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Journal of Pediatric Psychology Advance Access originally published online on June 14, 2007
Journal of Pediatric Psychology 2007 32(9):1127-1139; doi:10.1093/jpepsy/jsm045
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© The Author 2007. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Acute Neurocognitive Response to Methylphenidate Among Survivors of Childhood Cancer: A Randomized, Double-Blind, Cross-Over Trial

Heather M. Conklin, PhD1, Raja B. Khan, MD2, Wilburn E. Reddick, PhD3, Susan Helton, EdS1, Ronald Brown, PhD4, Scott C. Howard, MD5, Melanie Bonner, PhD6, Robbin Christensen, BS, DpH1,7, Shengjie Wu, MS8, Xiaoping Xiong, PhD8 and Raymond K. Mulhern, PhD1,*

1Division of Behavioral Medicine, 2Division of Neurology, 3Division of Translational Imaging Research, St Jude Children's Research Hospital, Memphis, TN, 4Department of Public Health, Temple University, Philadelphia, PA, 5Department of Hematology-Oncology, St Jude Children's Research Hospital, Memphis, TN, 6Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, 7Pharmaceutical Department, 8Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN

All correspondence concerning this article should be addressed to Heather M. Conklin St Jude Children's Research Hospital, 332 N. Lauderdale St., Mail Stop 740, Memphis, TN 38105-2794. E-mail: heather.conklin{at}stjude.org.


  Abstract

Objective To investigate the acute efficacy and adverse side effects of methylphenidate (MPH) among survivors of childhood cancer [acute lymphoblastic leukemia (ALL) or brain tumor (BT)] with learning impairments. Methods Participants (N = 122) completed a two-day, in-clinic, double-blind, cross-over trial during which they received MPH (0.60 mg/kg of body weight) and placebo that were randomized in administration order across participants. Performance was evaluated using measures of attention, memory, and academic achievement. Results A significant MPH versus placebo effect was revealed on a measure of attention, cognitive flexibility, and processing speed (Stroop Word-Color Association Test). Male gender, older age at treatment, and higher intelligence were predictive of better medication response. No significant differences were found for number or severity of adverse side effects as a function of active medication. Conclusions MPH shows some neurocognitive benefit and is well tolerated by the majority of children surviving ALL and BT.

Key words: brain tumor; leukemia; methylphenidate; stimulant medication..

* Deceased.

Received October 30, 2006; revision received April 23, 2007; accepted May 5, 2007


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