title: Impact of armodafinil on cognition in multiple sclerosis: a randomized, double-blind crossover pilot study.
abstract: OBJECTIVE
  Examine the efficacy of armodafinil in improving cognition in patients with multiple sclerosis (MS).
  
  
  BACKGROUND
  Many patients with MS experience cognitive difficulties. Armodafinil has shown promise as a cognitive enhancer in other patient populations. No studies have examined whether armodafinil improves cognition in patients with MS.
  
  
  METHODS
  We conducted a double-blind, placebo-controlled, crossover study testing the efficacy of armodafinil in reducing cognitive problems in patients with MS. We randomized 17 patients to receive a dose of lactose placebo about 2 hours before they underwent a neuropsychological testing session. After a week-long washout period, we gave them a single 250-mg dose of armodafinil about 2 hours before testing them a second time. We randomized another 16 patients to receive the active drug first, then the placebo. We excluded 3 of the participants before analyzing the data.
  
  
  RESULTS
  After correcting for multiple comparisons of the 8 neuropsychological dependent measures, we found that the patients had significantly improved delayed memory on a list-learning task after they took armodafinil (P = 0.0005), but no improvement on measures of executive function, visual memory, processing speed, or self-reported fatigue.
  
  
  CONCLUSIONS
  Results provide preliminary evidence that armodafinil may improve delayed verbal recall in patients with MS. A larger trial showing enhanced memory among patients taking long-term armodafinil could serve as a foundation for its possible clinical use as a memory enhancer in patients with MS.
authors.affiliation: Department of Psychology, University of Missouri-Kansas City, Kansas City, MO 64110, USA. brucejm@umkc.edu
authors.forename: Jared
authors.initials: J
authors.lastname: Bruce
authors.forename: Laura
authors.initials: L
authors.lastname: Hancock
authors.forename: Brandon
authors.initials: B
authors.lastname: Roberg
authors.forename: Amberly
authors.initials: A
authors.lastname: Brown
authors.forename: Erik
authors.initials: E
authors.lastname: Henkelman
authors.forename: Sharon
authors.initials: S
authors.lastname: Lynch
mesh_terms: D000328:Adult; D001559:Benzhydryl Compounds / Q000494:pharmacology* / Q000627:therapeutic use; D003071:Cognition / Q000187:drug effects*; D003072:Cognition Disorders / Q000150:complications / Q000188:drug therapy*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D056344:Executive Function / Q000187:drug effects; D005221:Fatigue / Q000150:complications / Q000188:drug therapy / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory / Q000187:drug effects; D008875:Middle Aged; D000077408:Modafinil; D009103:Multiple Sclerosis / Q000150:complications / Q000523:psychology*; D009483:Neuropsychological Tests; D018697:Nootropic Agents / Q000494:pharmacology* / Q000627:therapeutic use; D010865:Pilot Projects; D016896:Treatment Outcome
chemical_list: D001559:Benzhydryl Compounds; D018697:Nootropic Agents; D000077408:Modafinil