Lange Rüdiger, Volkmer Marek, Heesen Christoph, Liepert Joachim
Neurozentrum, Neurologische Universitatsklinik, Breisacherstr. 64, 79106, Freiburg, Germany.
J Neurol. 2009 Apr;256(4):645-50. doi: 10.1007/s00415-009-0152-7. Epub 2009 Apr 9.
To investigate the effects of Modafinil on focused attention, motor function and motor excitability in patients with multiple sclerosis (MS) and fatigue.
21 MS patients with fatigue were enrolled in this double-blind placebo-controlled study. Modafinil (MOD) or placebo (PL) was administered for 8 weeks. The d2 alertness test, the Nine Hole Peg Test (9HPT) and several transcranial magnetic stimulation (TMS) techniques were applied prior to and after the first drug ingestion and well as after 8 weeks of drug intake.
Prior to the first drug intake, the two groups were comparable. After the first drug ingestion, fatigue as measured by the Fatigue Severity Scale (FSS), performance of the d2 test and the 9HPT improved significantly in the MOD group and remained better than in the PL group after 8 weeks of treatment. Patients in the MOD group made fewer mistakes in the D2 test without being slower. They completed the 9HPT faster. Motor evoked potential amplitudes produced by paired pulse TMS were larger in the MOD group than the PL group. Motor thresholds and silent period durations remained unchanged.
Compared to PL, MOD improved fatigue, focused attention and dexterity and enhanced motor cortex excitability in this group of patients. MOD may be helpful in MS patients with fatigue to improve cognitive and motor abilities.
研究莫达非尼对多发性硬化症（MS）伴疲劳患者的注意力集中程度、运动功能和运动兴奋性的影响。
21例伴有疲劳的MS患者被纳入这项双盲安慰剂对照研究。给予莫达非尼（MOD）或安慰剂（PL）治疗8周。在首次服药前、首次服药后以及服药8周后应用d2警觉性测试、九孔插钉试验（9HPT）和几种经颅磁刺激（TMS）技术。
首次服药前，两组具有可比性。首次服药后，MOD组中通过疲劳严重程度量表（FSS）测量的疲劳、d2测试和9HPT的表现显著改善，且在治疗8周后仍优于PL组。MOD组患者在D2测试中犯错更少且速度未减慢。他们更快地完成了9HPT。配对脉冲TMS产生的运动诱发电位幅度在MOD组大于PL组。运动阈值和静息期持续时间保持不变。
与PL相比，MOD改善了该组患者的疲劳、注意力集中程度和灵活性，并增强了运动皮层兴奋性。MOD可能有助于改善MS伴疲劳患者的认知和运动能力。
