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Al-Adawi S, Al-Naamani A, Jaju S, Al-Farsi YM, Dorvlo ASS, Al-Maashani A, Al-Adawi SSH, Moustafa AA, Al-Sibani N, Essa MM, Burke DT, Qoronfleh MW. Methylphenidate improves executive functions in patients with traumatic brain injuries: a feasibility trial via the idiographic approach. BMC Neurol 2020; 20:103. [PMID: 32192470 PMCID: PMC7081568 DOI: 10.1186/s12883-020-01663-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 02/27/2020] [Indexed: 12/20/2022] Open
Abstract
Background Road traffic accidents are known to be the main cause of traumatic brain injury (TBI). TBI is also a leading cause of death and disability. This study, by means of the idiographic approach (single-case experimental designs using multiple-baseline designs), has examined whether methylphenidate (MPH - trade name Ritalin) had a differential effect on cognitive measures among patients with TBI with the sequel of acute and chronic post-concussion syndromes. The effect on gender was also explored. Methods In comparison with healthy controls, patients with TBI (acute and chronic) and accompanying mild cognitive impairment (MCI) were screened for their integrity of executive functioning. Twenty-four patients exhibiting executive dysfunction (ED) were then instituted with the pharmacological intervention methylphenidate (MPH). The methylphenidate was administered using an uncontrolled, open label design. Results The administration of methylphenidate impacted ED in the TBI group but had no effect on mood. Attenuation of ED was more apparent in the chronic phases of TBI. The effect on gender was not statistically significant with regard to the observed changes. Conclusions To our knowledge, this is the first feasibility trial from the Arabian Gulf to report the performance of a TBI population with mild cognitive impairment according to the IQCODE Arabic version. This investigation confirms anecdotal observations of methylphenidate having the potential to attenuate cognitive impairment; particularly those functions that are critically involved in the integrity of executive functioning. The present feasibility trial should be followed by nomothetic studies such as those that adhere to the protocol of the randomized controlled trial. This evidence-based research is the foundation for intervention and future resource allocation by policy- or public health decision-makers.
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Affiliation(s)
- Samir Al-Adawi
- Department of Behavioural Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman.
| | - Aziz Al-Naamani
- Department of Behavioural Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Sanjay Jaju
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Yahya M Al-Farsi
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Atsu S S Dorvlo
- Department of Mathematics and Statistics, College of Science, Sultan Qaboos University, Muscat, Oman
| | - Ali Al-Maashani
- Department of Neurosurgery, Khoula Hospital, Ministry of Health, Muscat, Oman
| | | | - Ahmed A Moustafa
- School of Social Sciences and Psychology, Marcs Institute of Brain and Behaviour, Western Sydney University, Penrith, NSW, Australia
| | - Nasser Al-Sibani
- Department of Behavioural Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Musthafa M Essa
- Department of Food Science and Nutrition, College of Agricultural and Marine Sciences, Sultan Qaboos University, Muscat, Oman.
| | - David T Burke
- Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - M Walid Qoronfleh
- Research & Policy Department, World Innovation Summit for Health (WISH), Qatar Foundation, P.O. Box 5825, Doha, Qatar.
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