Phase 4
Completed N=40
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
| Outcome | Result | p-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.
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.