Traumatic Brain Injury-Related Attention Deficits in Children: A Controlled Treatment Trial with Lisdexamfetamine Dimesylate (Vyvanse)

Abstract

Attention deficits are among the most common and persistent impairments resulting from traumatic brain injury (TBI). This study was the first to examine the effects of lisdexamfetamine dimesylate (LDX, Vyvanse) in treating TBI-related attention deficits in children. It was an extension of a previous controlled trial with adults. This was a 12-week, randomized, double-blind, placebo-controlled, dose-titration, crossover trial. In addition to weekly safety monitoring, there were assessments on a broad range of neuropsychological and behavioral measures at baseline, 6-weeks, and 12-weeks. A total of 20 carefully selected children were enrolled, ranging from 10 to 16 years of age. The sample consisted of cases with mainly mild TBI (based on the known details regarding their injuries), but they had persisting attention deficits and other post-concussion symptoms lasting from 2 to 29 months by the time of enrollment. A total of 16 children completed the trial. One of the children withdrew due to a mild anxiety reaction while on LDX. There were no other adverse effects. Positive treatment results were found on both formal testing of sustained attention and in terms of parent ratings of attention, emotional status, behavioral controls, and various aspects of executive functioning. The findings also served to highlight broader insights into the nature of attention deficits and their treatment in children with TBI.

Comprehensive assessment of executive functioning following childhood severe traumatic brain injury: clinical utility of the child executive functions battery

“…Given the low ecological validity of available standardized tests for EFs (Gioia et al, 2010;Chevignard et al, 2012), a number of studies have also used questionnaire based reports of executive functioning in everyday life [e.g., the Behavior Rating Inventory of Executive Function (BRIEF) questionnaire; Gioia et al, 2000], either in addition to standardized testing, or sometimes exclusively (Chevignard et al, 2010(Chevignard et al, , 2017Donders et al, 2010;Gioia et al, 2010;Ganesalingam et al 2011;Potter et al, 2011;Wilson et al, 2011;Krasny-Pacini et al, 2017;Le Fur et al, 2020;Maloney et al, 2020;Narad et al, 2020;Tramontana et al, 2021). However, given the low correlation between the BRIEF questionnaire and performance-based measures of EFs (Toplak et al, 2013), it remains crucial to comprehensively assess executive deficits using developmentally adequate tasks, in combination with questionnaires.…”

Chronic Administration of 7,8-DHF Lessens the Depression-like Behavior of Juvenile Mild Traumatic Brain Injury Treated Rats at Their Adult Age

“…Over the past two decades, the mortality of TBI in both the United States and Taiwan has dropped, which could be attributed to law enforcement efforts, advances in sports safety equipment, more accessible access to first aid, and improvements to diagnostic techniques [5][6][7]. With the increased survival rate also came an influx of TBI-related psychiatric cases [5][6][7][8][9][10].…”