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Influence of Methylphenidate on Long-Term Neuropsychological and Everyday Executive Functioning After Traumatic Brain Injury in Children with Secondary Attention Problems

Published online by Cambridge University Press:  10 June 2019

Elizabeth LeBlond ,
Julia Smith-Paine ,
Jacqlyn J. Riemersma ,
Paul S. Horn ,
Shari L. Wade  and
Brad G. Kurowski
Elizabeth LeBlond*
Affiliation:
Psychology Department, McMicken College of Arts and Sciences, University of Cincinnati, 2600 Clifton Ave, 155 B McMicken Hall, Cincinnati, Ohio, USA Division of Physical Medicine and Rehabilitation, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, MLC 4009, Cincinnati, Ohio, USA
Julia Smith-Paine
Affiliation:
Psychology Department, McMicken College of Arts and Sciences, University of Cincinnati, 2600 Clifton Ave, 155 B McMicken Hall, Cincinnati, Ohio, USA Division of Physical Medicine and Rehabilitation, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, MLC 4009, Cincinnati, Ohio, USA
Jacqlyn J. Riemersma
Affiliation:
Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, Ohio, USA
Paul S. Horn
Affiliation:
Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, Ohio, USA Division of Neurology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, MLC 2015, Cincinnati, Ohio, USA Department of Math and Sciences, McMicken College of Arts and Sciences, University of Cincinnati, 2600 Clifton Ave, 155 B McMicken Hall, Cincinnati, Ohio, USA
Shari L. Wade
Affiliation:
Psychology Department, McMicken College of Arts and Sciences, University of Cincinnati, 2600 Clifton Ave, 155 B McMicken Hall, Cincinnati, Ohio, USA Division of Physical Medicine and Rehabilitation, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, MLC 4009, Cincinnati, Ohio, USA Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, Ohio, USA
Brad G. Kurowski
Affiliation:
Division of Physical Medicine and Rehabilitation, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, MLC 4009, Cincinnati, Ohio, USA Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, Ohio, USA Department of Neurology, University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, Ohio, USA Department of Rehabilitation Medicine, University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, Ohio, USA
*
Correspondence and reprint requests to: Elizabeth LeBlond, Psychology Department, McMicken College of Arts and Sciences, University of Cincinnati, 2600 Clifton Ave, 155 B McMicken Hall, Cincinnati, Ohio, USA. E-mail: leblonei@mail.uc.edu
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Abstract

Objective: To investigate the effects of methylphenidate on long-term executive and neuropsychological functioning in children with attention problems following TBI, as well as the relationship between methylphenidate associated changes in lab-based neuropsychological measures of attentional control, processing speed, and executive functioning and parent- or self-report measures of everyday executive functioning. Method: 26 children aged 6–17 years, who were hospitalized for moderate-to-severe blunt head trauma 6 or more months previously, were recruited from a large children’s hospital medical center. Participants were randomized into a double-masked, placebo-controlled cross-over clinical trial. Participants completed a comprehensive neuropsychological battery and parent- and self-report ratings of everyday executive functioning at baseline, and at 4 weeks and 8 weeks following upward titration of medication to an optimal dose or while administered a placebo. Results: Methylphenidate was associated with significant improvements in processing speed, sustained attention, and both lab-based and everyday executive functioning. Significant treatment-by-period interactions were found on a task of sustained attention. Participants who were randomized to the methylphenidate condition for the first treatment period demonstrated random or erratic responding, with slower and more variable response times when given placebo during the second period. Conclusion: Results indicate that methylphenidate treatment is associated with positive outcomes in processing speed, sustained attention, and both lab-based and everyday measures of executive functioning compared to placebo group. Additionally, results suggest sustained attention worsens when discontinuing medication. (JINS, 2019, 25, 740–749)

Keywords

Attentional controlprocessing speedcross-overreaction timepediatricADHD
Type
Regular Research
Information
Journal of the International Neuropsychological Society , Volume 25 , Issue 7 , August 2019 , pp. 740 - 749
Copyright
Copyright © INS. Published by Cambridge University Press, 2019. 

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