McClure Margaret M, Barch Deanna M, Romero Michelle J, Minzenberg Michael J, Triebwasser Joseph, Harvey Philip D, Siever Larry J
VA VISN3 Mental Illness Research, Education, and Clinical Center, Bronx, New York 10468, USA.
Biol Psychiatry. 2007 May 15;61(10):1157-60. doi: 10.1016/j.biopsych.2006.06.034. Epub 2006 Sep 1.
The signature of impaired cognition in people with schizotypal personality disorder (SPD) may be centrally related to working memory impairments. Guanfacine, an alpha2A agonist that acts post-synaptically in the prefrontal cortex (PFC), has shown potential for reducing working memory limitations in other populations. This study examined the potential of guanfacine for improving context processing, a feature of working memory, in SPD.
29 individuals with SPD entered into a 4-week, randomized parallel-design, double-blind, placebo-controlled trial of guanfacine treatment, followed by a 4-week open-label extension. A modified version of the AX-Continuous Performance Test (AX-CPT) was administered. On this task, evidence of intact context processing includes few BX errors (false cue, correct probe) and higher levels of AY errors (correct cue, false probe).
At the end of double-blind treatment, participants treated with guanfacine demonstrated a significant reduction in BX errors and a small but significant increase in AY errors, a pattern that was not seen in the participants treated with placebo.
SPD participants improved in their context processing toward a normal response bias, making fewer BX and more AY errors, after being treated with guanfacine.
分裂型人格障碍（SPD）患者认知受损的特征可能与工作记忆障碍密切相关。胍法辛是一种在前额叶皮质（PFC）突触后起作用的α2A激动剂，已显示出在其他人群中减少工作记忆限制的潜力。本研究考察了胍法辛改善SPD患者情境加工（工作记忆的一个特征）的潜力。
29名SPD患者参加了一项为期4周的胍法辛治疗随机平行设计、双盲、安慰剂对照试验，随后进行了为期4周的开放标签扩展试验。采用了改良版的AX连续性能测试（AX-CPT）。在这项任务中，情境加工完整的证据包括较少的BX错误（错误线索，正确探测）和较高水平的AY错误（正确线索，错误探测）。
在双盲治疗结束时，接受胍法辛治疗的参与者BX错误显著减少，AY错误虽小但显著增加，而接受安慰剂治疗的参与者未出现这种模式。
接受胍法辛治疗后，SPD参与者在情境加工方面向正常反应偏差改善，BX错误减少，AY错误增加。
