title: Methylphenidate, cognition, and epilepsy: A double-blind, placebo-controlled, single-dose study.
abstract: OBJECTIVE
  To evaluate the potential efficacy of immediate-release methylphenidate (MPH) for treating cognitive deficits in epilepsy.
  
  
  METHODS
  This was a double-blind, randomized, single-dose, 3-period crossover study in patients with epilepsy and chronic cognitive complaints comparing the effects of placebo and MPH 10 and 20 mg given 1 week apart. Cognitive outcome was evaluated on the basis of an omnibus z score calculated from performance on the Conners Continuous Performance Test 3 (ability to discriminate between target and nontarget stimuli [d'] and hit reaction time standard deviation), Symbol-Digit Modalities Test, and Medical College of Georgia Paragraph Memory Test. Adverse events and seizure frequency were monitored. An open-label follow-up is reported elsewhere.
  
  
  RESULTS
  Thirty-five adult patients with epilepsy participated, of whom 31 finished. Demographics included the following: mean age = 35.3 years (range 20-62 years), 13 men and 18 women, and baseline seizure frequency of 2.8 per month. Epilepsy types were focal (n = 24), generalized (n = 6), or unclassified (n = 1). Mean epilepsy duration was 12.5 years. A statistically significant performance benefit was present at both 10-mg (p = 0.030) and 20-mg (p = 0.034) MPH doses. No seizures were associated with either MPH dose. Adverse effects leading to withdrawal included cognitive "fogginess" (n = 1 on 20 mg), anxiety/agitation (n = 1 on 10 mg), and tachycardia (n = 1). One participant was lost to follow-up after one 20-mg dose without side effect.
  
  
  CONCLUSIONS
  This single-dose study suggests that MPH may be effective in ameliorating some cognitive deficits in patients with epilepsy. Additional studies are required.
  
  
  BACKGROUND
  NCT02178995.
  
  
  METHODS
  This study provides Class II evidence that single doses of MPH improve cognitive performance on some measures of attention and processing speed in patients with epilepsy and cognitive complaints.
authors.affiliation: From Psychiatry and Behavioral Sciences (J.A., V.A.-J., S.S., J.O., J.J.B.) and Neurology and Neurological Sciences (K.I., V.B., K.M.), Stanford University, CA; and Neurology (D.W.L.), Emory University, Atlanta, GA. jadamsmd@uw.edu.
authors.forename: Jesse
authors.initials: J
authors.lastname: Adams
authors.affiliation: From Psychiatry and Behavioral Sciences (J.A., V.A.-J., S.S., J.O., J.J.B.) and Neurology and Neurological Sciences (K.I., V.B., K.M.), Stanford University, CA; and Neurology (D.W.L.), Emory University, Atlanta, GA.
authors.forename: Valerie
authors.initials: V
authors.lastname: Alipio-Jocson
authors.affiliation: From Psychiatry and Behavioral Sciences (J.A., V.A.-J., S.S., J.O., J.J.B.) and Neurology and Neurological Sciences (K.I., V.B., K.M.), Stanford University, CA; and Neurology (D.W.L.), Emory University, Atlanta, GA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Inoyama
authors.affiliation: From Psychiatry and Behavioral Sciences (J.A., V.A.-J., S.S., J.O., J.J.B.) and Neurology and Neurological Sciences (K.I., V.B., K.M.), Stanford University, CA; and Neurology (D.W.L.), Emory University, Atlanta, GA.
authors.forename: Victoria
authors.initials: V
authors.lastname: Bartlett
authors.affiliation: From Psychiatry and Behavioral Sciences (J.A., V.A.-J., S.S., J.O., J.J.B.) and Neurology and Neurological Sciences (K.I., V.B., K.M.), Stanford University, CA; and Neurology (D.W.L.), Emory University, Atlanta, GA.
authors.forename: Saira
authors.initials: S
authors.lastname: Sandhu
authors.affiliation: From Psychiatry and Behavioral Sciences (J.A., V.A.-J., S.S., J.O., J.J.B.) and Neurology and Neurological Sciences (K.I., V.B., K.M.), Stanford University, CA; and Neurology (D.W.L.), Emory University, Atlanta, GA.
authors.forename: Jemima
authors.initials: J
authors.lastname: Oso
authors.affiliation: From Psychiatry and Behavioral Sciences (J.A., V.A.-J., S.S., J.O., J.J.B.) and Neurology and Neurological Sciences (K.I., V.B., K.M.), Stanford University, CA; and Neurology (D.W.L.), Emory University, Atlanta, GA.
authors.forename: John J
authors.initials: JJ
authors.lastname: Barry
authors.affiliation: From Psychiatry and Behavioral Sciences (J.A., V.A.-J., S.S., J.O., J.J.B.) and Neurology and Neurological Sciences (K.I., V.B., K.M.), Stanford University, CA; and Neurology (D.W.L.), Emory University, Atlanta, GA.
authors.forename: David W
authors.initials: DW
authors.lastname: Loring
authors.affiliation: From Psychiatry and Behavioral Sciences (J.A., V.A.-J., S.S., J.O., J.J.B.) and Neurology and Neurological Sciences (K.I., V.B., K.M.), Stanford University, CA; and Neurology (D.W.L.), Emory University, Atlanta, GA.
authors.forename: Kimford
authors.initials: K
authors.lastname: Meador
mesh_terms: D000328:Adult; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects; D003072:Cognition Disorders / Q000150:complications* / Q000188:drug therapy*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004827:Epilepsy / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D009483:Neuropsychological Tests; D011930:Reaction Time; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000697:Central Nervous System Stimulants; D008774:Methylphenidate