0610 The effects of wakefulness promoting agents on neuronal activity in nucleus accumbens

Abstract Introduction Both modafinil and methylphenidate are frequently utilized for maintenance of wakefulness in narcolepsy and other sleep disorders. Both have been demonstrated to affect dopamine transporter, leading to an increase extracellular dopamine. Subsequent functional connectivity changes between nucleus accumbens and pallidum are noted. Animal studies demonstrate changes in neuronal activity with methylphenidate in nucleus accumbens. To our knowledge there has been no direct examination of human neural activity in nucleus accumbens after administration of modafinil or methylphenidate, compared to baseline. Methods Two subjects with placement of stereotactic electroencephalographic (sEEG) electrodes to identify optimal location for permanent deep brain stimulation electrodes in nucleus accumbens were given wakefulness promoting agents to optimize testing of stimulation sites during inpatient hospitalization. Assessment occurred at least 48 hours following surgical electrode insertion under inhaled general anesthesia. Retrospective analysis was performed on neural activity in nucleus accumbens during rest on and off medication. Frequency content was calculated in the following bands: delta (1-3 Hz), theta (4-7 Hz), alpha (8-12 Hz), beta (13-30 Hz), gamma (30-50 Hz), and high gamma (70-100 Hz). Power in each band is reported as the percentage contribution of each band to summed power across all bands. Results Total power was noted to be lower with both modafinil and methylphenidate. With modafinil, the beta band ratio was decreased (22.3% vs. 30.5%), the gamma band ratio was increased (24% vs. 22.4%), and the high gamma band was increased (39.5% vs. 32.9%). With methylphenidate, only the high gamma band was increased (40.3% vs. 22.9%). Conclusion Both methylphenidate and modafinil increase high gamma band neural activity in nucleus accumbens, while modafinil has additional effects on beta and gamma bands. Further assessment of modafinil and methylphenidate’s effects on neural activity are indicated to help better understand their mechanism of action and appropriate use as wakefulness promoting agents. Support (if any)