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Randomized Controlled Trial
. 2006 Mar;31(3):651-8.
doi: 10.1038/sj.npp.1300886.

Methylphenidate ('Ritalin') can ameliorate abnormal risk-taking behavior in the frontal variant of frontotemporal dementia

Shibley Rahman  1 , Trevor W Robbins, John R Hodges, Mitul A Mehta, Peter J Nestor, Luke Clark, Barbara J Sahakian
Affiliations
Randomized Controlled Trial

Methylphenidate ('Ritalin') can ameliorate abnormal risk-taking behavior in the frontal variant of frontotemporal dementia

Shibley Rahman et al. Neuropsychopharmacology. 2006 Mar.

Abstract

The frontal variant of frontotemporal dementia is a significant neurological condition worldwide. There exist few treatments available for the cognitive and behavioural sequelae of fvFTD. Previous research has shown that these patients display risky decision-making, and numerous studies have now demonstrated pathology affecting the orbitofrontal cortex. The present study uses a within-subjects, double-blind, placebo-controlled procedure to investigate the effects of a single dose of methylphenidate (40 mg) upon a range of different cognitive processes including those assessing prefrontal cortex integrity. Methylphenidate was effective in 'normalizing' the decision-making behavior of patients, such that they became less risk taking on medication, although there were no significant effects on other aspects of cognitive function, including working memory, attentional set shifting, and reversal learning. Moreover, there was an absence of the normal subjective and autonomic responses to methylphenidate seen in elderly subjects. The results are discussed in terms of the 'somatic marker' hypothesis of impaired decision-making following orbitofrontal dysfunction.

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Figures

Figure 1
Figure 1
(a) Methylphenidate significantly reduced betting behavior on the Cambridge Gamble Task. Error bars indicate the standard errors of the mean. (b) The reduction in betting behavior in fvFTD patients on methylphenidate normalizes task performance, that is, performance approaches of healthy older adults. *Healthy data from the placebo condition of Turner et al (2003), in 20 male volunteers aged 55–69 years (mean age 61 years). (c) Individual data in the fvFTD group show that the reduction in betting is apparent in every subject.
Figure 2
Figure 2
Methylphenidate treatment did not significantly affect deliberation times (a) or choice of most likely outcome (b) on the Cambridge Gamble Task.
See this image and copyright information in PMC

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