Abstract
Purpose
Impaired attention is reported in children following treatment for brain tumours (BT).
Attention problems impact on information processing and encoding, ultimately leading
to academic under-performance. Having been successfully used to manage attention-deficit/hyperactivity
disorder (ADHD), stimulants such as methylphenidate (MPH) have been investigated as
a beneficial treatment for survivors of childhood BT. In order to develop appropriate
strategies to manage late neurocognitive effects, the results of such trials should
be evaluated to identify those children most likely to benefit from stimulants.
Design
An advanced search was performed across twelve electronic databases for the selection
of relevant randomised controlled trials with at least one active stimulant-treated
arm. Abstracts were screened for eligibility and data on study design and results
were extracted.
Results
Of the 5446 records identified, 11 full text articles were assessed for eligibility
and seven included in qualitative synthesis. Of the seven papers there were four original
trials. Short term outcomes for MPH on objective direct measures of attention and
parent/teacher ratings of behaviour were favourable. Observations of side effects
indicate that MPH is generally well tolerated. Heterogeneity of study design and outcome
measures precluded meta-analysis.
Conclusion
Despite yielding only a small number of trials with limited sample size, studies investigating
the use of stimulant medication in survivors of childhood BT have provided promising
outcomes. Current evidence indicates males, older age when treated, and higher baseline
intelligence quotient (IQ) were predictive of greater responsiveness to MPH. While
encouraging, additional research using a standardised protocol of outcome measures
would be beneficial in identifying those likely to benefit from stimulant use. Further,
the available data have yet to establish clear evidence for the effectiveness of MPH
being translated into improvements on standardised measures of academic achievement.
Keywords
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Article info
Publication history
Published online: July 08, 2013
Identification
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© 2013 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
