Kaser Muzaffer, Deakin Julia B, Michael Albert, Zapata Camilo, Bansal Rachna, Ryan Dragana, Cormack Francesca, Rowe James B, Sahakian Barbara J
Department of Psychiatry, University of Cambridge; Behavioural and Clinical Neuroscience Institute, University of Cambridge; Department of Psychiatry (MK), Bahcesehir University, Istanbul, Turkey.
Department of Psychiatry, University of Cambridge; Cambridgeshire and Peterborough NHS Foundation Trust.
Biol Psychiatry Cogn Neurosci Neuroimaging. 2017 Mar;2(2):115-122. doi: 10.1016/j.bpsc.2016.11.009.
Cognitive dysfunction is a core feature of depression and tends to persist even after mood symptoms recover, leading to detrimental effects on clinical and functional outcomes. However, most currently available treatments have not typically addressed cognition. Modafinil has been shown to have beneficial effects on cognitive function and therefore has the potential to improve cognition in depression. The objective of this double-blind, placebo-controlled study was to investigate the effects of modafinil on cognitive functions in patients with remitted depression.
In total, 60 patients with remitted depression participated in the study. Cognitive functions were evaluated with tests of working memory, planning, attention, and episodic memory from the Cambridge Neuropsychological Test Automated Battery at the baseline session and after treatment. A double-blind, randomized, placebo-controlled, parallel groups design was used to assess the effects of single-dose (200 mg) modafinil ( = 30) or placebo ( = 30) on cognition and fatigue. The main outcome measures were neurocognitive test scores from the Cambridge Neuropsychological Test Automated Battery. Visual analogue scales for subjective feelings and fatigue were used as secondary measures.
The modafinil group had significantly better performance on tests of episodic memory ( = .01, η = .10) and working memory ( = .04, η = .06). Modafinil did not improve planning or sustained attention.
This study suggested that modafinil (200 mg) could improve episodic memory and working memory performance in patients with remitted depression. Modafinil may have potential as a therapeutic agent to help remitted depressed patients with persistent cognitive difficulties.
认知功能障碍是抑郁症的核心特征，即使情绪症状恢复后仍往往持续存在，对临床和功能结局产生不利影响。然而，目前大多数可用的治疗方法通常并未针对认知功能。已证明莫达非尼对认知功能有有益影响，因此有可能改善抑郁症患者的认知功能。这项双盲、安慰剂对照研究的目的是调查莫达非尼对缓解期抑郁症患者认知功能的影响。
共有60名缓解期抑郁症患者参与了该研究。在基线期和治疗后，使用剑桥神经心理测试自动成套测验中的工作记忆、计划、注意力和情景记忆测试来评估认知功能。采用双盲、随机、安慰剂对照、平行组设计，以评估单剂量（200毫克）莫达非尼（n = 30）或安慰剂（n = 30）对认知和疲劳的影响。主要结局指标是剑桥神经心理测试自动成套测验的神经认知测试分数。主观感受和疲劳的视觉模拟量表用作次要指标。
莫达非尼组在情景记忆测试（p = .01，η = .10）和工作记忆测试（p = .04，η = .06）中的表现明显更好。莫达非尼并未改善计划能力或持续注意力。
这项研究表明，莫达非尼（200毫克）可以改善缓解期抑郁症患者的情景记忆和工作记忆表现。莫达非尼可能有潜力作为一种治疗药物，帮助有持续性认知困难的缓解期抑郁症患者。
