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Recovery in pediatric brain injury: is psychostimulant medication beneficial?
S E Williams1, M D Ris, R Ayyangar
1Department of Psychiatry, Stanford University Medical Center, Stanford, California 94305, USA. sharonw@leland.Stanford.edu
Insights
Methylphenidate did not significantly improve attention, memory, or behavior in children with closed head injuries. This study questions its effectiveness for this pediatric population.
Area of Science:
- Pediatric Neurology
- Neuropsychology
- Pharmacology
Background:
- Children with closed head injuries often experience cognitive and behavioral deficits.
- Methylphenidate is commonly used to treat attention and hyperactivity disorders.
Purpose of the Study:
- To evaluate the efficacy of methylphenidate in improving cognitive and behavioral outcomes in pediatric patients with closed head injuries.
- To assess methylphenidate's impact on attention, memory, processing speed, and psychomotor skills.
Main Methods:
- A double-blind, placebo-controlled, crossover study was conducted with ten pediatric subjects.
- Methylphenidate and placebo were administered, and changes in cognitive and behavioral scores were measured.
Main Results:
- No significant differences were observed between methylphenidate and placebo groups.
- Methylphenidate did not show significant improvements in behavior, attention, memory, or processing speed.
Conclusions:
- The findings suggest that methylphenidate may not be effective for treating cognitive and behavioral issues in children with closed head injuries.
- Further research is needed to explore alternative or adjunctive treatments for this population.
Objective:
To assess the effects of methylphenidate on attention, memory, behavior, processing speed, and psychomotor skills of children with closed head injuries.
Design:
Double-blind, placebo-controlled, crossover design.
Setting:
An outpatient facility of a children's hospital medical center.
Patients:
Ten pediatric subjects identified through chart review. Subjects met baseline scores for hyperactivity (Conner's Hyperactivity Index greater than or equal to 60) and intellectual functioning (Verbal Intelligence Quotient greather than or equal to 70) and achieved minimal scores on two psychometric tests. All subjects evidenced head injury by focal lesions on computed tomography scan and/or sequelae reported at the time of injury. Severity of injury ranged from mild to severe. All subjects were medically stable at the time of testing. Mean time post injury was 2 years, 8 months.
Intervention:
Administration of methylphenidate and placebo.
Main Outcome Measures:
Percentage change in scores was calculated to assess differences between baseline and end of methylphenidate/placebo trials.
Results:
No significant differences between methylphenidate and placebo on measures assessing behavior, attention, memory, and processing speed.
Conclusions:
The results of the study call into question the effectiveness of methylphenidate in the pediatric head injury population.