The benefit of long-term methylphenidate in childhood brain injury survivorship: A review

Survivors of childhood Acquired Brain Injury (ABI) often report chronic and debilitating neurocognitive late effects. While short-term clinical trials have demonstrated the efficacy of methylphenidate in improving neurocognitive performance within the early phases of recovery, its effectiveness over longer treatment periods remains largely unexplored. The present systematic review aims to evaluate whether methylphenidate may serve as a beneficial long-term rehabilitative strategy for improving neuropsychological outcomes in childhood ABI. Database searches were conducted in MEDLINE, PsycINFO, EMBASE, and Cochrane Library from their inception to March 2023. Studies containing a neurocognitive, psychosocial, or quality of life outcome measure were included. A purpose-developed evaluation tool was used to assess the quality of the evidence base. Six of the 1926 identified articles were included within this review. Results drew upon three clinical populations; brain tumor (n = 76), acute lymphoblastic leukemia (n = 33), and epilepsy and other EEG abnormalities (n = 166). Study durations ranged between six to 12 months. Methylphenidate was associated with sustained improvements in attentional functioning, processing speed, social skills, and quality of life, with benefits extending beyond the initial recovery phase and into future development. Side effects of methylphenidate use were reported to be mild and temporary.