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

  • Clinical Study – Patient Study
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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.

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Authors and Affiliations

  1. Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands

    K. Gehring

  2. Department of Psychology, University of Houston, Houston, TX, USA

    S. Y. Patwardhan

  3. Neurology Care Line, The Michael E. DeBakey VA Medical Center, Houston, TX, USA

    R. Collins

  4. Department of Neurology, Baylor College of Medicine, Houston, TX, USA

    R. Collins

  5. Department of Neuro-Oncology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Unit 431, Houston, TX, 77030, USA

    M. D. Groves, C. A. Meyers & J. S. Wefel

  6. Department of Epidemiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA

    C. J. Etzel

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  1. K. Gehring
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  4. M. D. Groves
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  7. J. S. Wefel
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Correspondence to J. S. Wefel.

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Gehring, K., Patwardhan, S.Y., Collins, R. et al. A randomized trial on the efficacy of methylphenidate and modafinil for improving cognitive functioning and symptoms in patients with a primary brain tumor. J Neurooncol 107, 165–174 (2012). https://doi.org/10.1007/s11060-011-0723-1

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  • DOI: https://doi.org/10.1007/s11060-011-0723-1

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