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A statistical approach for classifying change in cognitive function in individuals following pharmacologic challenge: an example with alprazolam

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Abstract

Introduction

The effects of any drug treatment on cognitive function are typically studied in groups of subjects. Observations made about the behavior of the drug, in the study sample, are then generalized to the population from which the sample was drawn. However, the magnitude and pharmacodynamic qualities of the response to many central nervous system-active drugs are known to vary in the population. Therefore, it is useful to consider statistical models for the detection of cognitive change in response to a drug treatment in individual subjects.

Materials and methods

In this report, we first outline the statistical assumptions and requirements for the reliable estimation of clinically relevant individual change in cognition. We then used the sedative benzodiazepine, alprazolam, as a pharmacologic challenge in healthy volunteer subjects to test our statistical model, using a parallel groups placebo-controlled study design. After treatment, the nature and severity of alprazolam-induced cognitive change was determined for each individual.

Results

Our proposed method and analysis showed an excellent sensitivity and specificity for alprazolam-related cognitive deterioration in individuals.

Discussion and conclusions

These findings, although preliminary, suggest that statistically reliable decisions about the effects of sedative drugs on cognition can be made for individuals.

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Authors and Affiliations

  1. CogState Ltd, Melbourne, Australia

    Paul Maruff

  2. CNS Early Development, Pfizer Global Research & Development, Ann Arbor, MI, USA

    John Werth & Douglas Feltner

  3. Section of Neuropsychology, Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor, MI, USA

    Bruno Giordani & Angela F. Caveney

  4. Department of Psychology, University of Connecticut (Storrs, CT) & CNS Early Development, Pfizer Global Research & Development, Groton, CT, USA

    Peter J. Snyder

Authors
  1. Paul Maruff
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  2. John Werth
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  3. Bruno Giordani
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  4. Angela F. Caveney
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  5. Douglas Feltner
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  6. Peter J. Snyder
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Correspondence to Paul Maruff.

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Maruff, P., Werth, J., Giordani, B. et al. A statistical approach for classifying change in cognitive function in individuals following pharmacologic challenge: an example with alprazolam. Psychopharmacology 186, 7–17 (2006). https://doi.org/10.1007/s00213-006-0331-5

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  • DOI: https://doi.org/10.1007/s00213-006-0331-5

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