Methylphenidate & CBT Benefits TBI Patients with Cognitive Problems
These preliminary findings suggest that combined treatment with MAAT and methylphenidate can improve attention, episodic and working memory, and executive functioning following traumatic brain injury.
According to a study published in Neuropsychopharmacology, combining methylphenidate with cognitive-behavioral rehabilitation may be a potential option to improve outcomes in patients with persistent cognitive problems after traumatic brain injuries.
Methylphenidate, a stimulant drug, is indicated to treat attention-deficit/hyperactivity disorder (ADHD). Researchers from the Indiana University School of Medicine conducted a study (n=71) to compare the efficacy of two forms of cognitive therapy, Memory and Attention Adaptation Training (MAAT) and Attention Builders Training (ABT) with and without methylphenidate.
The 6-week trial enrolled adults who had a traumatic brain injury of at least mild severity at least 4 months prior and reported having cognitive problems or were identified as having cognitive problems during testing. Study patients were divided into four groups: MAAT + methylphenidate, ABT + methylphenidate, MAAT + placebo, and ABT + placebo. Outcome measures included scores on neuropsychological measures and subjective rating scales.
Study authors found that after 6 weeks, there were statistically significant treatment-related improvements in cognitive functioning for word list learning in the MAAT + placebo vs. ABT + placebo group. Nonverbal learning outcome measures were better in the MAAT + methylphenidate group vs. MAAT + placebo group. Auditory working memory and divided attention outcome measures were better in the MAAT + methylphenidate group vs. ABT + methylphenidate group.
The findings, though preliminary, suggest that combined treatment with MAAT and methylphenidate can improve attention, episodic and working memory, and executive functioning following traumatic brain injury, the authors concluded.
McDonald BC, Flashman LA, Arciniegas DB, et al. Methylphenidate and memory and attention adaptation training for persistent cognitive symptoms after traumatic brain injury: a randomized, placebo-controlled trial. Nature. 2016; doi:10.1038/npp.2016.261.