Modafinil benefits attentional set shifting in Schizophrenia
The abstract below is taken from a study by the University of Cambridge into the potential of Modafinil to improve cognition in long term sufferers of schizophrenia. The double blind, placebo controlled study found that application of Modafinil improved short-term verbal memory span as well as showing ‘trends towards improved visual memory and spatial planning.’ Most importantly, however, the study discovered that Modafinil created a significant improvement in attentional set shifting, aka the ability to actively change one’s focus of attention (which has been shown to be particular lacking in individuals with neuropsychiatric and neurodevelopmental disorders.[i])
What this means for the bigger picture
The positive link drawn between Modafinil and cognitive improvements in patients with schizophrenia could open new pathways into the treatment of various neuropsychiatric disorders; in particular the study points towards the usefulness of further research into the effects of psychostimulants and other potential cognitive enhancers on neurological disorders.
The study also reinforces the theory that ongoing cognitive difficulties are one of the major obstacles for social re-integration of schizophrenic individuals.
As a whole the study was well rounded and conducted as a double blind, placebo controlled crossover trial, all of which increases its reliability. If there is any drawback to the study it would be that the cohort of 20 was on the small side. Further study with larger cohorts would help to further verify the findings.
So what does this mean for Modafinil?
Most importantly this study suggests that Modafinil could prove to be a useful treatment for some of the most difficult symptoms of neurological disorders. Its ability to help lessen cognitive impairment could help long term sufferers better integrate into society.
These findings are corroborated by Linda Scoriels, also from the University of Cambridge, whose recent systematic review of Modafinil and schizophrenia[ii] concluded that “Modafinil has significant beneficial effect on broader aspects of patients’ functioning, including functional outcome, quality of life and wellbeing.”
For more reading on Modafinil and attention disorders have a look at this study on Modafinil and ADHD
There is also this study by the University of Cambridge looking at the effects of Modafinil on neurologically healthy individuals.
See below for the complete abstract with key findings in bold.
[i] Heisler JM1, Morales J1, Donegan JJ1, Jett JD1, Redus L1, O'Connor, ‘The attentional set shifting task: a measure of cognitive flexibility in mice.’ Journal of Visualised Experiments, 2015 Feb 4;(96). doi: 10.3791/51944. http://www.ncbi.nlm.nih.gov/pubmed/25741905
[ii] Linda Scorielsa, b, Peter B. Jonesa, Barbara J. Sahakiana, b, ‘Modafinil effects on cognition and emotion in schizophrenia and its neurochemical modulation in the brain.’ Neuropharmacology Volume 64, January 2013, Pages 168–184. Available http://www.sciencedirect.com/science/article/pii/S0028390812003474
Modafinil Improves Cognition and Attentional Set Shifting
in Patients with Chronic Schizophrenia
Turner DC, Clark L, Pomarol-Clotet E,
McKenna P, Robbins TW, Sahakian BJ.
1Department of Psychiatry,
University of Cambridge,
School of Clinical Medicine,
Hills Road, Cambridge, UK.
Neuropsychopharmacology. 2004 Apr 7
Modafinil, a novel cognitive enhancer, selectively improves neuropsychological task performance in healthy volunteers and adult patients with attention deficit hyperactivity disorder (ADHD). It has been argued that persistent cognitive deficits in patients with schizophrenia are responsible for the failure of many patients to rehabilitate socially even when psychotic symptoms are in remission. The present study examined the potential of modafinil as a cognitive enhancer in schizophrenia. Twenty chronic patients with a diagnosis of schizophrenia were entered into a double-blind, randomized, placebo-controlled crossover study using a 200 mg dose of Modvigil. Modafinil had some cognitive enhancing properties in schizophrenia similar to those observed in healthy adults and adult patients with ADHD. Improvement was seen on short-term verbal memory span, with trends towards improved visual memory and spatial planning. This was accompanied by slowed response latency on the spatial planning task. No effect on stop-signal performance was seen. Importantly, significant improvement in attentional set shifting was seen, despite no effect of modafinil on this task being seen in healthy volunteers or ADHD patients. Modafinil may have potential as an important therapy for cognitive impairment in patients with schizophrenia, particularly because of its beneficial effects on attentional set shifting.