The effects of guanfacine on working memory performance in patients with localization-related epilepsy and healthy controls

Abstract

Objectives Previous research has demonstrated that alpha2 agonists improve working memory performances in healthy individuals and in primates with prefrontal lesions. We conducted this study to determine whether the alpha2 agonist, guanfacine, could improve working memory performances in patients with frontal lobe epilepsy (FLE) and/or in those with focal epilepsy outside the frontal lobes (ie, temporal lobe epilepsy [TLE]). Methods Fourteen patients with FLE, 13 patients with TLE, and 10 healthy controls completed immediate and delayed match-to-sample tasks before and after ingestion of 2 to 3 mg of guanfacine. Results All 3 groups showed an increase in accuracy on the delayed match-to-sample task, but not the immediate match-to-sample task, following administration of guanfacine. Inspection of the group means revealed somewhat greater benefits for the control and FLE groups relative to the TLE group. Increased accuracy was not associated with slower performances in any group, suggesting that the cognitive benefits of guanfacine did not occur at the expense of increased sedation. Conclusions These data suggest that guanfacine improves working memory in patients with FLE and may be a viable treatment for attenuating such deficits in this patient population.