Methylphenidate improves working memory and set-shifting in AD/HD: relationships to baseline memory capacity.
OBJECTIVE
Catecholamine stimulant drugs are highly efficacious treatments for attention deficit/ hyperactivity disorders (AD/HD). Catecholamine modulation in humans influences performance of numerous cognitive tasks, including tests of attention and working memory (WM). Clear delineation of the effects of methylphenidate upon such cognitive functions in AD/HD would enhance understanding of the effects of drug treatment.


METHODS
Here we present a double-blind, placebo-controlled study of the cognitive effects of an acute dose of methylphenidate (c. .5 mg/kg) in 14 boys aged 10.86 (+/- 1.19) years meeting criteria for DSM-IV AD/HD. Current behaviour was ascertained using Conners' teacher and parent self-report questionnaires and IQ was tested using sub-tests from WISC-III-UK. Tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB) were selected to assess visuo-spatial recognition memory, spatial WM, planning, visual-search and attentional-set shifting.


RESULTS
Methylphenidate improved spatial WM, attentional-set shifting and visual-search task performance. Correlational analyses suggested possible relationships between WM capacity and spatial WM performance improvement. Also, poor performance on the attentional-set shifting task on placebo was associated with increased errors on the spatial WM task on placebo.


CONCLUSIONS
Methylphenidate may selectively improve both underlying cognitive difficulties in tasks dependent on intact fronto-striatal structures, and clinical symptoms of AD/HD. Pre-treatment measures may have some predictive value in determining individual differences in drug response.
University of Cambridge, Department of Psychiatry, UK. mitul.mehta2@imperial.ac.uk
Mitul A
MA
Mehta
Ian M
IM
Goodyer
Barbara J
BJ
Sahakian
D000293:Adolescent; D001288:Attention; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D002648:Child; D016000:Cluster Analysis; D003072:Cognition Disorders / Q000188:drug therapy*; D004311:Double-Blind Method; D006801:Humans; D008297:Male; D008568:Memory; D008774:Methylphenidate / Q000627:therapeutic use*; D012015:Reference Standards; D012718:Set, Psychology
D000697:Central Nervous System Stimulants; D008774:Methylphenidate