Traumatic Brain Injury-Related Attention Deficits in Children: A Controlled Treatment Trial with Lisdexamfetamine
Michael G Tramontana1, Jonathan W Prokop1, Edwin Williamson1
1Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, The Village at Vanderbilt, Suite 2200, 1500 21st Avenue South, Nashville, TN 37212, USA.
Insights
Lisdexamfetamine dimesylate (LDX) effectively improved attention deficits in children following traumatic brain injury (TBI). This medication demonstrated positive effects on attention, executive functioning, and behavior with minimal side effects.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Psychiatry
Background:
- Attention deficits are common, persistent impairments after traumatic brain injury (TBI).
- Previous research explored TBI-related attention deficits in adults.
- Pediatric TBI populations require targeted treatment strategies.
Purpose of the Study:
- To evaluate the efficacy of lisdexamfetamine dimesylate (LDX) for treating attention deficits in children with TBI.
- To extend findings from a prior adult controlled trial to a pediatric population.
- To assess the safety and tolerability of LDX in this cohort.
Main Methods:
- A 12-week, randomized, double-blind, placebo-controlled, dose-titration, crossover trial.
- Involved 20 children (10-16 years) with mild TBI and persistent attention deficits.
- Utilized weekly safety monitoring and comprehensive neuropsychological/behavioral assessments at baseline, 6, and 12 weeks.
Main Results:
- Significant improvements were observed in formal sustained attention testing.
- Parent ratings indicated positive changes in attention, emotional regulation, and executive functioning.
- LDX was generally well-tolerated, with one withdrawal due to mild anxiety.
Conclusions:
- Lisdexamfetamine dimesylate is a promising treatment for attention deficits in children with TBI.
- The findings support LDX's potential to improve cognitive and behavioral outcomes post-TBI.
- Further research can elucidate the broader implications for TBI-related attention and executive function deficits in pediatric populations.
Abstract:
Attention deficits are among the most common and persistent impairments resulting from traumatic brain injury (TBI). This study was the first to examine the effects of lisdexamfetamine dimesylate (LDX, Vyvanse) in treating TBI-related attention deficits in children. It was an extension of a previous controlled trial with adults. This was a 12-week, randomized, double-blind, placebo-controlled, dose-titration, crossover trial. In addition to weekly safety monitoring, there were assessments on a broad range of neuropsychological and behavioral measures at baseline, 6-weeks, and 12-weeks. A total of 20 carefully selected children were enrolled, ranging from 10 to 16 years of age. The sample consisted of cases with mainly mild TBI (based on the known details regarding their injuries), but they had persisting attention deficits and other post-concussion symptoms lasting from 2 to 29 months by the time of enrollment. A total of 16 children completed the trial. One of the children withdrew due to a mild anxiety reaction while on LDX. There were no other adverse effects. Positive treatment results were found on both formal testing of sustained attention and in terms of parent ratings of attention, emotional status, behavioral controls, and various aspects of executive functioning. The findings also served to highlight broader insights into the nature of attention deficits and their treatment in children with TBI.
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