BACKGROUND: The signature of impaired cognition in people with schizotypal personality disorder (SPD) may be centrally related to working memory impairments. Guanfacine, an alpha2A agonist that acts post-synaptically in the prefrontal cortex (PFC), has shown potential for reducing working memory limitations in other populations. This study examined the potential of guanfacine for improving context processing, a feature of working memory, in SPD. METHODS:29 individuals with SPD entered into a 4-week, randomized parallel-design, double-blind, placebo-controlled trial of guanfacine treatment, followed by a 4-week open-label extension. A modified version of the AX-Continuous Performance Test (AX-CPT) was administered. On this task, evidence of intact context processing includes few BX errors (false cue, correct probe) and higher levels of AY errors (correct cue, false probe). RESULTS: At the end of double-blind treatment, participants treated with guanfacine demonstrated a significant reduction in BX errors and a small but significant increase in AY errors, a pattern that was not seen in the participants treated with placebo. CONCLUSIONS: SPD participants improved in their context processing toward a normal response bias, making fewer BX and more AY errors, after being treated with guanfacine.
RCT Entities:
BACKGROUND: The signature of impaired cognition in people with schizotypal personality disorder (SPD) may be centrally related to working memory impairments. Guanfacine, an alpha2A agonist that acts post-synaptically in the prefrontal cortex (PFC), has shown potential for reducing working memory limitations in other populations. This study examined the potential of guanfacine for improving context processing, a feature of working memory, in SPD. METHODS: 29 individuals with SPD entered into a 4-week, randomized parallel-design, double-blind, placebo-controlled trial of guanfacine treatment, followed by a 4-week open-label extension. A modified version of the AX-Continuous Performance Test (AX-CPT) was administered. On this task, evidence of intact context processing includes few BX errors (false cue, correct probe) and higher levels of AY errors (correct cue, false probe). RESULTS: At the end of double-blind treatment, participants treated with guanfacine demonstrated a significant reduction in BX errors and a small but significant increase in AY errors, a pattern that was not seen in the participants treated with placebo. CONCLUSIONS: SPD participants improved in their context processing toward a normal response bias, making fewer BX and more AY errors, after being treated with guanfacine.
Authors: Margaret M McClure; Fiona Graff; Joseph Triebwasser; Mercedes Perez-Rodriguez; Daniel R Rosell; Harold Koenigsberg; Erin A Hazlett; Larry J Siever; Philip D Harvey; Antonia S New Journal: Am J Psychiatry Date: 2019-01-18 Impact factor: 18.112
Authors: Robert M Bilder; Sandra K Loo; James J McGough; Fiona Whelan; Gerhard Hellemann; Catherine Sugar; Melissa Del'Homme; Alexandra Sturm; Jennifer Cowen; Grant Hanada; James T McCracken Journal: J Am Acad Child Adolesc Psychiatry Date: 2016-06-07 Impact factor: 8.829
Authors: Nicole M Barcelos; Peter H Van Ness; Allison F Wagner; Martha G MacAvoy; Adam P Mecca; George M Anderson; Mark Trentalange; Keith A Hawkins; Mary Sano; Amy F T Arnsten; Christopher H van Dyck Journal: Neurobiol Aging Date: 2018-05-31 Impact factor: 4.673