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Effects of modafinil on neural correlates of response inhibition in alcohol-dependent patients.

Abstract：

BACKGROUND:Impaired response inhibition is a key feature of patients with alcohol dependence. Improving impulse control is a promising target for the treatment of alcohol dependence. The pharmacologic agent modafinil enhances cognitive control functions in both healthy subjects and in patients with various psychiatric disorders. However, very little is known about the underlying neural correlates of improvements in response inhibition following modafinil. METHODS:We conducted a randomized, double-blind, placebo-controlled, crossover study using functional magnetic resonance imaging with a stop signal task to examine effects of a single dose of modafinil (200 mg) on response inhibition and underlying neural correlates in abstinent alcohol-dependent patients (AD) (n = 16) and healthy control subjects (n = 16). RESULTS:Within the AD group modafinil administration improved response inhibition (reflected by the stop signal reaction time [SSRT]) in subjects with initial poor response inhibition, whereas response inhibition was diminished in better performing subjects. In AD patients with initial poor response inhibition, modafinil-induced SSRT improvement was accompanied by greater activation in the thalamus and supplementary motor area (SMA) and reduced connectivity between the thalamus and the primary motor cortex. In addition, the relationship between baseline response inhibition and modafinil-induced SSRT improvement was mediated by these changes in thalamus and SMA activation. CONCLUSIONS:These findings indicate that modafinil can improve response inhibition in alcohol-dependent patients through its effect on thalamus and SMA function but only in subjects with poor baseline response inhibition. Therefore, baseline levels of response inhibition should be taken into account when considering treatment with modafinil in AD.

journal_name

Biol Psychiatry

journal_title

Biological psychiatry

authors

Schmaal L,Joos L,Koeleman M,Veltman DJ,van den Brink W,Goudriaan AE

doi

10.1016/j.biopsych.2012.06.032

subject

Has Abstract

pub_date

2013-02-01 00:00:00

pages

211-8

issue

3

eissn

0006-3223

issn

1873-2402

pii

S0006-3223(12)00587-2

journal_volume

73

pub_type

杂志文章,随机对照试验

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