title: Tolcapone improves cognition and cortical information processing in normal human subjects.
abstract: Prefrontal cortical dopamine (DA) regulates various executive cognitive functions, including attention and working memory. Efforts to enhance prefrontal-related cognition, which have focused on catecholaminergic stimulant drugs, have been unsatisfactory. Recently, the demonstration that a functional polymorphism in the catecholamine-O-methyltransferase (COMT) gene impacts prefrontal cognition raises the possibility of a novel pharmacological approach for the treatment of prefrontal lobe executive dysfunction. To explore in a proof of concept study the effects of tolcapone, a CNS penetrant specific COMT inhibitor, we performed a randomized, double blind, placebo controlled, and crossover design of this drug in normal subjects stratified by COMT (val158met) genotype. COMT enzyme activity was determined in peripheral blood. Forty-seven normal volunteers with no family history of psychiatric disorders underwent neuropsychological testing and 34 of those subjects underwent physiological measurement of prefrontal information processing assessed by blood oxygen level-dependent functional magnetic resonance imaging (fMRI). We found significant drug effects on measures of executive function and verbal episodic memory and a significant drug by genotype interaction on the latter, such that individuals with val/val genotypes improved, whereas individuals with met/met genotypes worsened on tolcapone. fMRI revealed a significant tolcapone-induced improvement in the efficiency of information processing in prefrontal cortex during a working memory test. This study demonstrates enhancement of prefrontal cortical function in normal human subjects with a nonstimulant drug having COMT inhibitory activity. Our results are consistent with data from animal studies and from computational models of the effects of selective enhancement of DA signaling in the prefrontal cortex.
authors.affiliation: Genes, Cognition and Psychosis Program, Clinical Brain Disorders Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20854, USA.
authors.forename: José A
authors.initials: JA
authors.lastname: Apud
authors.forename: Venkata
authors.initials: V
authors.lastname: Mattay
authors.forename: Jingshan
authors.initials: J
authors.lastname: Chen
authors.forename: Bhaskar S
authors.initials: BS
authors.lastname: Kolachana
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Callicott
authors.forename: Roberta
authors.initials: R
authors.lastname: Rasetti
authors.forename: Guilna
authors.initials: G
authors.lastname: Alce
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Iudicello
authors.forename: Natkai
authors.initials: N
authors.lastname: Akbar
authors.forename: Michael F
authors.initials: MF
authors.lastname: Egan
authors.forename: Terry E
authors.initials: TE
authors.lastname: Goldberg
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Weinberger
mesh_terms: D000328:Adult; D019943:Amino Acid Substitution / Q000235:genetics; D001577:Benzophenones / Q000009:adverse effects / Q000494:pharmacology*; D001931:Brain Mapping; D002394:Catechol O-Methyltransferase / Q000235:genetics / Q000378:metabolism; D065098:Catechol O-Methyltransferase Inhibitors; D003071:Cognition / Q000187:drug effects* / Q000502:physiology; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004791:Enzyme Inhibitors / Q000009:adverse effects / Q000494:pharmacology; D005260:Female; D005838:Genotype; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008568:Memory / Q000187:drug effects* / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D009596:Nitrophenols / Q000009:adverse effects / Q000494:pharmacology*; D010919:Placebos; D017397:Prefrontal Cortex / Q000187:drug effects* / Q000378:metabolism / Q000502:physiology; D012016:Reference Values; D000077867:Tolcapone; D016896:Treatment Outcome
chemical_list: D001577:Benzophenones; D065098:Catechol O-Methyltransferase Inhibitors; D004791:Enzyme Inhibitors; D009596:Nitrophenols; D010919:Placebos; D000077867:Tolcapone; D002394:Catechol O-Methyltransferase