Single dose of Ritalin may raise awareness of mistakes: Study

By Dr. Ananya Mandal, MDFeb 28 2012

According to a new study by researchers at University of Melbourne, people who take Ritalin are far more aware of their mistakes.

Diminished awareness of performance errors limits the extent to which humans correct their behavior and has been linked to loss of insight in a number of clinical syndromes, including Alzheimer's Disease, Schizophrenia and Attention-Deficit Hyperactivity Disorder.

The study, by Dr Rob Hester from the Department of Psychological Sciences and colleagues at the Queensland Brain Institute, investigated how the brain monitors ongoing behavior for performance errors – specifically failures of impulse control. This study found that a single dose of methylphenidate (Ritalin) results in significantly greater activity in the brain’s error monitoring network and improved volunteers’ awareness of their mistakes.

Parts of the brain that deal with human error include the dorsal anterior cingulate (dACC) and inferior parietal lobule (IPL). These differ depending on whether participants are aware of their performance errors.  Critically, researchers showed that a single, clinically relevant dose of methylphenidate, which works by increasing the levels of catecholamines in the brain, dramatically improved error awareness in healthy adults.

Researchers used functional magnetic resonance imaging (fMRI) to show that methylphenidate was able to promote the conscious awareness of performance errors by strengthening activation differences within the dACC and IPL for errors made with and without awareness, compared to placebo and other comparison drugs.

The major limitation of the study was that it tried only a single dose of methylphenidate and in healthy participants. It needs to be replicated in people using standard clinical doses. However the study highlights the potential of pharmacotherapy in addressing problems of awareness and insight that features in a range of neurologic and psychiatric conditions.

Dr Hester said failure to recognize errors was related to poor insight into a person’s clinical condition, which can impair treatment. “For example, in conditions such as Schizophrenia and Alzheimer’s Disease, poor error awareness has been associated with delusions, paranoia and has been the cause of considerable distress to patients,” he said.

“Failing to recognize your own error at the time can account for the difference between your recollection and the reality that confronts you. Understanding the brain mechanisms that underlie how we become conscious of our mistakes is an important first step in improving error awareness, and potentially reducing these symptoms,” he said.

The study was published in the Journal of Neuroscience.