Modafinil effects in multiple sclerosis patients with fatigue.
BACKGROUND
To investigate the effects of Modafinil on focused attention, motor function and motor excitability in patients with multiple sclerosis (MS) and fatigue.


METHODS
21 MS patients with fatigue were enrolled in this double-blind placebo-controlled study. Modafinil (MOD) or placebo (PL) was administered for 8 weeks. The d2 alertness test, the Nine Hole Peg Test (9HPT) and several transcranial magnetic stimulation (TMS) techniques were applied prior to and after the first drug ingestion and well as after 8 weeks of drug intake.


RESULTS
Prior to the first drug intake, the two groups were comparable. After the first drug ingestion, fatigue as measured by the Fatigue Severity Scale (FSS), performance of the d2 test and the 9HPT improved significantly in the MOD group and remained better than in the PL group after 8 weeks of treatment. Patients in the MOD group made fewer mistakes in the D2 test without being slower. They completed the 9HPT faster. Motor evoked potential amplitudes produced by paired pulse TMS were larger in the MOD group than the PL group. Motor thresholds and silent period durations remained unchanged.


CONCLUSIONS
Compared to PL, MOD improved fatigue, focused attention and dexterity and enhanced motor cortex excitability in this group of patients. MOD may be helpful in MS patients with fatigue to improve cognitive and motor abilities.
Lange
Rüdiger
R
Neurozentrum, Neurologische Universitatsklinik, Breisacherstr. 64, 79106, Freiburg, Germany. ruediger.lange@uniklinik-freiburg.de
Volkmer
Marek
M
Heesen
Christoph
C
Liepert
Joachim
J
D000328:Adult; D000704:Analysis of Variance; D001288:Attention / Q000187:drug effects; D001559:Benzhydryl Compounds / Q000627:therapeutic use*; D004311:Double-Blind Method; D019054:Evoked Potentials, Motor / Q000187:drug effects; D005221:Fatigue / Q000188:drug therapy* / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D000077408:Modafinil; D009043:Motor Activity / Q000187:drug effects; D009103:Multiple Sclerosis / Q000150:complications* / Q000188:drug therapy; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D009483:Neuropsychological Tests; D012720:Severity of Illness Index; D013997:Time Factors; D050781:Transcranial Magnetic Stimulation
D001559:Benzhydryl Compounds; D018696:Neuroprotective Agents; D000077408:Modafinil