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Updated: May 12, 2026
Quantifying Cognitive Decrements Caused by Cranial Radiotherapy
Published on: October 18, 2011
Memantine for Prevention of Cognitive Late Effects in Children and Adolescents Receiving Radiation Therapy for Brain
Heather M Conklin1, Raja B Khan2, Jason M Ashford1
1Department of Psychology and Biobehavioral Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee.
Purpose:
Children receiving irradiation for brain tumors are at significant risk for cognitive deficits that notably impact quality of life. This is the first randomized, controlled investigation of the feasibility, acceptability, and preliminary efficacy of memantine (an N-methyl-D-aspartate receptor antagonist) for reducing cognitive late effects in children and adolescents undergoing radiation therapy.
Methods And Materials:
In a randomized, double-blind, controlled, pilot trial, children and adolescents took memantine (20 mg/d) or placebo for 12 weeks. Adherence was assessed using pill counts, and side effects were monitored using a structured interview. At baseline, 6 weeks (end of radiation therapy), 12 weeks (end of medication), and 1 year, participants completed cognitive assessments.
Results:
Thirty patients (age, 11.93 ± 2.87 years; 47% male) were included; memantine (n = 16) and placebo (n = 14) groups did not differ in age, sex, race, socioeconomic status, or baseline intelligence quotient (P > .26). Study participation (71%) and medication adherence (88% completed 12 weeks; 97% of medication taken) were high. Side effects were minimal with no difference between memantine and placebo groups in increase in severity from baseline to any medication week (P > .23). At 12 weeks, effect sizes (ESs) indicate the memantine group had better processing speed (Cogstate Identification, ES = .61), academic fluency (Woodcock-Johnson IV Reading Fluency, ES = .45; Math Fluency, ES = .81), and fatigue (Pediatric Quality of Life Inventory [PedsQL] Multidimensional Fatigue Scale, ES = .72), with some benefits persisting 1 year post treatment (eg, Woodcock-Johnson IV Reading Fluency ES = .65; Math Fluency ES = .71).
Conclusions:
Study findings from this randomized, controlled trial indicate memantine used as a neuroprotectant during irradiation for children and adolescents with brain tumors is feasible and acceptable, with preliminary evidence for better cognitive outcomes that requires validation in a larger trial.
