Disclosures: Kathryn A. Altonji, MD: No financial relationships or conflicts of interest

Objective: The objectives of this study were to describe the use of neurostimulants during inpatient rehabilitation in patients with brain tumors and to determine functional outcomes and adverse effects.

Design: Retrospective chart review and descriptive study Setting : Inpatient rehabilitation facility Participants : 15 patients with gliomas admitted for acute inpatient rehabilitation between 1/1/2017 – 12/31/2018

Interventions: Not applicable

Main Outcome Measures: Location of tumor, neurostimulant type and reason for use, functional measures at admission and discharge

Results: 15 patients were started or continued on neurostimulants during rehabilitation. 87% were men. The neurostimulants used were: methylphenidate (n=9), bromocriptine (n=1), modafinil (n=3), amantadine (n=1), armodafinil (n=2). Reasons for neurostimulant use included fatigue, initiation, motor slowing, alertness, processing, and attention. Tumor locations were 40% frontal, 20% parietal, 7% occipital, 20% temporal, 13% basal ganglia or corpus callosum. 53% were right hemisphere, 40% left and 7% midline. Average total functional independence measure scores improved from 30.4 on admission to 48.9 on discharge. Scores for social cognition and expression showed improvements from admission to discharge. 67% of patients were discharged home, 13% to skilled nursing facility, 13% to acute hospital, and 7% to hospice. There were no adverse effects reported including no seizures resulting from the use of neurostimulants during inpatient rehabilitation. A review of physician and team conference documentation revealed a generally favorable response to neurostimulants. Conclusions: The reasons for neurostimulant use for patients with gliomas were similar to the use in the traumatic brain injury population. The use of neurostimulants were well tolerated in this population, there were no adverse effects and generally good response.

Level of Evidence: Level IV

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/neurostimulant-use-during-inpatient-rehabilitation-in-patients-with-gliomas/