The Use of Stimulant Medication to Treat Neurocognitive Deficits in Patients with Pediatric Cancer, Traumatic Brain Injury, and Sickle Cell Disease:

A Review

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Elizabeth Nicholls, MIT; Aimee K. Hildenbrand, BS; Richa Aggarwal, BA; Lauren McCarthy; Brian Daly, PhD

Table of Contents

Postgraduate Medicine:

Volume 124 No. 5

Category:

Clinical Focus

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DOI: 10.3810/pgm.2012.09.2596
Abstract: Several chronic health conditions of childhood, including pediatric cancers, traumatic brain injury (TBI), and sickle cell disease (SCD) are associated with significant neurocognitive impairments that can compromise educational attainment and future vocational opportunities. The prominence of attentional deficits as part of the neurocognitive sequelae associated with each of these conditions has led some researchers to draw parallels with another chronic condition that manifests in childhood, specifically the inattentive subtype of attention-deficit/hyperactivity disorder (ADHD). Because ADHD shares similar neurocognitive and symptomatological features with pediatric cancer, TBI, and SCD, stimulant medications may be indicated to treat associated deficits in each condition. However, relatively few studies have investigated the safety and effectiveness of stimulant medications in treating neurocognitive sequelae in children with cancer, TBI, or SCD. Thus, clinicians have received little guidance regarding a potentially useful treatment modality for ameliorating the neurocognitive deficits that can profoundly impact the educational, psychosocial, and vocational development of youth with these chronic health conditions. We provide a review of the literature and synthesize current developments in research regarding treatment with stimulant medication for children with cancer, TBI, and SCD, as well as discuss special considerations for each condition.

Keywords: stimulant medications; pediatric cancers; traumatic brain injury; sickle cell disease; neurocognitive impairment