Recovery in pediatric brain injury: is psychostimulant medication beneficial?
OBJECTIVE
To assess the effects of methylphenidate on attention, memory, behavior, processing speed, and psychomotor skills of children with closed head injuries.


METHODS
Double-blind, placebo-controlled, crossover design.


METHODS
An outpatient facility of a children's hospital medical center.


METHODS
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.


METHODS
Administration of methylphenidate and placebo.


METHODS
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.
Williams
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Department of Psychiatry, Stanford University Medical Center, Stanford, California 94305, USA. sharonw@leland.Stanford.edu
Ris
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Ayyangar
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Schefft
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Berch
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D000293:Adolescent; D001288:Attention / Q000187:drug effects; D001930:Brain Injuries / Q000175:diagnosis / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000494:pharmacology / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007361:Intelligence Tests; D008297:Male; D008568:Memory / Q000187:drug effects; D008774:Methylphenidate / Q000494:pharmacology / Q000627:therapeutic use*; D011597:Psychomotor Performance / Q000187:drug effects; D016896:Treatment Outcome
D000697:Central Nervous System Stimulants; D008774:Methylphenidate