Methylphenidate effect on attention deficit in the acutely brain-injured adult

Kaelin, Darryl L.; Cifu, David X.; Matthies, Brigitte K.

doi:10.1016/s0003-9993(96)90211-7

Cited by 104 publications

(64 citation statements)

References 9 publications

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“…17 Overall, methylphenidate may accelerate the return to normal of hypofunctioning neurons or neural circuits. 12 The results of this study are largely consistent with previous research demonstrating methylphenidate-induced enhancement of consciousness in ABI. Although previous research suggesting the beneficial effect of methylphenidate in the early recovery phase after brain injury reported that this compound stimulated the formation of new synapses, 12 augmented neural activity within the reticular activating system, 8,18 and had a neuroprotective effect, 19 little is known about the anatomical target in the cerebral cortex associated with the recovery of consciousness after methylphenidate treatment in ABI.…”

Section: Discussionsupporting

confidence: 90%

“…7,8,12,13 However, no study has reported on changes in the metabolic pattern of cerebral cortex after methylphenidate therapy in patients with impaired consciousness after ABI. In this study, we evaluated the changes of cerebral metabolic pattern between before and after methylphenidate treatment and correlated cerebral glucose metabolism with improvement in the level of consciousness using SPM analysis.…”

Section: Discussionmentioning

confidence: 99%

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Effects of Methylphenidate on Cerebral Glucose Metabolism in Patients With Impaired Consciousness After Acquired Brain Injury

Kim

Shin²,

An³

2009

Clinical Neuropharmacology

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Objectives: To evaluate the effects of methylphenidate on cerebral glucose metabolism in patients with impaired consciousness after acquired brain injury.Methods: Fourteen patients with impaired consciousness after acquired brain injury were enrolled in our study. We evaluated the level of consciousness with the Glasgow Coma Scale upon initial evaluation and at the 6-week follow-up after methylphenidate medication (0.3 mg/kg per day, which was administered twice daily). Positron emission tomography was performed before and after 6 weeks of medication, and the effects of methylphenidate on cerebral glucose metabolism were analyzed using statistical parametric mapping. Results:The statistical parametric mapping analysis indicated that significant increases of the cerebral glucose metabolism after methylphenidate therapy, compared with the initial positron emission tomographic image, were most evident in the left precuneus, the right posterior cingulated and the right retrosplenial cortices, and the right inferior parietal cortex (P G 0.001). In addition, cerebral glucose metabolism was significantly increased in the right precuneus, the right superior and middle temporal gyri, and bilateral middle occipital gyri (P G 0.005). In the correlation analysis, improvement of the Glasgow Coma Scale scores after methylphenidate medication was significantly associated with increased cerebral glucose metabolism in the bilateral precuneus, the bilateral middle occipital gyri, and right middle frontal gyrus.Conclusions: Our findings suggest that the posteromedial parietal cortex, which is part of the neural network for consciousness, may be the relevant structure for the pharmacological response to methylphenidate treatment in patients with impaired consciousness after acquired brain injury.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Effects of Methylphenidate on Cerebral Glucose Metabolism in Patients With Impaired Consciousness After Acquired Brain Injury

Kim

Shin²,

An³

2009

Clinical Neuropharmacology

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“…Methylphenidate has been shown in several RCTs to improve attention after TBI [149]. These trials include a double-blind crossover trial in chronic TBI [154] and several additional RCTs of mild and moderate to severe TBI [155][156][157][158]. Case report and chart review data also support dextroamphetamine for improved attention after TBI [149].…”

Section: Managing Cognitive Complaintsmentioning

confidence: 98%

Review: Managing posttraumatic stress disorder in combat veterans with comorbid traumatic brain injury

Capehart¹,

Bass²

2012

JRRD

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“…Baseline attention may predict response to methylphenidate treatment of apathy which may in turn improve attention (23). We chose to measure attention with Wechsler Memory Scale – Revised (WMS-R) digit span tests (56) which has been reported to effectively measure attention, concentration, sequencing, number facility and auditory short-term memory (57–59) in dementia populations and to be a sensitive measure of drug response in methylphenidate trials (60). …”

Section: Issues In Designing a Trial To Test Treatments For Apathymentioning

confidence: 99%

Designing a Trial to Evaluate Potential Treatments for Apathy in Dementia: The Apathy in Dementia Methylphenidate Trial (ADMET)

Drye

Scherer

Lanctôt

et al. 2013

The American Journal of Geriatric Psychiatry

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Background Research on efficacious treatments for apathy in Alzheimer’s disease has been hindered by a lack of consensus diagnosis, difficulties in measurement, and studies with small sample sizes. Methods In designing the Apathy in Dementia Methylphenidate Trial (ADMET), a trial to evaluate the efficacy and safety of methylphenidate for the treatment of apathy in Alzheimer’s disease, we encountered the following issues: defining and measuring apathy, distinguishing apathy and depression, determining an appropriate test treatment, selecting relevant secondary outcomes, recruiting participants, and deciding on a suitable method for treatment unmasking. ADMET is a 6-week randomized, double-masked, placebo-controlled multicenter clinical trial with two parallel treatment groups assigned in a 1:1 ratio with randomization stratified by clinical center. The recruitment goal is 60 randomized participants over 2 years. The primary outcomes are change in apathy severity as measured by the Apathy Evaluation Scale and the Alzheimer Disease Cooperative Study-Clinical Global Impression of Change. Conclusion The design decisions made for ADMET are important elements to be considered in trials assessing the safety and efficacy of medications for clinically significant apathy in Alzheimer’s disease.

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Methylphenidate effect on attention deficit in the acutely brain-injured adult

Cited by 104 publications

References 9 publications

Effects of Methylphenidate on Cerebral Glucose Metabolism in Patients With Impaired Consciousness After Acquired Brain Injury

Effects of Methylphenidate on Cerebral Glucose Metabolism in Patients With Impaired Consciousness After Acquired Brain Injury

Review: Managing posttraumatic stress disorder in combat veterans with comorbid traumatic brain injury

Designing a Trial to Evaluate Potential Treatments for Apathy in Dementia: The Apathy in Dementia Methylphenidate Trial (ADMET)

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