Modafinil improves cognition and response inhibition in adult attention-deficit/hyperactivity disorder
Modafinil improves cognition and response inhibition in adult attention-deficit/hyperactivity disorder
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DOI：
10.1016/j.biopsych.2004.02.008
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发表时间：
2004-05-15
影响因子：
10.6
通讯作者：
Sahakian, BJ
中科院分区：
文献类型：
--
作者：
Turner, DC;Clark, L;Sahakian, BJ
背景：莫达非尼是一种新的认知增强剂，其临床特征类似于传统的兴奋剂，如哌醋甲酯，尽管其作用机制似乎不同。莫达非尼可能通过改善抑制控制，选择性地改善健康志愿者的神经心理任务表现。我们研究了莫达非尼在患有注意力缺陷/多动障碍的成年人中是否有类似的改善。20名DSM-IV诊断为注意力缺陷/多动障碍的患者进入了一项双盲、随机、安慰剂对照的交叉研究，使用单剂量200 mg的莫达非尼。莫达非尼产生了与在健康成年人中观察到的类似的认知增强模式，在短期记忆广度、视觉记忆、空间规划和停止信号运动抑制的测试中有所改善。在几项测量中，准确度的提高伴随着反应潜伏期的放缓。这种速度-准确度权衡的变化可能表明莫达非尼增加了对问题的“反映”能力，同时降低了冲动反应。持续注意力方面也有改善，健康受试者的注意力没有受到影响。如果这些好处被证明在长期服用时保持不变，莫达非尼可能有潜力成为治疗注意力缺陷/多动障碍的重要疗法，在改善停止信号反应抑制方面与哌醋甲酯等兴奋剂的效果相似，但没有苯丙胺药物常见的副作用。
Background: Modafinil, a novel cognitive enhancer, has a clinical profile similar to conventional stimulants such as methylphenidate, despite a seemingly different mechanism of action. Modafinil selectively improves neuropsychological task performance in healthy volunteers, possibly through improved inhibitory control. We examined whether modafinil induced similar improvements in adults with attention-deficit/hyperactivity disorder.Methods. Twenty patients with a DSM-IV diagnosis of attention-deficit/hyperactivity disorder were entered into a double-blind, randomized, placebo-controlled crossover study using a single 200 mg dose of modafinil.Results. Modafinil produced a similar pattern of cognitive enhancement to that observed in healthy adults, with improvements on tests of short-term memory span, visual memory, spatial planning, and stop-signal motor inhibition. On several measures, increased accuracy was accompanied by slowed response latency. This alteration in the speed-accuracy trade-off may indicate that modafinil increases the ability to "reflect" on problems coupled with decreased impulsive responding. Improvements were also seen in sustained attention, which was unaffected in healthy subjects.Conclusions. If these benefits are shown to be maintained with chronic administration, modafinil may have potential as an important therapy for attention-deficit/hyperactivity disorder with a similar effect to stimulants such as methylphenidate in improving stop-signal response inhibition but without the side effects commonly experienced with amphetamine like drugs.