Ameliorating attention problems in children with sickle cell disease: a pilot study of methylphenidate
Brian Daly1, Mary C Kral, Ronald T Brown
1Department of Psychology, Drexel University, Philadelphia, PA 19104, USA. brian.daly@drexel.edu
Insights
Methylphenidate (MPH) improved memory and inhibitory control in children with sickle cell disease (SCD). Moderate-dose MPH significantly enhanced attention, as reported by parents and teachers, suggesting it may help children with SCD and attention problems.
Area of Science:
- Pediatric Neurology
- Hematology
- Neuroscience
Background:
- Sickle cell disease (SCD) can lead to cerebrovascular complications, impacting cognitive functions like attention.
- Children with SCD and these complications often exhibit attention deficits, affecting their academic and daily functioning.
Purpose of the Study:
- To investigate the efficacy of methylphenidate (MPH) in improving cognitive performance and attention in children with SCD and cerebrovascular complications.
- To assess the short-term and longer-term effects of MPH on attention and cognitive measures in this population.
Main Methods:
- A pilot study involving two double-blind controlled trials: a laboratory trial (n=14) and a 3-week home/school crossover trial (n=20).
- Laboratory trial assessed sustained attention, reaction time, executive functions, and verbal memory with MPH versus placebo.
- Home/school trial used parent and teacher ratings to evaluate MPH efficacy at placebo, low-dose (LD), and moderate-dose (MD) levels.
Main Results:
- The laboratory trial showed significant improvements in memory and inhibitory control with MPH.
- Parent and teacher reports indicated that moderate-dose MPH led to superior attention improvements compared to placebo and LD MPH.
Conclusions:
- Methylphenidate positively influences specific cognitive domains, including memory and inhibitory control, in some children with SCD.
- Higher doses of MPH demonstrated greater improvements in attention, as rated by parents and teachers, compared to lower doses and placebo.
- MPH may serve as an effective intervention for attention problems in children with SCD and associated cerebrovascular complications.
Objective:
This pilot study examined whether methylphenidate (MPH) was effective in enhancing cognitive performance and attention for children with sickle cell disease (SCD) with cerebrovascular complications who evidence attention problems.
Methods:
In this multisite, pilot study, we evaluated 2 separate double-blind controlled clinical trials, including a laboratory trial of the short-term efficacy of MPH, with the second study a 3-week home/school crossover trial evaluating the efficacy of MPH. The laboratory trial included 14 participants between the age of 7 and 16 years. Assessments included measures of sustained attention, reaction time, executive functions, and verbal memory. The home/school trial included 20 participants. The outcome measures were parent and teacher ratings of attention. The first study compared MPH with placebo, while the second trial compared placebo, low-dose (LD) MPH, and moderate-dose MPH.
Results:
In the laboratory trial, significant effects were revealed for measures of memory and inhibitory control. Parent and teacher reports from the home/school trial indicate that moderate-dose MPH produced superior improvement in attention relative to the placebo and LD MPH.
Conclusions:
Stimulant medication positively impacted select measures of memory and inhibitory control in some children with SCD. Attention, as rated by parent and teachers, was improved for a greater number of children and adolescents on higher doses of MPH relative to LD MPH and placebo. Stimulant medication may provide an effective intervention for some children with SCD and cerebrovascular complications who demonstrate attention problems.
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