ClinicalTrials.gg
RecruitingNCT03998852ADACHOLUpdated Jun 10, 2026

In Vivo Involvement of the Cholinergic and Dopaminergic Systems in the Pathophysiology of Apathy.

A Phase 3 interventional study of Positron Emission Tomography (PET) with [18F]-FDOPA and Positron Emission Tomography (PET) with [18F]-FEOBV in Apathy, sponsored by University Hospital, Bordeaux. Recruiting at 1 site in France. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2026-06-10.

Sponsored by University Hospital, Bordeaux · Phase 3, Interventional, and Diagnostic

From the registry’s dates

  • Started Apr 2021; still recruiting 5 years 6 months later.
Phase
Phase 3
Study type
Interventional
Enrollment
30
Allocation
Not applicable
Ages
18 Years to 75 Years
Sex
All
01

Study summary

Apathy is a neurocognitive syndrome characterized by reduced goal-directed behaviors, contributing to decreased patient and caregiver quality of life. Apathy pathophysiology involves disruption of cortico-striato-thalamo-cortical loops, modulated by several neurotransmitter systems including dopamine and acetylcholine, thus complexifying pharmacological management. Post-stroke apathy (PSA) can provide a proper in vivo model to study the underlying neurochemical substrates of apathy as a syndrome. The present project aims to provide a better characterization of the cholinergic and dopaminergic functioning in apathy as a syndrome.

In order to precise the respective alterations of these two systems, investigators will use a positron emission tomography (PET) molecular imaging of dopaminergic (with [18F]-FDOPA, a marker of the decarboxylating enzyme of dopamine) and - for the first time in apathetic patients - cholinergic (with [18F]-FEOBV, a marker of the vesicular acetylcholine transporter) transmissions in 15 apathetic and 15 unapathetic patients 3 months after stroke, without overlapping depression. This dual imaging study may provide help in guiding therapeutic management of PSA. The functional network analysis allowed by functional MRI is crucial to complement regional neurotransmitter deficits observed with PET. Altogether, a multimodal approach in apathy, combining PET and MRI, can allow identifying which circuits of the cortico-striato-thalamo-cortical loops are disrupted and how these circuits are modulated by other neurotransmitters.

02

Conditions studied

  • Apathy

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Keywords

  • Apathy
  • Stroke
  • Cholinergic neurotransmission
  • Dopaminergic neurotransmission
03

In context

Stroke

8,255 studies on the registry are indexed under Stroke; 2,056 are open to participants now.

This study's planned enrollment of 30 is below the median of 49 across 6,024 interventional studies indexed under Stroke.

Browse Stroke studies →

Lead sponsor

University Hospital, Bordeaux is the lead sponsor of 806 studies on the registry; 197 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Patient of legal age and younger than 75 years
  • Patient with a Rankin score less then or equal to 2 and with or without apathy, demonstrated by AI scales at 3 months after stroke (apathetic patient = AI scale score > 2)
  • Affiliate or beneficiary of a social security scheme
  • Subjects (female study subjects and female partners of male participants) using highly effective methods (intra-uterine device, progestin or estrogen-progestin contraceptive, sterilization)
  • Free, informed and written consent signed by the participant and the investigator (at the latest on the day of inclusion and before any examination required by the research)

Exclusion criteria

Exclusion Criteria:

  • Patients over 75 years old
  • Taking of any pharmacological treatment likely to affect cholinergic systems at the time of PET-scan: Amitriptyline, Atropine, Brompheniramine, Chlorphenamine, Chlorpromazine, Clomipramine, Clozapine, Dimenhydrinate, Diphenhydramine, Doxepine, Hyoscyamine, Imipramine, Meclozine, Nortriptyline, Oxybutynine, Promethazine, Scopolamine, Trimipramine, Hydroxyzine.
  • Taking of any pharmacological treatment likely to affect dopaminergic systems at the time of PET-scan: glucagon, haloperidol, reserpin
  • Taking of any selective serotonine reuptake inhibitors treatment
  • White matter T2 hyperintense lesions (Fazekas score > 3)
  • Class III to IV Heart Failure Patient
  • Patients with allergy or conter-indication to entacapone
  • Subjects with positive pregnancy test (BHCG dosage and Urine dipstick), and/or currently breast-feeding
  • Patients unable to come back to hospital for at least 2-follow-up visits
  • Patient with a chronic neurological disorder or severe psychiatric disorder
  • Patient with cognitive impairment (\<24) and depression (CES-D score > 17 for men and >23 for women)
  • Patient presenting a counter-indication for MRI
  • Patient presenting a counter-indication for TEP with [18F]-FEOBV or [18F]-FDOPA (known allergy)
  • Patient who underwent a PET examination in the previous month
  • Patient with state of health not allowing a displacement in the department of imaging of the CHU: bedridden state, state of health very deteriorated
  • Patient deprived of liberty by judicial or administrative decision
  • Patient under legal protection or unable to express its own consent
  • Subject within exclusion period from another clinical trial
Terms in these criteria, in plain language(3)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

MMSE and MoCA

Short tests of memory and thinking, each scored out of 30. Lower scores suggest more difficulty; criteria give a range, either to include people with memory problems or to leave them out.

05

Study design

Phase
Phase 3
Primary purpose
Diagnostic
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
30 participants (estimated)

Study arms

  • Experimental
    Molecular imaging

    Positron Emission Tomography (PET) molecular imaging of dopaminergic and cholinergic systems using two radiotracers

    Drug: Positron Emission Tomography (PET) with [18F]-FDOPA · Drug: Positron Emission Tomography (PET) with [18F]-FEOBV · Device: Magnetic Resonnance Imaging (MRI) · Other: Neuropsychological evaluation

Interventions

  • DrugPositron Emission Tomography (PET) with [18F]-FDOPA

    Positron Emission Tomography (PET) with \[18F\]-FDOPA

  • DrugPositron Emission Tomography (PET) with [18F]-FEOBV

    Positron Emission Tomography (PET) with \[18F\]-FEOBV

  • DeviceMagnetic Resonnance Imaging (MRI)

    MRI protocol will be performed on the same day that the \[18F\]-FEOBV PET imaging, using a 3T scanner (Philips Medical System). Different types of images will be acquired.

  • OtherNeuropsychological evaluation

    Neuropsychological evaluation will be performed, consisting in an assessment of apathy by actigraphy (social or physical activities will be recorded during seven days) and a complementary assessment of apathy using the Lille Apathy Rating Scale (LARS)

06

What researchers measure

Primary outcomes

  1. [18F]-FDOPA SUVr

    Standardized uptake value for the \[18F\]-FDOPA radiotracer

    Time frame: Between 7 and 30 days after first visit

  2. [18F]-FEOBV SUVr

    Standardized uptake value for the \[18F\]-FEOBV radiotracer

    Time frame: First visit (Day 0)

Secondary outcomes

  1. Apathy Inventory Score

    Apathy score from 0 to 36. Apathetic patient = score \>2

    Time frame: First visit (Day 0)

  2. Beck Anxiety Inventory (BAI) Score

    Beck Anxiety Inventory (BAI). Score from . Anxiety = score \> 22

    Time frame: First visit (Day 0)

  3. Lille Apathy Rating Scale (LARS) Score

    Complementary assessment of apathy. Score from - 36 to 36. Score \< - 22 : no apathy * 21 to -17 : apathy tendancy * 16 to -10 : moderate apathy * 9 to 36 : severe apathy

    Time frame: First visit (Day 0)

  4. Multidimensional Fatigue Inventory (MFI) Score

    The MFI contains 20 items classified into four dimensions : general fatigue, mental fatigue, reduced activities and motivation. The statements are rated on a 5-point Likert scale (from "Yes, that is true" to "No, that is not true") representing the patient's current feeling. Low MFI scores reflect a higher degree of fatigue.

    Time frame: First visit (Day 0)

  5. Center of Epidemiology Studies Depression Scale (CES-D) Score

    Center of Epidemiology Studies Depression Scale (CES-D) The frequency of occurrence of symptoms is measured with a 4 points scale : o = Never 1. = Occasionally 2. = Quite often 3. = Frequently The total score is between 0 and 60. Highest scores correspond to the presence of a more severe depressive symptomatology Depressive patients = score \> 17 for men and \>23 for women

    Time frame: First visit (Day 0)

  6. Fractional anisotropy

    Fractional anisotropy measured with structural MRI

    Time frame: First visit (Day 0)

  7. Mean diffusivity

    Mean diffusivity measured with structural MRI

    Time frame: First visit (Day 0)

  8. Cerebral blood flow maps

    Cerebral blood flow maps provided by arterial spin labeling sequences

    Time frame: First visit (Day 0)

07

Study locations

1 of 1 sites recruiting
08

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Apr 2021 (actual). Primary completion is estimated for Apr 2027, 72 months after the start.

Of 92 non-industry phase 3 interventional studies under Stroke, half reached primary completion within 44 months of starting (the median), counting those still running; a quarter within 27 and three quarters within 71. This study's planned 72 months is above that.

Counting every sponsor, half of 129 studies reached it within 44 months; a quarter within 27 and three quarters within 68.

How these figures are worked out, and which studies are left out of them.

Registered
Jun 20, 2019
First posted
Jun 26, 2019
StartActual
Apr 13, 2021
Primary completionEst.
Apr 13, 2027
CompletionEst.
May 13, 2027
Last update
Jun 10, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jun 10, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT03998852
Responsible party
Sponsor
First posted
Jun 26, 2019
Start date
Apr 13, 2021
Primary completion
Apr 13, 2027 (estimated)
Completion
May 13, 2027 (estimated)
Last update
Jun 10, 2026

Study contacts

Nicolas BALAMOUTOFF
Contact
nicolas.balamoutoff@chu-bordeaux.fr
05 56 79 55 40

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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