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  • Title: Visual P300 latency predicts treatment response to modafinil in patients with narcolepsy.
    Author: Sangal RB, Sangal JM, Belisle C.
    Journal: Clin Neurophysiol; 1999 Jun; 110(6):1041-7. PubMed ID: 10402091.
    Abstract:
    OBJECTIVE: To evaluate the hypothesis that visual P300 latency (VL) predicts treatment response to modafinil (a new wake-promoting agent) in patients with narcolepsy. DESIGN: Comparison of responders and non-responders in a double-blind randomized placebo-controlled trial. SETTING: Private practice referral sleep disorders center. PATIENTS: Twenty one patients with narcolepsy (ages 17-65 years). INTERVENTIONS: Auditory and visual P300 testing using 31 evenly spaced scalp electrodes, and baseline polysomnograms and objective and subjective tests of daytime sleepiness, followed by modafinil treatment for 9 weeks. Polysomnograms and tests of sleepiness were then repeated. MAIN OUTCOME MEASURE: The Maintenance of Wakefulness Test (MWT). Response defined as a final MWT > 7.3min (normative sample mean - 3 SD), plus an increase > 1SD based on normative sample (3.6 min) over baseline MWT. RESULTS: Non-responders had longer age-adjusted 31-electrode mean VL (448.4 ms vs. 410.8 ms, P = 0.024), and larger auditory P300 amplitude, with no topographical P300 differences. Non-responders and responders did not differ on any other baseline clinical variable. Using a cut-off of 0.5 SE from normal regression constant, shorter age-adjusted VL predicted modafinil response, with specificity of 0.71 and sensitivity of 0.86. CONCLUSIONS: VL predicts treatment response to modafinil in patients with narcolepsy.
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