Johansson B, Wentzel A-P, Andréll P, Mannheimer C, Rönnbäck L
Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg , Gothenburg , Sweden .
Brain Inj. 2015;29(6):758-65. doi: 10.3109/02699052.2015.1004747. Epub 2015 Mar 20.
Post-traumatic brain injury symptoms, such as mental fatigue, have considerable negative impacts on quality-of-life. In the present study the effects of methylphenidate in two different dosages were assessed with regard to mental fatigue, pain and cognitive functions in persons who had suffered a traumatic brain injury.
Fifty-one subjects were included and 44 completed the study. The treatment continued for 12 weeks, including three treatment periods with no medication for 4 weeks, administration of low dose methylphenidate (up to 5 mg × 3) for 4 weeks and normal dose methylphenidate (up to 20 mg × 3) for a further 4 weeks. The patients were randomized into three groups where all groups were given all treatments.
Significantly reduced mental fatigue, assessed with the Mental Fatigue Scale (MFS) and increased information processing speed (coding, WAIS-III), were detected. The SF-36 vitality and social functioning scales were also improved significantly. Pain was not reduced by methylphenidate. The positive effects of treatment were dose-dependent, with the most prominent effects being at 60 mg methylphenidate/day spread over three doses. Observed side-effects were increased blood pressure and increased heart rate.
Methylphenidate was generally well-tolerated and it improved long-lasting mental fatigue and processing speed after traumatic brain injury.
创伤性脑损伤症状，如精神疲劳，对生活质量有相当大的负面影响。在本研究中，评估了两种不同剂量的哌醋甲酯对创伤性脑损伤患者精神疲劳、疼痛和认知功能的影响。
纳入51名受试者，44名完成了研究。治疗持续12周，包括三个治疗阶段，4周不服药，4周服用低剂量哌醋甲酯（最高5mg×3），再4周服用正常剂量哌醋甲酯（最高20mg×3）。患者被随机分为三组，所有组都接受所有治疗。
使用精神疲劳量表（MFS）评估发现精神疲劳显著减轻，信息处理速度（编码，韦氏成人智力量表第三版）提高。SF-36活力和社会功能量表也有显著改善。哌醋甲酯未减轻疼痛。治疗的积极效果呈剂量依赖性，最显著的效果出现在每天60mg哌醋甲酯分三次服用时。观察到的副作用是血压升高和心率加快。
哌醋甲酯总体耐受性良好，可改善创伤性脑损伤后的长期精神疲劳和处理速度。
