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Responsible use of psychostimulants

Psychostimulants have a place in the therapy of attentional disorders. However, they are also widely used off-label to enhance cognitive performance, and their mechanisms of action remain elusive. Westbrook et al. studied the effects of these drugs and concurrently measured striatal dopamine synthesis capacity in young, healthy participants (see the Perspective by Janes). They administered a placebo, methylphenidate (a dopamine and noradrenaline reuptake blocker), and sulpiride (a selective D2 receptor antagonist) while participants made explicit cost-benefit decisions about whether to engage in cognitive effort. Higher dopamine synthesis capacity in the caudate nucleus was associated with greater willingness to allocate cognitive effort. In addition, methylphenidate and sulpiride increased subjective values and motivation to work specifically for people with low dopamine synthesis capacity. Cognition-enhancing drugs may thus act at the motivational level rather than directly boosting cognition per se.
Science, this issue p. 1362; see also p. 1300

Abstract

Stimulants such as methylphenidate are increasingly used for cognitive enhancement but precise mechanisms are unknown. We found that methylphenidate boosts willingness to expend cognitive effort by altering the benefit-to-cost ratio of cognitive work. Willingness to expend effort was greater for participants with higher striatal dopamine synthesis capacity, whereas methylphenidate and sulpiride, a selective D2 receptor antagonist, increased cognitive motivation more for participants with lower synthesis capacity. A sequential sampling model informed by momentary gaze revealed that decisions to expend effort are related to amplification of benefit-versus-cost information attended early in the decision process, whereas the effect of benefits is strengthened with higher synthesis capacity and by methylphenidate. These findings demonstrate that methylphenidate boosts the perceived benefits versus costs of cognitive effort by modulating striatal dopamine signaling.
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Supplementary Material

Summary

Materials and Methods
Supplementary Results
Figs. S1 to S5
Tables S1 to S7
References (3137)

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File (aaz5891-westbrook-sm.pdf)

References and Notes

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Published In

Science
Volume 367 | Issue 6484
20 March 2020

Submission history

Received: 21 September 2019
Accepted: 20 January 2020
Published in print: 20 March 2020

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Acknowledgments

We thank the individuals who participated in this study and J. Wilmott for eye-tracking code and consultation. Funding: This work was supported by NWO VICI grant 453-14-005 (2015/01379/VI) to R.C., NIH grant F32MH115600-01A1 to A.W., and NIH grant R01MH080066 to M.J.F. Author contributions: Conceptualization: R.C., A.W., M.J.F., Data curation: J.I.M., R.v.d.B., L.H., D.P., Formal analysis: A.W., R.v.d.B., R.C., M.J.F., Funding acquisition: R.C., A.W., Investigation: J.I.M., R.v.d.B., L.H., D.P., Project administration: J.I.M. and R.C., Software: A.W., Writing: A.W., M.J.F., R.C., Supervision: R.C. and M.J.F. Competing interests: The authors declare no competing interests. Data and materials availability: Data and analysis scripts will be made publicly available at the conclusion of the parent study at http://hdl.handle.net/11633/aac2qvfx.

Authors

Affiliations

Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, RI, USA.
Radboud University, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, Netherlands.
Radboud University Medical Centre, Department of Psychiatry, Nijmegen, Netherlands.
Radboud University, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, Netherlands.
Radboud University Medical Centre, Department of Psychiatry, Nijmegen, Netherlands.
Radboud University, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, Netherlands.
Radboud University Medical Centre, Department of Psychiatry, Nijmegen, Netherlands.
Radboud University, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, Netherlands.
Radboud University Medical Centre, Department of Psychiatry, Nijmegen, Netherlands.
Radboud University, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, Netherlands.
Radboud University Medical Centre, Department of Psychiatry, Nijmegen, Netherlands.
Radboud University, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, Netherlands.
Radboud University Medical Centre, Department of Psychiatry, Nijmegen, Netherlands.
Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, RI, USA.
Carney Institute for Brain Science, Brown University, Providence, RI, USA.

Funding Information

Notes

*Corresponding author. Email: [email protected]
Senior authors contributed equally to this work and are listed in alphabetical order.

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