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阿莫达非尼对多发性硬化症认知功能的影响:一项随机、双盲交叉试点研究。

Impact of armodafinil on cognition in multiple sclerosis: a randomized, double-blind crossover pilot study.

作者信息

Bruce Jared, Hancock Laura, Roberg Brandon, Brown Amberly, Henkelman Erik, Lynch Sharon

机构信息

Department of Psychology, University of Missouri-Kansas City, Kansas City, MO 64110, USA.

出版信息

Cogn Behav Neurol. 2012 Sep;25(3):107-14. doi: 10.1097/WNN.0b013e31826df7fd.

Abstract

OBJECTIVE

Examine the efficacy of armodafinil in improving cognition in patients with multiple sclerosis (MS).

BACKGROUND

Many patients with MS experience cognitive difficulties. Armodafinil has shown promise as a cognitive enhancer in other patient populations. No studies have examined whether armodafinil improves cognition in patients with MS.

METHODS

We conducted a double-blind, placebo-controlled, crossover study testing the efficacy of armodafinil in reducing cognitive problems in patients with MS. We randomized 17 patients to receive a dose of lactose placebo about 2 hours before they underwent a neuropsychological testing session. After a week-long washout period, we gave them a single 250-mg dose of armodafinil about 2 hours before testing them a second time. We randomized another 16 patients to receive the active drug first, then the placebo. We excluded 3 of the participants before analyzing the data.

RESULTS

After correcting for multiple comparisons of the 8 neuropsychological dependent measures, we found that the patients had significantly improved delayed memory on a list-learning task after they took armodafinil (P = 0.0005), but no improvement on measures of executive function, visual memory, processing speed, or self-reported fatigue.

CONCLUSIONS

Results provide preliminary evidence that armodafinil may improve delayed verbal recall in patients with MS. A larger trial showing enhanced memory among patients taking long-term armodafinil could serve as a foundation for its possible clinical use as a memory enhancer in patients with MS.

摘要

目的

研究阿莫达非尼改善多发性硬化症(MS)患者认知功能的疗效。

背景

许多MS患者存在认知障碍。阿莫达非尼在其他患者群体中已显示出作为认知增强剂的潜力。尚无研究探讨阿莫达非尼是否能改善MS患者的认知功能。

方法

我们进行了一项双盲、安慰剂对照、交叉研究,以测试阿莫达非尼减轻MS患者认知问题的疗效。我们将17名患者随机分组,在他们接受神经心理学测试前约2小时给予一剂乳糖安慰剂。经过为期一周的洗脱期后,在他们第二次测试前约2小时给予他们一剂250毫克的阿莫达非尼。我们将另外16名患者随机分组,先接受活性药物,然后接受安慰剂。在分析数据前,我们排除了3名参与者。

结果

在对8项神经心理学相关指标进行多重比较校正后,我们发现患者服用阿莫达非尼后,在一项列表学习任务中的延迟记忆有显著改善(P = 0.0005),但在执行功能、视觉记忆、处理速度或自我报告的疲劳指标上没有改善。

结论

结果提供了初步证据,表明阿莫达非尼可能改善MS患者的延迟言语回忆。一项更大规模的试验显示长期服用阿莫达非尼的患者记忆力增强,可为其在MS患者中作为记忆增强剂的可能临床应用奠定基础。

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