title: The effect of methylphenidate on prefrontal cognitive functioning, inattention, and hyperactivity in velocardiofacial syndrome.
abstract: OBJECTIVE
  Methylphenidate (MPH) is commonly used to treat attention-deficit/hyperactivity disorder (ADHD) in all children, including those with velocardiofacial syndrome (VCFS). Yet concerns have been raised regarding its safety and efficacy in VCFS. The goal of this study was to examine the safety and efficacy of MPH in children with VCFS.
  
  
  METHODS
  Thirty-four children and adolescents with VCFS and ADHD participated in a randomized, controlled trial with a 2:1 ratio of MPH versus placebo. All subjects underwent a cardiological evaluation before and after MPH administration. The primary outcome measure was prefrontal cognitive performance following a single dose of MPH or placebo. A follow-up assessment was conducted after a 6-month treatment with MPH.
  
  
  RESULTS
  Compared with placebo, single MPH administration was associated with a more robust improvement in prefrontal cognitive performance, including achievements in the Hearts and Flowers executive function task and the visual continuous performance task. After 6 months of treatment, a 40% reduction in severity of ADHD symptoms was reported by parents on the Revised Conners Rating Scale. All subjects treated with MPH reported at least one side effect, but it did not necessitate discontinuation of treatment. MPH induced an increase in heart rate and blood pressure that was usually minor, but was clinically significant in two cases. No differences in response to MPH were observed between catechol-O-methyltransferase Met versus Val carriers.
  
  
  CONCLUSIONS
  The use of MPH in children with VCFS appears to be effective and relatively safe. A comprehensive cardiovascular evaluation for children with VCFS before and during stimulant treatment is recommended.
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Tamar
authors.initials: T
authors.lastname: Green
authors.forename: Ronnie
authors.initials: R
authors.lastname: Weinberger
authors.forename: Adele
authors.initials: A
authors.lastname: Diamond
authors.forename: Michael
authors.initials: M
authors.lastname: Berant
authors.forename: Leora
authors.initials: L
authors.lastname: Hirschfeld
authors.forename: Amos
authors.initials: A
authors.lastname: Frisch
authors.forename: Omer
authors.initials: O
authors.lastname: Zarchi
authors.forename: Abraham
authors.initials: A
authors.lastname: Weizman
authors.forename: Doron
authors.initials: D
authors.lastname: Gothelf
mesh_terms: D000293:Adolescent; D001288:Attention / Q000187:drug effects*; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D001794:Blood Pressure / Q000187:drug effects; D002394:Catechol O-Methyltransferase / Q000235:genetics; D002675:Child, Preschool; D003071:Cognition / Q000187:drug effects*; D004062:DiGeorge Syndrome / Q000150:complications / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006579:Heterozygote; D006801:Humans; D006948:Hyperkinesis / Q000188:drug therapy; D008297:Male; D008774:Methylphenidate / Q000009:adverse effects* / Q000627:therapeutic use*; D011597:Psychomotor Performance / Q000187:drug effects; D055815:Young Adult
chemical_list: D008774:Methylphenidate; D002394:Catechol O-Methyltransferase