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哌醋甲酯在小儿脑肿瘤幸存者中的长期效用关键问题:一项回顾性临床病例系列研究

Key Questions on the Long-Term Utility of Methylphenidate in Paediatric Brain Tumour Survivorship: A Retrospective Clinical Case Series.

作者信息

Hagan Alexander J, Verity Sarah J

机构信息

Department of Paediatric Health Psychology, Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, UK.

Newcastle University Centre for Cancer, Newcastle upon Tyne NE1 7RU, UK.

出版信息

Children (Basel). 2024 Feb 2;11(2):187. doi: 10.3390/children11020187.

Abstract

Methylphenidate has an established role in the management of attention-deficit hyperactivity disorder and attentional deficit secondary to brain injury. Increasingly, methylphenidate is considered for the attentional deficit in paediatric brain tumour survivors. A small number of studies have explored the benefit of methylphenidate in this population; however, studies are of short duration and do not address the impact of medium to long-term use of methylphenidate on intellectual function. We identified six patients who are survivors of a paediatric brain tumour aged 12-18 years with greater than three years of use of methylphenidate for inclusion in a clinical case series. We used this patient cohort to identify key questions to inform a future long-term cohort study. Linear mixed model and reliable change index analyses were performed on the data. Reliable change index analyses showed benefits to working memory ( = 3), processing speed ( = 2), and full-scale IQ ( = 4) performance for some patients. This exploratory case series suggests the potential medium to long-term benefit of methylphenidate in brain tumour survivorship, indicating the need for larger, appropriately powered studies. These patient data, alongside a discussion of learning points from our previously published studies, are used as a conduit for the identification of questions relating to the use of methylphenidate in a paediatric brain tumour.

摘要

哌甲酯在治疗注意力缺陷多动障碍及脑损伤继发的注意力缺陷方面具有既定作用。越来越多的人考虑将哌甲酯用于治疗小儿脑肿瘤幸存者的注意力缺陷。少数研究探讨了哌甲酯对这一人群的益处;然而,这些研究持续时间较短,且未涉及哌甲酯中长期使用对智力功能的影响。我们纳入了6名年龄在12至18岁之间、使用哌甲酯超过三年的小儿脑肿瘤幸存者,将其纳入一个临床病例系列。我们利用这个患者队列来确定关键问题,为未来的长期队列研究提供参考。对数据进行了线性混合模型和可靠变化指数分析。可靠变化指数分析显示,部分患者在工作记忆(=3)、处理速度(=2)和全量表智商(=4)表现方面有所获益。这个探索性病例系列表明哌甲酯在脑肿瘤幸存者中可能具有中长期益处,这表明需要开展更大规模、有足够效力的研究。这些患者数据,连同我们之前发表的研究中的经验教训讨论,被用作确定与小儿脑肿瘤中使用哌甲酯相关问题的渠道。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1255/10887678/95542e04f56c/children-11-00187-g001.jpg

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