Visual P300 latency predicts treatment response to modafinil in patients with narcolepsy

Clin Neurophysiol. 1999 Jun;110(6):1041-7. doi: 10.1016/s1388-2457(99)00035-8.


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.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Benzhydryl Compounds / therapeutic use*
  • Central Nervous System Stimulants / therapeutic use*
  • Double-Blind Method
  • Electroencephalography
  • Evoked Potentials, Auditory / physiology*
  • Evoked Potentials, Visual / physiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Modafinil
  • Narcolepsy / drug therapy*
  • Narcolepsy / physiopathology*
  • Predictive Value of Tests
  • Reaction Time / physiology


  • Benzhydryl Compounds
  • Central Nervous System Stimulants
  • Modafinil