Healthy Volunteers Clinical Trial
Official title:
Effect of Armodafinil on Simulated Driving, Electroencephalogram and Cognitive Performance in Sleep Deprived Healthy Subjects
Sleep deprivation slows reaction time, reduces vigilance and impairs judgment and information
processing. Chronic effects include metabolic dysfunction, cardiovascular disease and cancer.
Sleep deprivation affects quality of life when it causes errors in judgment, whether these
occur behind the wheel of an automobile or in a hospital. Armodafinil, a non-amphetamine
wakefulness promoting medication, indicated for excessive sleepiness associated with
obstructive sleep apnea, narcolepsy, and shift work sleep disorder is used to mitigate the
effects of sleep deprivation.
This study will characterize the effect of armodafinil on driving simulator performance. The
effects of armodafinil compared to placebo will be studied in a double blind crossover trial
involving 10 healthy subjects with serial assessments at baseline and after extensive sleep
deprivation. Using simultaneous electroencephalogram (EEG) recording during simulated driving
and neurocognitive assessments of vigilance, the relationship between brain activity and
cognitive performance will be established.
On the first study day, the subjects will come to the Clinical Research Center (CRC) early in
the morning. In the first 90 minutes (acclimation session) of the study day EEG electrodes
will be applied and EEG signals will be measured continuously throughout the session.
Subjects will be instructed of the controls and operation of the driving simulator and
perform a 10 minute test drive to familiarize with it. Afterwards they will perform a battery
of cognitive tests including the Motor Praxis Task, the Visual Object Learning Test, the
Fractal-2-Back, the Abstract Matching, the Line Orientation Test, the Digit-Symbol
Substitution Task, the Balloon Analog Risk Test, and the Psychomotor Vigilance Test to get
familiar with the cognitive tests. The cognitive battery will last approximately 25 minutes.
The collected data of the conditioning session won't be part of the analysis. The purpose of
the session is that subjects adapt to the measures.
Following the acclimation session, the resting baseline for the subjects will be measured
which will consist of a simultaneous assessment of cognitive performance and brain activity.
The subjects will first drive for 30 minutes on the driving simulator to establish a resting
baseline of the driving performance. Afterwards a resting baseline for cognitive tests will
be established to measure attention, vigilance, risk-taking and decision-making. EEG will be
recorded concurrently during driving and cognitive tests. No blood samples will be taken
during the assessment of the resting baseline. Subjects will be discharged from the CRC after
completion of the baseline session (approximately 2 hours) until the evening. During this
time subjects are not allowed to sleep and they will be informed to not consume any caffeine
containing products (e.g. Red Bull, coffee). Upon return to the CRC, the subjects will be
sleep deprived and supervised by at least one of the study coordinators and at least one
additional person to make sure the subjects don't fall asleep during the night.
The following day, 24 hours after the resting baseline session, the fatigue baseline session
will start. Sessions of resting baseline and fatigue baseline will be scheduled for the same
time of day on two consecutive days to account for circadian alignment. The testing procedure
will be identical to the resting baseline session that means subjects will drive for 60
minutes on the driving simulator and perform the same cognitive tests as in the baseline
session. After completion of the fatigue baseline session, the study drug (armodafinil 250 mg
or placebo) will be administered. To determine the pharmacokinetics, blood samples will be
obtained prior to drug dosing and at 0.5, 1, 1.5, 2, 3, 4, 6, 8 and 10 hours post-dose
through an intravenous catheter placed in the arm vein of the subjects. After study drug
intake subjects will perform 5 sessions on the driving simulator consisting of 30-minute
drives. The same battery of tests performed at baseline will be performed between the drives.
The tested cognitive abilities play an important role during driving and the investigators
will investigate to what extent sleep deprivation alters these abilities and how armodafinil
is able to counter the deteriorating effects of sleep deprivation on these capabilities.
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