Short-Term Efficacy of Methylphenidate: A Randomized, Double-Blind, Placebo-Controlled Trial Among Survivors of Childhood Cancer

Mulhern, Raymond K.; Khan, Raja B.; Kaplan, Stuart L.; Helton, Susan; Christensen, Robbin; Bonner, Melanie J.; Brown, Ronald T.; Xu, Xiaoping; Wu, Sengjie; Gururangan, Sridharan; Reddick, Wilburn E.

doi:10.1200/jco.2004.04.128

Cited by 172 publications

(94 citation statements)

References 27 publications

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“…More specifically, they identified improved vigilance in attention and caregiver reports of more efficacious everyday attention/concentration as major benefits of treatment. Mulhern et al [2004a] published a subsequent study that is similarly rigorous. Again, the population was longterm survivors of ALL and brain tumors; 83 individuals were enrolled.…”

Section: Pharmacological Interventions For Survivors Of a Pediatric Cmentioning

confidence: 87%

Interventions to improve neuropsychological functioning in childhood cancer survivors

Butler

Sahler

Askins

et al. 2008

Dev Disabil Res Revs

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A very brief historical review on the identification of neurocognitive deficits in patients treated for a pediatric malignancy that involved CNS disease, treatment, or a combination is provided. This review is particularly directed toward providing a foundation upon which the introduction of specific brain injury rehabilitation efforts and subsequent research were introduced into this population of patients. Three primary methods by which clinicians and researchers have attempted to improve neurocognitive functioning with survivors of pediatric cancer that have suffered a CNS insult are identified. From a pharmacological perspective, research is reviewed that documents the potential beneficial effects of stimulant medication. Results of two drug trials that used double-blind crossover methodology are reviewed, and it is highly likely that medications may be of significant benefit to pediatric cancer survivors who are experiencing attentional deficits, impairment in social functioning, and also declines in academic achievement. We next describe psychologically based brain injury rehabilitation efforts, including on-treatment schooling and reentry, within the survivor population. A phase III clinical trial of a comprehensive rehabilitation approach is discussed in detail. New directions in the area of brain injury rehabilitation for childhood cancer survivors are presented, and the need for professionals in this area to work toward a team approach is emphasized.

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Section: Pharmacological Interventions For Survivors Of a Pediatric Cmentioning

confidence: 87%

Interventions to improve neuropsychological functioning in childhood cancer survivors

Butler

Sahler

Askins

et al. 2008

Dev Disabil Res Revs

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“…However, there are several long-term debilitating effects following radiotherapy in children, including cognitive decline and motor, hormonal and psychological-emotional dysfunctions. 4,5 Furthermore, survivors of childhood cancer have an increased risk of long-term cerebrovascular mortality, and the risk of death from cerebrovascular disease increases linearly with the local radiation dose to the prepontine cistern. 6 More than four centuries ago, it was observed that the vascular and the nervous systems show similar anatomical patterning.…”

Section: Introductionmentioning

confidence: 99%

Irradiation to the Young Mouse Brain Caused Long-Term, Progressive Depletion of Neurogenesis but did not Disrupt the Neurovascular Niche

Boström

Kalm

Karlsson

et al. 2013

J Cereb Blood Flow Metab

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We investigated the effects of ionizing radiation on microvessel structure and complexity in the hippocampus. We also assessed neurogenesis and the neurovascular niche. Postnatal day 14 male C57BL/6 mice received a single dose of 8 Gy to the whole brain and were killed 6 hours, 1 week, 7 weeks, or 1 year later. Irradiation decreased the total number of microvessels and branching points from 1 week onwards and decreased the total microvessel area 1 and 7 weeks after irradiation. After an initial increase in vascular parameter densities, concomitant with reduced growth of the hippocampus, the densities normalized with time, presumably adapting to the needs of the surrounding nonvascular tissue. Irradiation decreased the number of neural stem and progenitor cells in the hippocampus. The relative loss increased with time, resulting in almost completely ablated neurogenesis (DCX þ cells) 1 year after irradiation (77% decreased 1 week, 86% decreased 7 weeks, and 98% decreased 1 year after irradiation compared with controls). After irradiation, the distance between undifferentiated stem cells and microvessels was unaffected, and very few dying endothelial cells were detected. Taken together, these results indicate that the vasculature adjusts to the surrounding neural and glial tissue after irradiation, not vice-versa.

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“…Health care resource utilization can be optimized through risk-adapted interventions [Ris, 2007] guided by biopsychosocial staging methods [Kazak et al, 2007] adapted to pediatric brain tumors. Although more research is needed, this approach promises to significantly improve the outcomes of these children by taking advantage of recent evidence showing the importance of contextual factors [e.g., family health and resources; Carlson-Green et al, 1995] in outcomes, and also the mitigating effects of early cognitivebehavioral [e.g., attention training; Butler and Copland, 2002] and pharmacological [Mulhern et al, 2004] interventions. n…”

Section: Future Directionsmentioning

confidence: 98%

Neurodevelopmental outcomes of children with low‐grade gliomas

Ris¹,

Beebe²

2008

Dev Disabil Res Revs

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As a group, children with low-grade gliomas (LGGs) enjoy a high rate of long-term survival and do not require the intensity of neurotoxic treatments used with higher risk pediatric brain tumors. Because they are generally considered to have favorable neurobehavioral outcomes, they have not been studied as thoroughly as higher-grade brain tumors by late-effects researchers. In this article, we review the literature on the neurobehavioral effects associated with low-grade gliomas and conclude that, (1) this is a large, understudied group of survivors of pediatric brain tumors; (2) recent small- and large-scale studies document increased risk in multiple cognitive-behavioral domains after treatment for LGGs compared with healthy peers; (3) such risk is not uniform but varies with tumor location and treatments; and (4) a life span development perspective is essential to a complete understanding of the risks faced by these children. More research on the most efficacious biopsychosocial treatment models for improving the outcomes of survivors of low-grade glioma is recommended, informed by a better understanding of theireducational needs. Investigations of genetic influences on outcome as well as prospective studies of these patients as they age are also recommended.

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Short-Term Efficacy of Methylphenidate: A Randomized, Double-Blind, Placebo-Controlled Trial Among Survivors of Childhood Cancer

Abstract: Treatment with MPH can at least temporarily reduce some attentional and social deficits among survivors of childhood ALL and BT. Long-term follow-up will reveal those subsets of patients who are more likely to benefit from MPH.

Cited by 172 publications

References 27 publications

Interventions to improve neuropsychological functioning in childhood cancer survivors

Interventions to improve neuropsychological functioning in childhood cancer survivors

Irradiation to the Young Mouse Brain Caused Long-Term, Progressive Depletion of Neurogenesis but did not Disrupt the Neurovascular Niche

Neurodevelopmental outcomes of children with low‐grade gliomas

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