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Psychopharmacologic treatment of acquired attention disorders in children with brain injury
D M Mahalick1, P W Carmel, J P Greenberg
1Department of Surgery (Section of Neurosurgery), UMDNJ-New Jersey Medical School, Newark, N.J., 07103-2499, USA.
Insights
Psychostimulant therapy, particularly methylphenidate, effectively treats attentional disorders in children with brain injuries. This treatment significantly improved cognitive functions compared to placebo, showing no improvement from baseline.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Psychopharmacology
Background:
- Pediatric brain injury frequently results in neurobehavioral deficits, primarily affecting attention.
- Attentional deficits are a common sequela in both pediatric and adult populations post-head injury.
- Existing research on psychostimulants for adult neurobehavioral deficits post-head injury shows mixed but potentially beneficial results.
Purpose of the Study:
- To investigate the efficacy of methylphenidate in treating acquired attentional disorders in children following brain injury.
- To evaluate the impact of psychostimulant therapy on neurobehavioral dysfunction in pediatric brain injury survivors.
Main Methods:
- Prospective, double-blind, placebo-controlled, cross-over study design.
- Inclusion of 14 children with varying degrees of acquired brain injury.
- Assessment of methylphenidate's efficacy using neurobehavioral tasks measuring attention and concentration.
Main Results:
- Methylphenidate demonstrated statistically significant improvements in attention and concentration compared to placebo.
- No significant differences were observed between baseline and placebo conditions.
- Findings suggest methylphenidate is highly effective for pediatric attentional disorders post-brain injury.
Conclusions:
- Methylphenidate is an effective treatment for attentional deficits secondary to brain injury in children.
- Other psychostimulants like Cylert, Adderall, Wellbutrin, and dextroamphetamine sulfate may also be beneficial.
- Psychostimulant therapy offers a promising intervention for improving cognitive function in pediatric brain injury patients.
Abstract:
This investigation examined the efficacy of psychostimulant therapy in alleviating neurobehavioral dysfunction attendant to pediatric brain injury. The most commonly reported neurobehavioral sequelae associated with head injury in the pediatric population involve deficits along the attentional matrix. This is also the most common objectively documented neurobehavioral finding among children as well as adults. There are several investigations in the adult literature which have employed the use of psychostimulants in treating both psychiatric and neuropsychological residua associated with head injury. Overall, the results of these studies are equivocal, but suggest a beneficial impact on general functioning. The present prospective investigation utilized a double-blind, placebo-controlled, cross-over experimental design to examine the efficacy of methylphenidate in treating children with acquired attentional disorders secondary to brain injury. A cohort of 14 children with varying degrees of head injury were recruited for participation. As expected, differences between drug and placebo conditions uniformly achieved statistical significance. Additionally, there were no differences in performance between baseline and placebo conditions on neurobehavioral tasks of attention and concentration. Current findings suggest that methylphenidate (and probably other psychostimulants such as Cylert, Adderal, Wellbutrin and dextroamphetamine sulfate) is an extremely effective agent in treating attentional disorders secondary to brain injury in children.