Journal of Neuro-Oncology

, Volume 107, Issue 1, pp 165–174

A randomized trial on the efficacy of methylphenidate and modafinil for improving cognitive functioning and symptoms in patients with a primary brain tumor

  • K. Gehring
  • S. Y. Patwardhan
  • R. Collins
  • M. D. Groves
  • C. J. Etzel
  • C. A. Meyers
  • J. S. Wefel
Clinical Study – Patient Study

Abstract

Limited research is available regarding the efficacy of psychostimulants in treating cognitive function in primary brain tumor patients. An open-label, randomized, pilot trial examined both the general and differential efficacy of 4 weeks of methylphenidate (MPH) and modafinil (MOD) in 24 brain tumor patients. Participants completed cognitive tests and self-report measures of fatigue, sleep disturbance, mood and quality of life at baseline and after 4 weeks.

Following stimulant treatment, there was evidence of a beneficial effect on test performance in speed of processing and executive function requiring divided attention. Patients with the greatest deficit in executive function at baseline appeared to derive the greatest benefit following stimulant therapy. Inconsistent, differential effects were found on a measure of attention in favor of MPH and on a measure of processing speed in favor of MOD. There was also evidence of a general beneficial effect on patient-reported measures of fatigue, mood, and quality of life, with no statistically significant differences between treatment arms in these measures over time. The results from this small pilot study should be interpreted with caution, but appear to warrant additional research, in larger study samples, targeting fatigue, processing speed and executive function, and exploring different doses of stimulants. Future studies may also wish to explore the specific patient factors that may be associated with responsiveness to psychostimulant treatment.

Keywords

Cognitive deficit Brain tumor Psychostimulant Stimulant treatment 

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Copyright information

© Springer Science+Business Media, LLC. 2011

Authors and Affiliations

  • K. Gehring
    • 1
  • S. Y. Patwardhan
    • 2
  • R. Collins
    • 3
    • 4
  • M. D. Groves
    • 5
  • C. J. Etzel
    • 6
  • C. A. Meyers
    • 5
  • J. S. Wefel
    • 5
  1. 1.Center of Research on Psychology in Somatic DiseasesTilburg UniversityTilburgThe Netherlands
  2. 2.Department of PsychologyUniversity of HoustonHoustonUSA
  3. 3.Neurology Care LineThe Michael E. DeBakey VA Medical CenterHoustonUSA
  4. 4.Department of NeurologyBaylor College of MedicineHoustonUSA
  5. 5.Department of Neuro-OncologyThe University of Texas M.D. Anderson Cancer CenterHoustonUSA
  6. 6.Department of EpidemiologyThe University of Texas M.D. Anderson Cancer CenterHoustonUSA

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