REALITY MONITORING (MORDOR)

March 4, 2025 updated by: Hôpital le Vinatier

MONITORING OF REALITY AND DOPAMINE: A PHARMACOLOGICAL RESEARCH

Reality-monitoring characterizes the ability to determine whether information was perceived in the environment or only imagined . Impaired reality-monitoring abilities have been associated with hallucinations in patients with schizophrenia and patients with Parkinson's disease.

The investigators hypothesize a link between dopaminergic (DA) transmission and reality-monitoring.

Study Overview

Detailed Description

This hypothesis is based on several studies in the literature: 1) DA transmission anomalies are observed in both schizophrenia and Parkinson's disease; 2) DA agonists may induce hallucination; 3) DA antagonists reduce hallucinations and improve reality-monitoring abilities in patients with schizophrenia. In addition, also suggesting a link between mesocorticolimbic connectivity, subcortical DA transmission and reality-monitoring, The investigators have shown that fronto-temporal transcranial Direct Current Stimulation (tDCS) leads:

  • on the one hand, to modulate reality-monitoring performance in healthy volunteers and patients;
  • on the other hand, to induce subcortical DA release. However, to date, no study has yet explored the direct link between DA transmission and reality-monitoring.

Study Type

Interventional

Enrollment (Estimated)

39

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 45 years (Adult)

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Healthy volunteers who have given their written informed consent
  • Men and women from 18 to 45 years old
  • Normal or corrected vision
  • Being fluent in French or French for native language
  • Being affiliated with health insurance

Exclusion Criteria:

  • Healthy volunteers who have given their written informed consent
  • Men and women from 18 to 45 years old
  • Normal or corrected vision
  • Being fluent in French or French for native language
  • Being affiliated with health insurance
  • Inadmissibility of the subject's consent or refusal
  • Working-memory deficit (as controlled with MMSE score< 23)
  • Any past or current psychiatric or somatic condition(as controlled with the Mini International Neuropsychiatric Interview, MINI)
  • Any past or current neurological condition
  • History of cranio-cerebral trauma, arterial hypotension or hypertension, cardiological or serious medical condition
  • Abnormal potassium dosage (below 3.1 mmol/L or above 4.9 mmol/L)
  • Anormal ECG
  • History of schizophrenia or bipolar disorder in first-degree relatives
  • Alcohol-drinking and caffeine intake at least during 24 hours before each session
  • Drug therapy excepting contraceptives
  • Cardiologic or severe medical conditio
  • Pregnancy(checked with a pregnancy autotest), lactation, or insufficient contraceptive measure (precautionary measure)
  • Consumption of recreational drugs during the last 6 months
  • Known sensitivity to any of the study medication and their excipients
  • Lactose intolerance
  • Porphyria
  • Hepatic insufficiency

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Basic Science
  • Allocation: Randomized
  • Interventional Model: Crossover Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Dopamine precursor
In the first condition, volunteers will receive a dopamine (DA) precursor (L-dopa, 100mg). L-dopa will be combined with a dose of an Aromatic amino acid decarboxylase inhibitor (Benserazide) 25mg to multiplicate its bioavailability and with a dose of domperidone 10mg (peripheral antagonist of DA) to minimize the risk of side effects.

In the first condition, volunteers will receive a 100mg dose of L-dopa, 25mg dose of Aromatic amino acid decarboxylase inhibitors (Benserazide) and 10mg dose of Domperidone. In the second condition, volunteers will receive Sulpiride 800mg. In the third condition, volunteers will receive placebo Reality-monitoring performances will be evaluated with a standardized task. Working-memory will be evaluated with the n-back task. Self-monitoring performances will be observed during a speech production experiment in which speakers monitor their auditory feedback while speaking.

Speech Bayesian reasoning: This task is a home-made task investigating the influence of prior on speech processing. Subjects will be required to identify speech in ambiguous auditory stimuli. Visual Bayesian reasoning: This task investigates the influence of prior on visual processing. Subjects will be required to recognize morph between faces and house.

Active Comparator: D2 antagonist
In the second condition, volunteers will receive a D2 antagonist (Sulpiride, 800mg)
In the second condition, volunteers will receive Sulpiride 800 mg
Placebo Comparator: PLACEBO
In the third condition, volunteers will receive a placebo (lactose)
In the third condition, volunteers will receive placebo

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Reality-monitoring performance
Time Frame: One month

Measured with a behavioral task developed, validated and used in investigators lab.

During the memory retrieval phase, 48 words will be presented, including the 32 words presented during encoding as well as 16 new words. Subjects will be required to identify whether each word was previously heard, imagined or new. Three words lists will be used and assigned randomly depending on the substance condition (L-dopa, Sulpiride, placebo). Each verbal list will include 16 items with the "imagine hear" encoding condition and 16 items with the "listen" encoding condition.

A single measure including two variables of interest will account for the main evaluation criteria:

  • The average conditional source-identification measure (ACSIM) which represents the overall ability to correctly retrieve the source, conditional on that item was recognized as already presented.
  • The source misattributions,the number of confusions between heard and imagined events.
One month

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Reaction times at the reality-monitoring task and scores of subjective confidence rating for reality-monitoring responses
Time Frame: One month
Regarding reality-monitoring, a single test in which investigators will also measure the reaction times at the reality-monitoring task and scores of subjective confidence rating for reality-monitoring responses. The variable of interest will be the number of high-confident incorrect source-recognition responses. Investigators finally measure the vividness of each "imagined" or "listened" word with Visual Analogue Scales (VAS) from 0 to 100.
One month
Other cognitive tasks
Time Frame: One month

In the same test investigators will measure the number of correct/incorrect responses and reaction times at the n-back working memory task.

  • The effect of dopamine modulation on the ability the ability to determine our speech as self-generated will be measured with a self-monitoring task. Investigators measure the magnitude of a voice peak response reflecting the feeling of agency.
  • The effect of dopamine modulation on perception will be evaluated with the performances measured during 2 home-made Bayesian reasoning tasks, evaluating speech processing and visual processing, respectively.
One month

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: FILIPE GALVAO, Centre Hospitalier le Vinatier

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 15, 2024

Primary Completion (Estimated)

June 30, 2026

Study Completion (Estimated)

December 31, 2026

Study Registration Dates

First Submitted

January 23, 2023

First Submitted That Met QC Criteria

February 1, 2023

First Posted (Actual)

February 2, 2023

Study Record Updates

Last Update Posted (Actual)

March 25, 2025

Last Update Submitted That Met QC Criteria

March 4, 2025

Last Verified

February 1, 2025

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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