The Utility of Methylphenidate for Fatigue in Long-Term Neurological Conditions: A Meta-analytical Review.

IF 0.8 4区医学 Q4 CLINICAL NEUROLOGY

Clinical Neuropharmacology Pub Date : 2023-11-01 Epub Date: 2023-10-18 DOI:10.1097/WNF.0000000000000572

Alexander James Hagan, Ram Kumar

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引用次数: 0

Abstract

Objective: Fatigue is a chronic and debilitating symptom of many long-term neurological conditions (LTNCs). Although methylphenidate provides some promise in alleviating fatigue in other clinical groups, little work has explored its potential utility within LTNCs. The current systematic review and meta-analysis evaluates the utility of methylphenidate for symptoms of fatigue in LTNCs.

Methods: Five databases (PsycINFO, MEDLINE, Embase, Scopus, and Cochrane Library) were searched for relevant articles from their inception to February 2022. A purpose-developed evaluation tool was used to assess each study's research quality (QuEST:F).

Results: Of the 1698 articles identified, 11 articles were included within this review (n = 370). Meta-analytical findings reported an overall significant benefit of methylphenidate for symptoms of fatigue across a mixed neurological sample ( g = -0.44; 95% confidence interval, -0.77 to -0.11). Subgroup analyses identified a significantly greater benefit ( P < 0.001) of methylphenidate for fatigue in LTNCs with static pathogenic trajectories (eg, traumatic brain injury) (number needed to treat = 2.5) compared with progressive conditions (eg, multiple sclerosis) (number needed to treat = 40.2).

Conclusions: Methylphenidate may pose an effective intervention for the treatment of fatigue in a number of LTNCs. Nonetheless, given the quality of the current evidence base, there exists a clear need for further robust assessment of the utility of methylphenidate-with a focus on subgroup-specific variability.

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哌醋甲酯治疗长期神经系统疾病疲劳的效用:一项荟萃分析综述。

目的:疲劳是许多长期神经系统疾病(ltnc)的慢性衰弱症状。尽管哌醋甲酯在其他临床组中提供了一些缓解疲劳的希望，但很少有工作探索其在ltnc中的潜在效用。当前的系统综述和荟萃分析评估了哌醋甲酯对ltnc患者疲劳症状的效用。方法:检索5个数据库(PsycINFO、MEDLINE、Embase、Scopus和Cochrane Library)自成立至2022年2月的相关文章。使用目的开发的评估工具来评估每个研究的研究质量(QuEST:F)。结果:在1698篇文献中，11篇文献被纳入本综述(n = 370)。荟萃分析结果报告了哌醋甲酯在混合神经系统样本中对疲劳症状的总体显着益处(g = -0.44;95%置信区间为-0.77 ~ -0.11)。亚组分析发现，与进步性疾病(如多发性硬化症)(需要治疗的人数= 40.2)相比，哌醋甲酯对具有静态致病轨迹(如创伤性脑损伤)(需要治疗的人数= 2.5)的ltnc的疲劳有更大的益处(P < 0.001)。结论:哌甲酯可能对许多ltnc的疲劳治疗起到有效的干预作用。尽管如此，鉴于目前证据基础的质量，显然需要进一步对哌甲酯的效用进行强有力的评估——重点关注亚组特异性变异性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Neuropharmacology 医学-临床神经学

CiteScore

1.20

自引率

10.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Clinical Neuropharmacology is a peer-reviewed journal devoted to the pharmacology of the nervous system in its broadest sense. Coverage ranges from such basic aspects as mechanisms of action, structure-activity relationships, and drug metabolism and pharmacokinetics, to practical clinical problems such as drug interactions, drug toxicity, and therapy for specific syndromes and symptoms. The journal publishes original articles and brief reports, invited and submitted reviews, and letters to the editor. A regular feature is the Patient Management Series: in-depth case presentations with clinical questions and answers.