Impaired cognition and attention in adults: pharmacological management strategies
Authors Hervé Allain, Yvette Akwa, Lucette Lacomblez, Alain Lieury, Danièle Bentué-Ferrer
Published 15 March 2007 Volume 2007:3(1) Pages 103—116
Hervé Allain1, Yvette Akwa2, Lucette Lacomblez3, Alain Lieury4, Danièle Bentué-Ferrer1
1Laboratoire de Pharmacologie Expérimentale et Clinique, Pôle des Neurosciences de Rennes, Faculté de Médecine, Université de Rennes I, France; 2INSERM U788, Le Kremlin Bicêtre cedex, France; 3Service de Pharmacologie, Fédération de Neurologie, Hôpital Pitié-Salpêtrière, Paris, France; 4Laboratoire de Psychologie Expérimentale, Université de Haute Bretagne, France
Abstract: Cognitive psychology has provided clinicians with specific tools for analyzing the processes of cognition (memory, language) and executive functions (attention-concentration, abstract reasoning, planning). Neuropsychology, coupled with the neurosciences (including neuroimaging techniques), has authenticated the existence of early disorders affecting the “superior or intellectual” functions of the human brain. The prevalence of cognitive and attention disorders is high in adults because all the diseases implicating the central nervous system are associated with cognitive correlates of variable intensity depending on the disease process and the age of the patient. In some pathologies, cognitive impairment can be a leading symptom such as in schizophrenia, posttraumatic stress disorder or an emblematic stigmata as in dementia including Alzheimer’s disease. Paradoxically, public health authorities have only recognized as medications for improving cognitive symptoms those with proven efficacy in the symptomatic treatment of patients with Alzheimer’s disease; the other cognitive impairments are relegated to the orphanage of syndromes and symptoms dispossessed of medication. The purpose of this review is to promote a true “pharmacology of cognition” based on the recent knowledge in neurosciences. Data from adult human beings, mainly concerning memory, language, and attention processes, will be reported. “Drug therapeutic strategies” for improving cognition (except for memory function) are currently rather scarce, but promising perspectives for a new neurobiological approach to cognitive pharmacology will be highlighted.
Keywords: cognitive disorders, attention, memory, pharmacology, treatment, pharmacovigilance, dementia.