Fluency tests of verbal and non-verbal executive functions performance in anxiety patients with allostatic load and neuroticism treated with alprazolam.

SORIA CA, REMEDI C, DALESSIO L, ROLDÁN EJA; D ALESSIO L

Vienna

Congreso; European Congress of Neuropsychopharmacology; 2016

European College of Neuropsychopharmacology

Purpose Anxiety disorders commonly associates to chronic stress, allostatic load and neuroticism. High levels of cortisol and neurotransmitters turnover have been involved in the pathogenesis of the stress related neuropsychiatric disorders, with functionally-relevant effects on prefrontal cortex brain neuroplasticity and with behaviour and/or cognitive dysfunction consequences, in particular impairments in executive functions [1][2]. The impact of chronic stress on cognitive performance in humans has been much less studied and the role of the pharmacological treatment is still under research with controversial results [3][4] Previously we have found that anxiety symptoms and stress related biochemical variables quickly normalize with alprazolam (a positive allosteric modulator of GABA A receptor) administration. There for in the present study we aimed to determine the influence of alprazolam administration, on fluency tests of verbal and non-verbal (visuo-constructive) executive functions (FTEF) [5], in patients with anxiety, allostatic load, and neuroticism after 12 week of treatment with alprazolam, in an open phase IV clinical trial.Methods: Fifty-two patients with GAD (general anxiety disorders, DSM IV), with >6 in Hamilton scale (HAM-A), allostatic load (>3 Crimmins and Seeman criteria), neuroticism (NEO-FFI inventory), and normal Mini-Mental State Examination were included. All patients completed a cognitive assessment; Five Point Test (FPT) and Verbal Fluency Test (VFT), and neurochemical assessment; Salivary 3-Methoxy-4-hydroxyphenylglycol (MHPG) and cortisol levels at basal (-1 week), and after treatment (2 week and 12 week). All patients received on demand of alprazolam (0.25-1mg/t.i.d/12weeks). Groups with normal and impaired performance in FPT and/or VFT (more than two standard deviation from the corresponding normative data for age and gender), were compared at basal and after treatment. Student´s t-test, ANOVA test, and Pearson?s correlations were determined.Results: Fifty-two patients, 18 males (43.11± 12.34 years) and 34 females (48.35±11.7 years) were included in this study (one intent to treat). FTEF were impaired at basal in 22 patients (42.3%) with lower performance in visuo-constructive fluency FPT and in semantic VFT (p