, Volume 236, Issue 9, pp 2747–2759 | Cite as

Moral decision making under modafinil: a randomized placebo-controlled double-blind crossover fMRI study

  • Thao Ngo
  • Marta Ghio
  • Lars Kuchinke
  • Patrik Roser
  • Christian BellebaumEmail author
Original Investigation



Modafinil is increasingly used by healthy humans as a neuroenhancer in order to improve cognitive functioning. Research on the effects of modafinil on cognition yielded most consistent findings for complex tasks relying on the prefrontal cortex (PFC).


The present randomized placebo-controlled double-blind crossover study aimed to investigate the effect of a single dose of modafinil (200 mg) on everyday moral decision making and its neural correlates, which have been linked to the ventro- and dorsomedial PFC.


Healthy male study participants were presented with short stories describing everyday moral or neutral dilemmas. Each moral dilemma required a decision between a personal desire and a moral standard, while the neutral dilemmas required decisions between two personal desires. The participants underwent this task twice, once under the influence of modafinil and once under placebo. Brain activity associated with the processing of the dilemmas was assessed by means of functional magnetic resonance imaging.


For the processing of moral vs. neutral dilemmas, activations were found in a network of brain regions linked to social cognitive processes including, among others, the bilateral medial PFC, the insula, and the precuneus. Modafinil was found to increase the number of moral decisions and had no effect on brain activity associated with dilemma processing. Exploratory analyses revealed reduced response-locked activity in the dorsomedial PFC for moral compared to neutral dilemmas under modafinil, but not under placebo.


The results are discussed in terms of altered predictions of others’ emotional states under modafinil, possibly due to higher processing efficiency.


Moral reasoning Decision making Modafinil Prefrontal cortex fMRI 


Funding information

We would like to thank the Mercator Foundation for financial support.

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Biological Psychology, Institute for Experimental PsychologyHeinrich Heine UniversityDüsseldorfGermany
  2. 2.Methods and EvaluationInternational Psychoanalytic University BerlinBerlinGermany
  3. 3.Department of Psychiatry and Psychotherapy, LWL University HospitalRuhr-University BochumBochumGermany
  4. 4.Department of Addictive DisordersPsychiatric Services Aargau AGBruggSwitzerland

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