title: Combined neuropsychological and neurophysiological assessment of drug effects on groups and individuals.
abstract: An initial standardized approach for combining neuropsychological and neurophysiological measures in order to assess the neurocognitive effects of drugs in groups and individuals is introduced. Its application is illustrated with sedatives, antiepileptic drugs, psychostimulants, antihistamines, and intoxicants. Task performance, electroencephalography, and evoked potential measures during computerized attention and memory testing that are most sensitive to drug effects are identified in a sample population and then applied to individuals. In six example exploratory studies, drug effects were detected with an average area under curve (AUC) of 0.97 (p < 0.0001; 95% sensitivity, 96% specificity). In 10 example validation studies with other drugs and/or different subjects and populations, detection was strong in the eight studies with drugs and doses known to have significant neurocognitive effects (AUC 0.83, p < 0.0001; 82% sensitivity, 89% specificity), whereas no effect was detected in the two studies with drugs known to have faint neurocognitive effects (AUC 0.56, p > 0.10). Individual differences in response to different drugs with similar clinical uses, to varying doses of the same drug, and in pharmacodynamic response were then demonstrated. The significant (p < 0.01) increase in sensitivity and specificity of combined neuropsychological and neurophysiological measures compared with the former alone suggests that fewer subjects may be needed to assess the neurocognitive effects of drugs in future studies. The findings suggest that the concept of combining neuropsychological testing with simultaneous measures of neurophysiological function is worth further exploration.
authors.affiliation: San Francisco Brain Research Institute and SAM Technology, San Francisco, CA 94117, USA. alan@sfbri.org
authors.forename: Alan
authors.initials: A
authors.lastname: Gevins
authors.forename: Aaron B
authors.initials: AB
authors.lastname: Ilan
authors.forename: An
authors.initials: A
authors.lastname: Jiang
authors.forename: Lita
authors.initials: L
authors.lastname: Sam-Vargas
authors.forename: Cliff
authors.initials: C
authors.lastname: Baum
authors.forename: Cynthia S
authors.initials: CS
authors.lastname: Chan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D002491:Central Nervous System Agents / Q000008:administration & dosage / Q000494:pharmacology*; D002648:Child; D003071:Cognition / Q000187:drug effects*; D004569:Electroencephalography; D005071:Evoked Potentials / Q000187:drug effects; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory / Q000187:drug effects*; D008875:Middle Aged; D009483:Neuropsychological Tests; D011597:Psychomotor Performance / Q000187:drug effects; D016032:Randomized Controlled Trials as Topic / Q000379:methods*; D012107:Research Design; D055815:Young Adult
chemical_list: D002491:Central Nervous System Agents