil will provide improvements in prefrontal cortical activation in patients with OSAHS (Obstructive Sleep Apnea/Hypopnea Syndrome) who have residual sleepiness despite receiving nCPAP therapy.

Outcome Measures

OutcomeResultp-value
PRIMARY
Change From Baseline to Endpoint in Number of Contiguous Activated Voxels Meeting Predefined Threshold in Dorsolateral Prefrontal Cortex (DLPFC) on Functional Magnetic Resonance Imaging (fMRI) as a Measure of Prefrontal Cortical Activation
-1932.3; -2428.1 0.7382
SECONDARY
Change From Baseline to Endpoint in Mean Response Latency in the 2-Back Working Memory Test at Endpoint - Mean Performance Speed
2.3; -59.0 0.1661
SECONDARY
Change From Baseline to Endpoint in the Number of Contiguous Activated Voxels Meeting the Predefined Threshold in the Anterior Cingulate Cortex (ACC)
-107.3; -206.5 0.5774
SECONDARY
Change From Baseline to Endpoint in the Number of Contiguous Voxels Meeting the Predefined Threshold in the Posterior Parietal Cortex (PPC)
-595.0; -773.3 0.8610
SECONDARY
Change From Baseline to Endpoint in the Number of Contiguous Activated Voxels Meeting the Predefined Threshold in the Thalamus
-841.7; -1417.9 0.6907
SECONDARY
Pattern Recognition Memory (PRM) Percent Correct (Immediate) From the CANTAB Battery-Change From Baseline to Endpoint
-0.1; 3.2 0.2456
SECONDARY
Pattern Recognition Memory (PRM) Percent Correct (Delayed) From the CANTAB Battery-Change From Baseline to Endpoint
0.4; -1.1 0.7115
SECONDARY
Reaction Time Index (RTI) Median Correct Latency, Five Choice Test From the CANTAB Battery-Change From Baseline to Endpoint
-6.5; -12.5 0.6103
SECONDARY
Reaction Time Index (RTI) Median Correct Latency, One Choice Test From the CANTAB Battery-Change From Baseline to Endpoint
-13.5; -4.5 0.9619
SECONDARY
One Touch Stockings of Cambridge (OTS) Mean Correct Latency, (Easy) From the CANTAB Battery-Change From Baseline to Endpoint
-787.9; -666.7 0.4544
SECONDARY
One Touch Stockings of Cambridge (OTS) Mean Correct Latency, (Hard) From the CANTAB Battery-Change From Baseline to Endpoint
-733.3; -6898.1 0.0193 sig
SECONDARY
One Touch Stockings of Cambridge (OTS) Mean Choices to Correct, (Easy) From the CANTAB Battery-Change From Baseline to Endpoint
0.0; 0.0 0.1704
SECONDARY
One Touch Stockings of Cambridge (OTS) Mean Choices to Correct, (Hard) From the CANTAB Battery-Change From Baseline to Endpoint
-0.2; 0.0 0.0609
SECONDARY
Epworth Sleepiness Scale Change From Baseline to Endpoint
-5.8; -2.9 0.0499 sig
SECONDARY
Clinical Global Impression of Change (CGI-C)- Number of Responders at Endpoint
13; 9 0.7343
SECONDARY
Total Score From the Medical Outcomes Study 6-Item Cognitive Function Scale (MOS-CF6)-Change From Baseline to Endpoint
6.1; -0.2 0.1246
SECONDARY
Blood Oxygenation Level Dependent (BOLD) Signal Intensity - Percent Change From Baseline to Endpoint in the Dorsolateral Prefrontal Cortex (DLPFC)
-0.398; 4.704 0.7382
SECONDARY
Blood Oxygenation Level Dependent (BOLD) Signal Intensity - Percent Change From Baseline to Endpoint in the Anterior Cingulate Cortex (ACC)
-1.777; 7.148 1.000
SECONDARY
Blood Oxygenation Level Dependent (BOLD) Signal Intensity -Change From Baseline to Endpoint in the Posterior Parietal Cortex (PPC)
3.199; -2.021 0.8861
SECONDARY
Blood Oxygenation Level Dependent (BOLD) Signal Intensity - Percent Change From Baseline to Endpoint in the Thalamus
16.363; 2.099 0.4738
SECONDARY
Activation-Performance Relationship Between the Functional Magnetic Resonance Imaging (fMRI) in Dorsolateral Prefrontal Cortex (DLPFC) and 2-Back Working Memory Test - Number of Voxels Activated at Endpoint
0.422; -0.445 0.0573
SECONDARY
Activation-Performance Relationship Between the Functional Magnetic Resonance Imaging (fMRI) in Anterior Cingulate Cortex (ACC) and 2-Back Working Memory Test - Number of Voxels Activated at Endpoint
0.254; -0.152 0.2727
SECONDARY
Activation-Performance Relationship Between Functional Magnetic Resonance Imaging (fMRI) in Posterior Parietal Cortex (PPC) and the 2-Back Working Memory Test -Number of Voxels Activated at Endpoint
0.355; -0.358 0.1169
SECONDARY
Activation-Performance Relationship Between Functional Magnetic Resonance Imaging (fMRI) in the Thalamus and 2-Back Working Memory Test -Number of Voxels Activated at Endpoint
0.405; -0.038 0.0692
SECONDARY
Activation-Performance Relationship Between the Functional Magnetic Resonance Imaging (fMRI) in Dorsolateral Prefrontal Cortex (DLPFC) and 2-Back Working Memory Test - Blood Oxygen Level Dependent (BOLD) Signal Intensity at Endpoint
-0.122; 0.789 0.6030
SECONDARY
Activation-Performance Relationship Between Functional Magnetic Resonance Imaging (fMRI) in Anterior Cingulate Cortex (ACC) and 2-Back Working Memory Test -Blood Oxygen Level Dependent (BOLD) Signal Intensity at Endpoint
0.025; -0.012 0.9170
SECONDARY
Activation-Performance Relationship on Functional Magnetic Resonance Imaging (fMRI) in Posterior Parietal Cortex (PPC) and 2-Back Working Memory Test - Blood Oxygen Level Dependent (BOLD) Signal Intensity at Endpoint
0.065; 0.364 0.7813
SECONDARY
Activation-Performance Relationship on Functional Magnetic Resonance Imaging (fMRI) in the Thalamus and 2-Back Working Memory Test - Blood Oxygen Level Dependent (BOLD) Signal Intensity at Endpoint
-0.029; 0.582 0.9010
SECONDARY
Number of Contiguous Activated Voxels Meeting Predefined Threshold in the DLPFC on fMRI on the 2 Back Working Memory Test - Change From Baseline-Subgroup-Responders in 2 Back Working Memory Test
-1411.6; -1359.0
SECONDARY
Number of Contiguous Activated Voxels Meeting Predefined Threshold in the ACC on fMRI by 2-Back Working Memory Test -Change From Baseline; Subgroup-Responders in 2 Back Memory Test
-38.6; -227.8
SECONDARY
Number of Contiguous Activated Voxels Meeting Predefined Threshold in the PPC on fMRI by 2-Back Working Memory Test-Change From Baseline; Subgroup-Responders in 2 Back Memory Test
-789.1; -397.7
SECONDARY
Number of Contiguous Activated Voxels Meeting Predefined Threshold in the Thalamus on fMRI by 2-Back Working Memory Test-Change From Baseline; Subgroup-Responders in 2 Back Memory Test
-764.7; -1446.7
SECONDARY
Number of Contiguous Activated Voxels Meeting Predefined Threshold in the DLPFC on fMRI by 2-Back Working Memory Test-Change From Baseline; Subgroup-Non Responders in 2 Back Memory Test
-2279.4; -2784.4
SECONDARY
Number of Contiguous Activated Voxels Meeting Predefined Threshold in the ACC on fMRI by 2-Back Working Memory Test-Change From Baseline; Subgroup-Non Responders in 2 Back Memory Test
-153.1; -199.4
SECONDARY
Number of Contiguous Activated Voxels Meeting Predefined Threshold in the PPC on fMRI by 2-Back Working Memory Test-Change From Baseline; Subgroup-Non Responders in 2 Back Memory Test
-465.5; -898.5
SECONDARY
Number of Contiguous Activated Voxels Meeting Predefined Threshold in the Thalamus on fMRI by 2-Back Working Memory Test-Change From Baseline; Subgroup-Non Responders in 2 Back Memory Test
-893.1; -1408.3
SECONDARY
Change From Baseline to Endpoint in the BOLD Signal Intensity in the Dorsolateral Prefrontal Cortex (DLPFC) at Resting State
5.556; 3.755 0.7053
SECONDARY
Change From Baseline to Endpoint in the BOLD Signal Intensity in the Anterior Cingulate Cortex (ACC) at Resting State
2.778; 0.0 0.5163
SECONDARY
Change From Baseline in the BOLD Signal Intensity in the Posterior Parietal Cortex (PPC) at Resting State
2.667; 2.479 0.8711
SECONDARY
Change From Baseline to Endpoint in the BOLD Signal Intensity in the Thalamus at Resting State
5.128; 1.429 0.1825
SECONDARY
Change From Baseline to Endpoint in the Number of Voxels Meeting Predefined Threshold in the Dorsolateral Prefrontal Cortex (DLPFC) at Resting State
941.5; -174.5 0.9282
SECONDARY
Change From Baseline to Endpoint in the Number of Voxels Meeting Predefined Threshold in Anterior Cingulate Cortex (ACC) at Resting State
-27.5; -54.0 1.0000
SECONDARY
Change From Baseline to Endpoint in the Number of Voxels Meeting Predefined Threshold in Posterior Parietal Cortex (PPC) at Resting State
22.0; 104.3 0.5284
SECONDARY
Change From Baseline to Endpoint in the Number of Voxels Meeting Predefined Threshold in the Thalamus at Resting State
-621.0; -883.8 0.8997
SECONDARY
Change From Baseline to Endpoint (2 Weeks or Last Observation After Baseline) in the Mean Response Latency in the Psychomotor Vigilance-Like Test
-31.9; -6.8 0.1305

Eligibility Criteria

Inclusion Criteria

  • Patient has a current diagnosis of OSAHS and has a complaint of excessive sleepiness despite effective nCPAP therapy.
  • Patient has excessive sleepiness as evidenced by a mean sleep latency of less than 8 minutes, as determined by the MSLT.
  • Patient has an ESS score of 10 or more at the initial screening visit.
  • Patient has a habitual sleep time beginning no earlier than 2100 and ending no later than 0700.
  • Patient is right-handed. Patients who are ambidextrous may be eligible following consultation with the medical monitor.
  • Women of childbearing potential must use a medically accepted method of contraception and must agree to continue use of this method for the duration of the study and for 30 days after participation in the study.
  • Patient exhibits reasonable accuracy (≥80%) on the 2-back working memory task during the training session at the second screening visit.

Exclusion Criteria

The Patient:

  • The patient is a current smoker or has a prior history of smoking (defined as ≥1 pack-year) within 2 years prior to the screening visit.
  • consumes caffeine including coffee, tea and/or other caffeine-containing beverages or food averaging more than 400 mg of caffeine per day (approximately equivalent to 4 or more cups of coffee).
  • has NART-predicted verbal IQ and QIDS-SR16 scores within protocol-specific exclusionary ranges.
  • has a clinically significant, uncontrolled medical or psychiatric conditions (treated or untreated).
  • has a confirmed or probable diagnosis of a current sleep disorder other than OSAHS.
  • has used any excluded prescription drugs or procedures for prohibited and allowed drugs within the excluded timeframe.
  • has a history of alcohol, narcotic, or any other drug abuse.
  • has a positive UDS, without medical explanation, at the screening visit.
  • has a clinically significant deviation from normal in the physical examination.
  • is a pregnant or lactating woman. Any woman becoming pregnant during the study will be withdrawn from the study.
  • has a past or present seizure disorder, head trauma that is clinically significant, or past neurosurgery.
  • has used an investigational drug within 1 month before the screening visit.
  • has any disorder that may interfere with drug absorption, distribution, metabolism, or excretion (including gastrointestinal surgery).
  • has a known hypersensitivity to armodafinil or modafinil, or any other component of the study drug tablets.
  • has a history of any clinically significant cutaneous drug reaction, or a history of clinically significant hypersensitivity reaction, including multiple allergies or drug reactions.
  • has known human immunodeficiency virus (HIV).
  • has clinical laboratory test value(s) outside the range(s) specified in the Protocol, or presents a clinically significant laboratory abnormality without prior written approval by the medical monitor.
  • has worked the night shift within 28 days of the baseline visit, or will work the night shift during the double-blind segment of the study.
  • anticipates any travel across more than 3 time zones at any time during the study.
  • needs to use any of the excluded medications identified in this protocol.
  • is unable to complete neuroimaging studies, performance tasks, self-rating scales, and all other study assessments.
  • has a contraindication to fMRI scanning, (such as an implanted pacemaker/defibrillator, aneurysm clips, drug infusion device or metallic foreign body).
  • is suspected to be unable to tolerate fMRI scanning (eg, claustrophobic) and/or the testing paradigm.
  • has physical or other characteristics that suggest imaging data will be unobtainable or degraded.
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT00711516). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.

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