title: Modafinil enhances alerting-related brain activity in attention networks.
abstract: BACKGROUND
  Modafinil is a wake-promoting agent and has been reported to be effective in improving attention in patients with attentional disturbance. However, neural substrates underlying the modafinil effects on attention are not fully understood.
  
  
  OBJECTIVE
  We employed a functional magnetic resonance imaging (fMRI) study with the attention network test (ANT) task in healthy adults and examined which networks of attention are mainly affected by modafinil and which neural substrates are responsible for the drug effects.
  
  
  METHODS
  We used a randomized placebo-controlled within-subjects cross-over design. Twenty-three healthy adults participated in two series of an fMRI study, taking either a placebo or modafinil. The participants performed the ANT task, which is designed to measure three distinct attentional networks, alerting, orienting, and executive control, during the fMRI scanning. The effects of modafinil on behavioral performance and regional brain activity were analyzed.
  
  
  RESULTS
  We found that modafinil enhanced alerting performance and showed greater alerting network activity in the left middle and inferior occipital gyri as compared with the placebo. The brain activations in the occipital regions were positively correlated with alerting performance.
  
  
  CONCLUSIONS
  Modafinil enhanced alerting performance and increased activation in the occipital lobe in the alerting network possibly relevant to noradrenergic activity during the ANT task. The present study may provide a rationale for the treatment of patients with distinct symptoms of impaired attention.
authors.affiliation: Department of Pharmacology, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan.
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Ikeda
authors.affiliation: Anesthesiology and Clinical Physiology, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Funayama
authors.affiliation: Department of Neuropsychiatry, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan.
authors.forename: Amane
authors.initials: A
authors.lastname: Tateno
authors.affiliation: Anesthesiology and Clinical Physiology, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
authors.forename: Haruhisa
authors.initials: H
authors.lastname: Fukayama
authors.affiliation: Department of Neuropsychiatry, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan.
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Okubo
authors.affiliation: Department of Pharmacology, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan. hsuzuki@nms.ac.jp.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Suzuki
mesh_terms: D000328:Adult; D001288:Attention / Q000187:drug effects*; D001559:Benzhydryl Compounds / Q000494:pharmacology*; D001921:Brain / Q000503:physiopathology*; D018592:Cross-Over Studies; D056344:Executive Function / Q000502:physiology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D000077408:Modafinil; D009949:Orientation; D064690:Wakefulness-Promoting Agents / Q000494:pharmacology*
chemical_list: D001559:Benzhydryl Compounds; D064690:Wakefulness-Promoting Agents; D000077408:Modafinil
keywords: Alerting; Attention network test; Modafinil; fMRI