EFFECTS OF METHYLPHENIDATE ON ATTENTIONAL FUNCTION AFTER TRAUMATIC BRAIN INJURY - A RANDOMIZED, PLACEBO-CONTROLLED TRIAL

Attention deficits after traumatic brain injury (TBI) are common and d isabling. Many pharmacologic agents have been used to ameliorate atten tion deficits, and considerable interest has focused on methylphenidat e (MP) because of its documented efficacy in attention deficit disorde r. However, clinical studies of MP in subjects with TBI have yielded m ixed results. We examined the effects of MP on attentional function in individuals with TBI referred specifically for attentional assessment and treatment. Subjects were studied in a double-blind, placebo-contr olled, repeated crossover design, using five different tasks designed to measure various facets of attentional function. MP produced a signi ficant improvement in the speed of mental processing. Orienting to dis tractions, most aspects of sustained attention, and measures of motor speed were unaffected. These results suggest that MP may be a useful t reatment in TBI but is primarily useful for symptoms that can be attri buted to slowed mental processing.