Journal of Clinical Oncology, Vol 16, 2522-2527, Copyright © 1998 by American Society of Clinical Oncology
Methylphenidate therapy improves cognition, mood, and function of brain tumor patients
CA Meyers, MA Weitzner, AD Valentine and VA Levin
Department of Neuro-Oncology, The University of Texas M.D. Anderson Cancer Center, Houston 77030, USA. cmeyers@audumla.mdacc.tmc.edu
PURPOSE: Patients with malignant glioma develop progressive neurobehavioral
deficits over the course of their illness. These are caused both by the
effects of the disease and the effects of radiation and chemotherapy. We
sought to determine whether methylphenidate treatment would improve these
patients' neurobehavioral functioning despite their expected neurologic
deterioration. PATIENTS AND METHODS: Thirty patients with primary brain
tumors underwent neuropsychologic assessment before and during treatment
with methylphenidate. Ability to function in activities of daily living and
magnetic resonance imaging (MRI) findings were also documented. Patients
were assessed on 10, 20, and 30 mg of methylphenidate twice daily. RESULTS:
Significant improvements in cognitive function were observed on the 10-mg
twice- daily dose. Functional improvements included improved gait,
increased stamina and motivation to perform activities, and in one case,
increased bladder control. Adverse effects were minimal and immediately
resolved when treatment was discontinued. There was no increase in seizure
frequency and the majority of patients on glucocorticoid therapy were able
to decrease their dose. Gains in cognitive function and ability to perform
activities were observed in the setting of progressive neurologic injury
documented by MRI in half of the subjects. CONCLUSION: This study
demonstrated improved patient function in the setting of a progressive
neurologic illness. Methylphenidate should be more widely considered as
adjuvant brain tumor therapy.
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