Methylphenidate-mediated motor control network enhancement in patients with traumatic brain injury

Brain Inj. 2018;32(8):1040-1049. doi: 10.1080/02699052.2018.1469166. Epub 2018 May 8.

Abstract

Primary objective: To investigate functional improvement late (>6 months) after traumatic brain injury (TBI). To this end, we conducted a double-blind, placebo-controlled experimental medicine study to test the hypothesis that a widely used cognitive enhancer would benefit patients with TBI.

Research design: We focused on motor control function using a sequential finger opposition fMRI paradigm in both patients and age-matched controls.

Methods and procedures: Patients' fMRI and DTI scans were obtained after randomised administration of methylphenidate or placebo. Controls were scanned without intervention. To assess differences in motor speed, we compared reaction times from the baseline condition of a sustained attention task.

Main outcomes and results: Patients' reaction times correlated with wide-spread motor-related white matter abnormalities. Administration of methylphenidate resulted in faster reaction times in patients, which were not significantly different from those achieved by controls. This was also reflected in the fMRI findings in that patients on methylphenidate activated the left inferior frontal gyrus significantly more than when on placebo. Furthermore, stronger functional connections between pre-/post-central cortices and cerebellum were noted for patients on methylphenidate.

Conclusions: Our findings suggest that residual functionality in patients with TBI may be enhanced by a single dose of methylphenidate.

Keywords: Traumatic brain injury; functional MRI; functional connectivity; methylphenidate; structural connectivity.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Brain Injuries, Traumatic / complications
  • Brain Injuries, Traumatic / diagnostic imaging*
  • Brain Injuries, Traumatic / drug therapy*
  • Brain Mapping
  • Case-Control Studies
  • Central Nervous System Stimulants / therapeutic use*
  • Cognition Disorders / diagnostic imaging
  • Cognition Disorders / drug therapy
  • Cognition Disorders / etiology
  • Diffusion Magnetic Resonance Imaging
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Linear Models
  • Magnetic Resonance Imaging
  • Male
  • Methylphenidate / therapeutic use*
  • Middle Aged
  • Motor Activity / drug effects
  • Motor Activity / physiology*
  • Neural Pathways / diagnostic imaging
  • Neural Pathways / drug effects*
  • Neuropsychological Tests
  • Oxygen / blood
  • Reaction Time / drug effects
  • Tomography, X-Ray Computed
  • White Matter / diagnostic imaging
  • White Matter / drug effects
  • Young Adult

Substances

  • Central Nervous System Stimulants
  • Methylphenidate
  • Oxygen