Cognitive control regulates cognitive and emotional systems to facilitate goal-directed behavior in the context of task-irrelevant distractors. Cognitive control deficits contribute to residual functional impairments across psychiatric disorders and represent a promising novel treatment target. Translational evidence suggests that modafinil may enhance performance in executive functions; however, differential effects on regulatory control in cognitive and emotional domains have not been examined. The present pre-registered randomized-controlled pharmacological fMRI trial examined differential effects of modafinil (single-dose, 200 mg) on cognitive and emotional conflict processing. To further separate objective cognitive enhancing effects from subjective performance perception, a metacognitive paradigm was employed. Results indicated that modafinil specifically enhanced cognitive conflict performance and concomitantly increased activation in the inferior frontal gyrus and its functional communication with the dorsomedial prefrontal cortex. Exploratory analysis further revealed modafinil-enhanced basolateral amygdala reactivity to cognitive conflict, with stronger reactivity being associated with higher cognitive conflict performance. Whereas modafinil enhanced cognitive performance in the metacognitive paradigm, confidence indices remained unaffected. Overall, the present results suggest that modafinil has the potential to enhance cognitive conflict processing while leaving emotional conflict processing unaffected. On the neural level modafinil enhanced the recruitment of a network engaged in general conflict and regulatory control processes, whereas effects on the amygdala may reflect improved arousal-mediated attention processes for conflicting information. The pattern of cognitive enhancing effects in the absence of effects on affective processing suggests a promising potential to enhance cognitive control in clinical populations.

中文翻译：

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莫达非尼通过增强额下回的激活及其与背突前额叶皮层的沟通来增强认知能力，但不能增强情绪冲突。

认知控制调节认知和情绪系统，以在与任务无关的干扰因素的情况下促进目标导向的行为。认知控制缺陷会导致整个精神疾病的残余功能障碍，并代表了一种有希望的新型治疗靶点。转化证据表明莫达非尼可以增强执行功能的表现。但是，尚未研究对认知和情绪领域的调节控制的不同影响。目前预先注册的随机对照药理功能磁共振成像试验检查了莫达非尼（单剂量200毫克）对认知和情绪冲突处理的不同作用。为了进一步将主观表现感知的客观认知增强作用分开，采用了元认知范式。结果表明莫达非尼特别增强认知冲突的表现，并同时增加额下回的激活及其与背突前额叶皮层的功能性沟通。探索性分析进一步揭示了莫达非尼增强的基底外侧杏仁核对认知冲突的反应性，其中较强的反应性与较高的认知冲突表现有关。尽管莫达非尼增强了元认知范式中的认知表现，但置信指数仍然不受影响。总的来说，目前的结果表明莫达非尼具有增强认知冲突处理的潜力，同时保持情感冲突处理不受影响。在神经方面，莫达非尼增强了参与一般冲突和监管控制程序的网络的招募，而对杏仁核的影响可能反映了唤醒信息介导的注意力冲突过程的改善。在不影响情感加工的情况下，认知增强作用的模式提示了在临床人群中增强认知控制的潜力。