Methylphenidate improves cognitive function and health-related quality of life in survivors of childhood brain tumours

Verity, Sarah J; Halliday, Gail; Hill, Rebecca; Ryles, Jade; Bailey, Simon

doi:10.1080/09602011.2022.2157446

Cited by 4 publications

(12 citation statements)

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“…Despite growing evidence for the utility of psychostimulants in children with acquired brain injuries (including CNS tumors) (Hagan and Verity, 2023; Nicholls et al, 2012; Verity et al, 2022), the use of methylphenidate is not considered as a routine option in mainstream clinical practice. Respondents noted that the highly constrained resources that are available to pediatric psychologists in many pediatric neuro-oncology PTCs restricts practice to the provision of a skeleton service.…”

Section: Discussionmentioning

confidence: 99%

“…Held approximately twice per month, the clinic provides screening, assessment, and methylphenidate intervention, where appropriate, to survivors of childhood CNS tumors. We have found significant benefit to our patients via this intervention (Verity et al, 2022). Our clinical information sheets for parents and children, and our assessment, prescribing, and followup protocols, are available on request by any UK PTC.…”

Section: Current Survivorship Clinicmentioning

confidence: 90%

“…Because the primary neurocognitive deficits that are reported by survivors of childhood CNS tumors are those that are mediated by the frontal lobes, psychostimulants such as methylphenidate have been proposed as an effective and generally well-tolerated rehabilitative intervention (Conklin et al, 2007(Conklin et al, , 2009(Conklin et al, , 2010Verity et al, 2022). Recent systematic and meta-analytical reviews offer further evidence for the efficacy of methylphenidate in improving neurocognitive deficits among childhood survivors of acquired brain injury (including survivors of childhood CNS tumors) (Hagan and Verity, 2023;Nicholls et al, 2012).…”

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confidence: 99%

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Barriers to the use of Methylphenidate in Pediatric Neuro-oncology Services

Hagan,

Bailey,

Verity

2023

Cognitive and Behavioral Neurology

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Background: Survivors of childhood CNS tumors are at a significant risk of chronic and multifaceted neurocognitive late effects. Recent findings indicate the potential utility of methylphenidate in addressing neurocognitive and academic plateauing and improving quality-of-life outcomes in this clinical population. However, the prescription of methylphenidate in neuro-oncology services remains inconsistent. Objective: To explore the neurocognitive assessment and rehabilitative interventions (including the use of methylphenidate) offered to survivors of childhood CNS tumors within mainland UK. Method: We used a semi-structured questionnaire to gather qualitative data from clinical psychologists and neuropsychologists within National Health Service pediatric neuro-oncology principal treatment centers (PTCs) during May 2018. Thematic analytical methods were used to explore themes within the collected data. Results: Eleven (58%) of the 19 PTCs returned the completed questionnaire. Respondents reported inadequate resource of psychology in many pediatric neuro-oncology PTCs, which limited the provision of methylphenidate to a restricted proportion of the patient group (i.e., those with the most profound neurocognitive difficulties). Respondents reported an interest in exploring the utility of methylphenidate in their patient group yet described a lack of appropriate evidence of its efficacy. In addition, respondents highlighted the need for the provision of accessible research summaries and treatment protocols addressing the use of methylphenidate. Conclusion: We anticipate that national collaboration between clinicians and researchers working in the cancer survivorship field will support the advancement of interventions such as methylphenidate for the growing clinical population of survivors of childhood CNS tumors.

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Section: Discussionmentioning

confidence: 99%

Section: Current Survivorship Clinicmentioning

confidence: 90%

mentioning

confidence: 99%

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Barriers to the use of Methylphenidate in Pediatric Neuro-oncology Services

Hagan,

Bailey,

Verity

2023

Cognitive and Behavioral Neurology

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“…Evidence of the effect of longer-term use of methylphenidate in the brain tumour population is limited. Three published studies report on the effects of this treatment in cohorts at 12 months of use, two of these sourcing the same participant pool [12][13][14]. Studies of participants at 12 months showed improvement in attention as measured by the Conners' Continuous Performance Task [12] and on selective attention using the Test of Everyday Attention for Children [14].…”

Section: Introductionmentioning

confidence: 99%

Key Questions on the Long-Term Utility of Methylphenidate in Paediatric Brain Tumour Survivorship: A Retrospective Clinical Case Series

Hagan,

Verity

2024

Children

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Methylphenidate has an established role in the management of attention-deficit hyperactivity disorder and attentional deficit secondary to brain injury. Increasingly, methylphenidate is considered for the attentional deficit in paediatric brain tumour survivors. A small number of studies have explored the benefit of methylphenidate in this population; however, studies are of short duration and do not address the impact of medium to long-term use of methylphenidate on intellectual function. We identified six patients who are survivors of a paediatric brain tumour aged 12–18 years with greater than three years of use of methylphenidate for inclusion in a clinical case series. We used this patient cohort to identify key questions to inform a future long-term cohort study. Linear mixed model and reliable change index analyses were performed on the data. Reliable change index analyses showed benefits to working memory (n = 3), processing speed (n = 2), and full-scale IQ (n = 4) performance for some patients. This exploratory case series suggests the potential medium to long-term benefit of methylphenidate in brain tumour survivorship, indicating the need for larger, appropriately powered studies. These patient data, alongside a discussion of learning points from our previously published studies, are used as a conduit for the identification of questions relating to the use of methylphenidate in a paediatric brain tumour.

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“…Two studies looked at the impact of methylphenidate over a 12 month period. One of these studies was written by our team: Methylphenidate Improves Cognitive Function and Health-Related Quality of Life in Survivors of Childhood Brain Tumours [10]. We looked at anonymised data from 29 patients who were using methylphenidate.…”

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confidence: 99%

Is Methylphenidate Useful to Survivors of Childhood Brain Tumour? An Accessible Summary of Recent Research

2024

Psychol J Res Open

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Many children and young people experience long-term difficulties after having a brain tumour. This paper discusses interventions using the medication methylphenidate and describes the current research in this area being conducted at the Great North Children's Hospital (Newcastle upon Tyne) and Newcastle University Centre for Cancer. The children, young people, and their families who use our hospital tell us that some of their most challenging difficulties only happened once the brain tumour treatment had finished. Some survivors of childhood brain tumour are left with lifelong disabilities that result from their cancer or treatment. These disabilities are often related to brain injury, and can be relatively invisible to the general public. Some disabilities only become apparent over the time following treatment. These are known as 'long-term late effects' . The most common long-term late effect that is reported after childhood brain tumour is an acquired brain injury. We see signs of an acquired brain injury following brain tumour in behaviour such as reduced attention, a reduction in ability to remember things, a slowing down of how quickly the child can take in information, and an impact on their academic performance and overall intellectual ability (IQ). Depending on the location of the tumour, brain injury can present in a different way. It is important to remember that the term 'brain injury' refers to any injury affecting the brain, so information on brain injury on the internet may not apply to the specific injury a child has acquired. A child can develop brain injury after a brain tumour due to one or many different factors, including any build-up of fluid in the brain before the tumour was discovered (hydrocephalus), surgery, post-surgical complications (such as posterior fossa syndrome), certain chemotherapies, or radiotherapy. Generally, the younger a child is at the time of diagnosis, the more likely they are to experience significant late effects.We have worked with a number of patients and their families in Newcastle at the Great North Children's Hospital to help us understand what the role of methylphenidate might be in helping to reduce long-term late effects that affect intellectual and academic ability. Methylphenidate is a medication that is used for a few different reasons. Usually people have heard of methylphenidate by one of its brand names, 'Ritalin' , which they know is used for children with Attention Deficit Hyperactivity Disorder (ADHD). We do not use this

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Methylphenidate improves cognitive function and health-related quality of life in survivors of childhood brain tumours

Cited by 4 publications

References 54 publications

Barriers to the use of Methylphenidate in Pediatric Neuro-oncology Services

Barriers to the use of Methylphenidate in Pediatric Neuro-oncology Services

Key Questions on the Long-Term Utility of Methylphenidate in Paediatric Brain Tumour Survivorship: A Retrospective Clinical Case Series

Is Methylphenidate Useful to Survivors of Childhood Brain Tumour? An Accessible Summary of Recent Research

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