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Methylphenidate and Cognitive Training in Elderly (PACTE-1)

Primary Purpose

Healthy Volunteers

Status
Recruiting
Phase
Phase 2
Locations
France
Study Type
Interventional
Intervention
Methylphenidate
Placebo
CogniPlus software
Pseudo cognitive training
Sponsored by
University Hospital, Lille
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Healthy Volunteers focused on measuring Cognitive disorders, cognitive training, symptomatic treatment, Methylphenidate, elderly

Eligibility Criteria

55 Years - 75 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Without severe chronic neurological or mental or psychiatric pathology
  • Absence of cognitive impairment affecting autonomy (scores on the dementia scale of Mattis> 130 and the IADL = 4)
  • Right-handed participant
  • Subjects holding driving license B and continuing a driving activity
  • Affiliate or beneficiary of a social security scheme
  • Subject having signed informed consent
  • Subject having agreed to be registered on the National File of Healthy Volunteers
  • Patient willing to comply with all procedures of the study and its duration
  • No planned changes in lifestyle (nutritional and physical, social interactions) during the life of the protocol

Exclusion Criteria:

  • Administrative reasons: impossibility of receiving informed information, inability to participate in the whole study, absence of coverage by the social security system, refusal to sign consent.
  • Subject simultaneously participating in another clinical trial or in an exclusion period.
  • Subject under tutelage or curatelle.
  • Subject during breastfeeding or pregnancy.
  • Subject not sufficiently fluent in the French language to understand the instructions necessary to carry out the cognitive tests.
  • Subject with uncorrected visual pathology or motor pathology (orthopedic example) likely to interfere with the passing of tests.
  • Subject with dependencies pre-existing to medicines, drugs or alcohol.
  • Presence of contraindications to MRI: Claustrophobia, Anxiety crisis, Morphotype not allowing access to MRI, metal implant (eg a pacemaker), surgical clips Ferromagnetic, orbital or brain metallic foreign bodies).
  • Hypersensitivity to methylphenidate or any other constituents of the product.
  • Subject with a personal and / or family history of motor tics and Gilles de la Tourette syndrome.
  • Subjects with a previous psychiatric history (based on the semi-structured psychiatric interview with the MINI of DSM IV adapted to DSM V): state, severe depression, severe generalized anxiety, anorexia nervosa or anorexic disorders, suicidal tendencies, psychotic symptoms, severe mood disorders, mania, schizophrenia, psychopathic personality disorder or borderline disorder. Dysthymia and an isolated history of depression do not constitute an exclusion criterion.
  • Subjects consuming one or more psychotropic drugs or related products (antidepressants, antipsychotics, antiepileptic drugs, daily use of benzodiazepine anxiolytics or other anxiolytics, vesperal hypnotic intake). A history of taking point hypnotics is not a criterion of exclusion. However, there should be no regular and regular intake in the previous 3 months and less than once a week (ideally, lack of intake would be desirable but would considerably limit the potential for inclusion). They will be asked not to change their habits during the study period.
  • Subjects with dysthyroidism or thyrotoxicosis
  • Subjects with pre-existing cardiovascular disorders including severe hypertension, heart failure, occlusive arterial disease, angina pectoris, congenital heart disease with hemodynamic repercussions, cardiomyopathy, myocardial infarction, arrhythmias and channelopathies
  • Subject with angle-closure glaucoma.
  • Significant abnormalities on MRI and EEG according to the investigator's judgment
  • Presence of untreated hypertension discovered during screening
  • Subject with pheochromocytoma
  • Pre-existing cerebrovascular disorders, cerebral aneurysm, vascular abnormalities, including vasculitis or stroke in the subject
  • Subjects with hepatic and renal insufficiency
  • Obese subject according to WHO classification (BMI> 30)
  • Presence of one of the following treatments that cannot be stopped for a period corresponding to 5 half-lives before inclusion: selective and non-selective MAOIs (nialamide and iproniazide, selegiline), other indirect sympathomimetics (phenylpropanolamine, pseudoephedrine, Phenylephrine), halogenated volatile anesthetics, guanethidine and related compounds.
  • Treatment with alpha sympathomimetics (oral and / or nasal route) (etilefrin, midodrine, naphazoline, oxymetazoline, tetryzoline, tuaminoheptane, tymazoline), opiates and morphine derivatives. These concomitant treatments are contraindicated at baseline and throughout the study period.
  • Subject with leukopathy classified ≥2 on the Fazekas scale

Sites / Locations

  • Hôpital Roger Salengro, CHURecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Experimental

Arm Label

Methylphenidate and structured cognitive training

Placebo and structured cognitive training

Methylphenidate and pseudo cognitive training

Placebo and pseudo cognitive training

Arm Description

Methylphenidate (capsules of Ritaline LP 10) encapsulated, 0,3 mg per kg per day during 6 weeks Structured cognitive training with CogniPlus software, twice per week during 6 weeks

Placebo, identical capsules to encapsulated MPH, number of capsules per day identical to MPH during 6 weeks Structured cognitive training with CogniPlus software, twice per week during 6 weeks

Methylphenidate (capsules of Ritaline LP 10) encapsulated, 0,3 mg per kg per day during 6 weeks Pseudo cognitive training with 45 minutes documentary videos and 15 minutes quiz, twice per week during 6 weeks

Placebo, identical capsules to encapsulated MPH, number of capsules per day identical to MPH during 6 weeks Pseudo cognitive training with 45 minutes documentary videos and 15 minutes quiz, twice per week during 6 weeks

Outcomes

Primary Outcome Measures

The difference of the average response time to a choice task at inclusion and at the end of treatment (after 6 weeks)

Secondary Outcome Measures

Change from baseline the composite cognitive functions
A composite measure of several cognitive functions: attention, executive functions, working memory, verbal and nonverbal episodic memory, visuo-spatial functions
Change from baseline of the results to task on a driving simulator
A composite measure of task on a driving simulator: travel time, speed parameters(average speed, maintaining the target speed) compliance with the instructions and code of the road (number and type of errors), number of cars doubled, reaction time in analytics.
Behavior Rating Inventory of Executive Function (BRIEF-A)
Hospital Anxiety and Depression scale (HAD)
Number of undesirable effects of treatment
Change from baseline the parameters of structured cognitive training (CogniPlus®)
A composite measure of parameters following : processing speed, inhibition and working memory resources.
Resting state EEG
EEG with Attentional Network Test and Go / No Go task
resting state functional MRI
The changes of resting state functional MRI after treatment and cognitive training

Full Information

First Posted
September 5, 2017
Last Updated
August 16, 2022
Sponsor
University Hospital, Lille
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1. Study Identification

Unique Protocol Identification Number
NCT03280251
Brief Title
Methylphenidate and Cognitive Training in Elderly
Acronym
PACTE-1
Official Title
Potentiation of Cognitive Functions in Healthy Elderly by Association of Methylphenidate and Cognitive Training: Proof of Concept Study in Order to Develop a Synergic Symptomatic Treatment for the Cognitive Disorders Before Dementia
Study Type
Interventional

2. Study Status

Record Verification Date
July 2022
Overall Recruitment Status
Recruiting
Study Start Date
September 19, 2018 (Actual)
Primary Completion Date
November 2024 (Anticipated)
Study Completion Date
November 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University Hospital, Lille

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Currently, there is no available drug to treat the symptoms of neurodegenerative and vascular cognitive disorders that affect millions of people worldwide. Methylphenidate is indicated at high dose (1 mg/kg/day) in children having attention deficit and hyperactivity disorder (ADHD) and remains the best cognitive enhancer drug at lower dose. However, there is no proof of efficacy with chronic administration, outside ADHD, and concern remains about long-term cardiac and vascular risks in elderly and particularly in population with vascular risk factors and drug abuse in young people. Moreover, the effect appears to be very limited at the very advanced stage of dementia, for which the neuronal plasticity is too reduced to expect a benefit of training. Taken all together, we sought to develop a new paradigm of association of both pharmacological and non-pharmacological procedure to enhance the neuronal plasticity in order to expect a persistent effect on slight to mild cognitive disorders with benefit on ecological test (i.e. driving). Finally, short-term treatment would reduce the safety concerns. The concept will be to prove that low dose of methylphenidate associated with active cognitive training during 6 weeks can improve the cognitive function in healthy aged volunteers with a persistent effect at 3 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Healthy Volunteers
Keywords
Cognitive disorders, cognitive training, symptomatic treatment, Methylphenidate, elderly

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
Care ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
120 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Methylphenidate and structured cognitive training
Arm Type
Experimental
Arm Description
Methylphenidate (capsules of Ritaline LP 10) encapsulated, 0,3 mg per kg per day during 6 weeks Structured cognitive training with CogniPlus software, twice per week during 6 weeks
Arm Title
Placebo and structured cognitive training
Arm Type
Experimental
Arm Description
Placebo, identical capsules to encapsulated MPH, number of capsules per day identical to MPH during 6 weeks Structured cognitive training with CogniPlus software, twice per week during 6 weeks
Arm Title
Methylphenidate and pseudo cognitive training
Arm Type
Experimental
Arm Description
Methylphenidate (capsules of Ritaline LP 10) encapsulated, 0,3 mg per kg per day during 6 weeks Pseudo cognitive training with 45 minutes documentary videos and 15 minutes quiz, twice per week during 6 weeks
Arm Title
Placebo and pseudo cognitive training
Arm Type
Experimental
Arm Description
Placebo, identical capsules to encapsulated MPH, number of capsules per day identical to MPH during 6 weeks Pseudo cognitive training with 45 minutes documentary videos and 15 minutes quiz, twice per week during 6 weeks
Intervention Type
Drug
Intervention Name(s)
Methylphenidate
Intervention Description
Methylphenidate (capsules of Ritaline LP 10) encapsulated, 0,3 mg per kg per day during 6 weeks
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo, identical capsules to encapsulated MPH, number of capsules per day identical to MPH during 6 weeks
Intervention Type
Other
Intervention Name(s)
CogniPlus software
Intervention Description
Structured cognitive training with CogniPlus software, twice per week during 6 weeks
Intervention Type
Other
Intervention Name(s)
Pseudo cognitive training
Intervention Description
Pseudo cognitive training with 45 minutes documentary videos and 15 minutes quiz, twice per week during 6 weeks
Primary Outcome Measure Information:
Title
The difference of the average response time to a choice task at inclusion and at the end of treatment (after 6 weeks)
Time Frame
6 weeks after the beginning of the treatment
Secondary Outcome Measure Information:
Title
Change from baseline the composite cognitive functions
Description
A composite measure of several cognitive functions: attention, executive functions, working memory, verbal and nonverbal episodic memory, visuo-spatial functions
Time Frame
Baseline, at 6 weeks, at 12 weeks
Title
Change from baseline of the results to task on a driving simulator
Description
A composite measure of task on a driving simulator: travel time, speed parameters(average speed, maintaining the target speed) compliance with the instructions and code of the road (number and type of errors), number of cars doubled, reaction time in analytics.
Time Frame
Baseline, at 6 weeks, at 12 weeks
Title
Behavior Rating Inventory of Executive Function (BRIEF-A)
Time Frame
Baseline, at 6 weeks, at 12 weeks
Title
Hospital Anxiety and Depression scale (HAD)
Time Frame
Baseline, at 6 weeks, at 12 weeks
Title
Number of undesirable effects of treatment
Time Frame
at 2 weeks, at 4 weeks, at 6 weeks, at 12 weeks
Title
Change from baseline the parameters of structured cognitive training (CogniPlus®)
Description
A composite measure of parameters following : processing speed, inhibition and working memory resources.
Time Frame
Baseline, at 6 weeks, at 12 weeks
Title
Resting state EEG
Description
EEG with Attentional Network Test and Go / No Go task
Time Frame
Baseline, at 6 weeks, at 12 weeks
Title
resting state functional MRI
Description
The changes of resting state functional MRI after treatment and cognitive training
Time Frame
Baseline, at 6 weeks, at 12 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
55 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Without severe chronic neurological or mental or psychiatric pathology Absence of cognitive impairment affecting autonomy (scores on the dementia scale of Mattis> 130 and the IADL = 4) Right-handed participant Subjects holding driving license B and continuing a driving activity Affiliate or beneficiary of a social security scheme Subject having signed informed consent Subject having agreed to be registered on the National File of Healthy Volunteers Patient willing to comply with all procedures of the study and its duration No planned changes in lifestyle (nutritional and physical, social interactions) during the life of the protocol Exclusion Criteria: Administrative reasons: impossibility of receiving informed information, inability to participate in the whole study, absence of coverage by the social security system, refusal to sign consent. Subject simultaneously participating in another clinical trial or in an exclusion period. Subject under tutelage or curatelle. Subject during breastfeeding or pregnancy. Subject not sufficiently fluent in the French language to understand the instructions necessary to carry out the cognitive tests. Subject with uncorrected visual pathology or motor pathology (orthopedic example) likely to interfere with the passing of tests. Subject with dependencies pre-existing to medicines, drugs or alcohol. Presence of contraindications to MRI: Claustrophobia, Anxiety crisis, Morphotype not allowing access to MRI, metal implant (eg a pacemaker), surgical clips Ferromagnetic, orbital or brain metallic foreign bodies). Hypersensitivity to methylphenidate or any other constituents of the product. Subject with a personal and / or family history of motor tics and Gilles de la Tourette syndrome. Subjects with a previous psychiatric history (based on the semi-structured psychiatric interview with the MINI of DSM IV adapted to DSM V): state, severe depression, severe generalized anxiety, anorexia nervosa or anorexic disorders, suicidal tendencies, psychotic symptoms, severe mood disorders, mania, schizophrenia, psychopathic personality disorder or borderline disorder. Dysthymia and an isolated history of depression do not constitute an exclusion criterion. Subjects consuming one or more psychotropic drugs or related products (antidepressants, antipsychotics, antiepileptic drugs, daily use of benzodiazepine anxiolytics or other anxiolytics, vesperal hypnotic intake). A history of taking point hypnotics is not a criterion of exclusion. However, there should be no regular and regular intake in the previous 3 months and less than once a week (ideally, lack of intake would be desirable but would considerably limit the potential for inclusion). They will be asked not to change their habits during the study period. Subjects with dysthyroidism or thyrotoxicosis Subjects with pre-existing cardiovascular disorders including severe hypertension, heart failure, occlusive arterial disease, angina pectoris, congenital heart disease with hemodynamic repercussions, cardiomyopathy, myocardial infarction, arrhythmias and channelopathies Subject with angle-closure glaucoma. Significant abnormalities on MRI and EEG according to the investigator's judgment Presence of untreated hypertension discovered during screening Subject with pheochromocytoma Pre-existing cerebrovascular disorders, cerebral aneurysm, vascular abnormalities, including vasculitis or stroke in the subject Subjects with hepatic and renal insufficiency Obese subject according to WHO classification (BMI> 30) Presence of one of the following treatments that cannot be stopped for a period corresponding to 5 half-lives before inclusion: selective and non-selective MAOIs (nialamide and iproniazide, selegiline), other indirect sympathomimetics (phenylpropanolamine, pseudoephedrine, Phenylephrine), halogenated volatile anesthetics, guanethidine and related compounds. Treatment with alpha sympathomimetics (oral and / or nasal route) (etilefrin, midodrine, naphazoline, oxymetazoline, tetryzoline, tuaminoheptane, tymazoline), opiates and morphine derivatives. These concomitant treatments are contraindicated at baseline and throughout the study period. Subject with leukopathy classified ≥2 on the Fazekas scale
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
David Devos, MD,PhD
Phone
3 20 44 54 49
Ext
+33
Email
david.devos@chru-lille.fr
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David Devos, MD,PhD
Organizational Affiliation
University Hospital, Lille
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hôpital Roger Salengro, CHU
City
Lille
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
David DEVOS, MD,PhD

12. IPD Sharing Statement

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Methylphenidate and Cognitive Training in Elderly

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