Article

OBJECTIVE: To investigate the feasibility, safety and efficacy of
extended-release methylphenidate in enhancing processing speed, complex
attentional functioning and everyday attentional behaviour after traumatic brain
injury. DESIGN: Seven week randomised, placebo-controlled, double-blind, parallel
pilot study. SETTING: Inpatient and outpatient Acquired Brain Injury Rehabilitation Program. PARTICIPANTS: Eleven individuals with reduced processing
speed and/or attention deficits following complicated mild to severe traumatic
brain injury. INTERVENTIONS: Participants were allocated using a blocked
randomisation schedule to receive daily extended-release methylphenidate
(Ritalin(R) LA at a dose of 0.6 mg/kg) or placebo (lactose) in identical
capsules. MAIN OUTCOMES: Tests of processing speed and complex attention, and
ratings of everyday attentional behaviour were completed at baseline, week 7
(on-drug), week 8 (off-drug) and 9 months follow-up. Vital signs and side effects
were monitored from baseline to week 8. RESULTS: Three percent ( n = 11) of
individuals screened participated (mean post-traumatic amnesia duration = 63.80
days, SD = 45.15). Results were analysed for six and four individuals on
methylphenidate and placebo, respectively. Groups did not differ on attentional
test performance or relative/therapist ratings of everyday attentional behaviour.
One methylphenidate participant withdrew due to difficulty sleeping.
Methylphenidate was associated with trends towards increased blood pressure and
reported anxiety. CONCLUSION: Methylphenidate was not associated with enhanced
processing speed, attentional functioning or everyday attentional behaviour after
traumatic brain injury. Alternative treatments for attention deficits after traumatic brain injury should be explored given the limited feasibility of
methylphenidate in this population.

Langue : ANGLAIS