Methylphenidate therapy improves cognition, mood, and function of brain tumor patients.
OBJECTIVE
Patients with malignant glioma develop progressive neurobehavioral deficits over the course of their illness. These are caused both by the effects of the disease and the effects of radiation and chemotherapy. We sought to determine whether methylphenidate treatment would improve these patients' neurobehavioral functioning despite their expected neurologic deterioration.


METHODS
Thirty patients with primary brain tumors underwent neuropsychologic assessment before and during treatment with methylphenidate. Ability to function in activities of daily living and magnetic resonance imaging (MRI) findings were also documented. Patients were assessed on 10, 20, and 30 mg of methylphenidate twice daily.


RESULTS
Significant improvements in cognitive function were observed on the 10-mg twice-daily dose. Functional improvements included improved gait, increased stamina and motivation to perform activities, and in one case, increased bladder control. Adverse effects were minimal and immediately resolved when treatment was discontinued. There was no increase in seizure frequency and the majority of patients on glucocorticoid therapy were able to decrease their dose. Gains in cognitive function and ability to perform activities were observed in the setting of progressive neurologic injury documented by MRI in half of the subjects.


CONCLUSIONS
This study demonstrated improved patient function in the setting of a progressive neurologic illness. Methylphenidate should be more widely considered as adjuvant brain tumor therapy.
Department of Neuro-Oncology, The University of Texas M.D. Anderson Cancer Center, Houston 77030, USA. cmeyers@audumla.mdacc.tmc.edu
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Meyers
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Weitzner
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Valentine
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Levin
D000293:Adolescent; D000328:Adult; D000339:Affect / Q000187:drug effects*; D000368:Aged; D001921:Brain / Q000187:drug effects / Q000503:physiopathology; D001932:Brain Neoplasms / Q000150:complications*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects*; D005260:Female; D005910:Glioma / Q000150:complications*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy* / Q000209:etiology; D008774:Methylphenidate / Q000627:therapeutic use*; D008875:Middle Aged; D009422:Nervous System Diseases / Q000188:drug therapy* / Q000209:etiology; D009483:Neuropsychological Tests; D016896:Treatment Outcome
D000697:Central Nervous System Stimulants; D008774:Methylphenidate