Modafinil modulates anterior cingulate function in chronic schizophrenia.

Author(s): Spence SA, Green RD, Wilkinson ID, Hunter MD

Affiliation(s): Sheffield Cognition and Neuroimaging, Academic Clinical Psychiatry, Division of Genomic Medicine, University of Sheffield, The Longley Centre, Norwood Grange Drive, Sheffield S5 7JT, UK. s.a.spence@sheffield.ac.uk

Publication date & source: 2005-07, Br J Psychiatry., 187:55-61.

Publication type: Clinical Trial; Randomized Controlled Trial

BACKGROUND: Schizophrenia is associated with widespread cognitive deficits that have an impact on social function. Modafinil promotes wakefulness and is reported to enhance cognition. AIMS: To study the acute effects of modafinil administration upon brain activity and cognitive performance in people with chronic schizophrenia. METHOD: In a randomised double-blind placebo-controlled crossover design, 19 patients received either modafinil (100 mg) or placebo prior to undertaking a working memory task with functional magnetic resonance imaging. RESULTS: Seventeen patients completed the study and another underwent acute relapse 4 days post-drug. Modafinil administration was associated with significantly greater activation in the anterior cingulate cortex during the working memory task. The anterior cingulate cortex signal correlated with cognitive performance, although only a subset of patients exhibited 'enhancement'. CONCLUSIONS: Modafinil modulates anterior cingulate cortex function in chronic schizophrenia but its beneficial cognitive effects may be restricted to a subset of patients requiring further characterisation.