QOL-06. METHYLPHENIDATE IMPROVES HEALTH-RELATED QUALITY OF LIFE AND ATTENTIONAL IMPAIRMENT IN PAEDIATRIC NEURO-ONCOLOGY SURVIVORS

Abstract

Treatment for paediatric brain tumour (BT) is increasingly effective in preserving life but is associated with lifelong neurocognitive sequelae. Most frequently documented domains of impairment include executive function and its components: processing speed, working memory, and attention. Deficits impact on the child's ability to take in and consolidate new material, leading to failure to make age-expected intellectual gains. In addition to intellectual impairments, cranial radiation survivors report decreased Health-Related Quality of Life (HRQoL) comparative to other BT patients. As part of a tailored treatment package, pharmacological interventions have been introduced to maximise the intellectual potential of these patients. OBJECTIVE: To explore the impact of methylphenidate (MPH) upon HRQoL in survivors of childhood BT with learning impairments. METHODS: Participants (N=12) with paediatric BT with a history of radiotherapy or hydrocephalus and current learning impairment received MPH. Cognitive impact of MPH was evaluated using measures of selective and sustained attention, inhibition, set shifting, response and processing speed using a common test battery (TEA-Ch 2), and parent and teacher response questionnaires (SNAP-18). HRQoL subjective impact was assessed using parent and participant response questionnaires (PEDSQL) and clinical interview. RESULTS: All patients showed a significant increase in raw scores on all psychometric measures excepting measures of response inhibition. All participants reported increased HRQoL in a number of areas, specifically in improved self-esteem, confidence, and peer interactions, and improved speed of processing and selective attention. 4 participants noted a reduction in fatigue. CONCLUSIONS: MPH provides HRQoL and cognitive improvement in this participant group with limited side-effects.