Article (Scientific journals)
Changes in cerebral metabolism in patients with a minimally conscious state responding to zolpidem.
Chatelle, Camille; Thibaut, Aurore; Gosseries, Olivia et al.
2014In Frontiers in Neuroscience, 8, p. 917
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Keywords :
minimally conscious state; zolpidem; brain metabolism; Positron Emission Tomography; prefrontal cortex; mesocircuit hypothesis
Abstract :
[en] BACKGROUND: Zolpidem, a short-acting non-benzodiazepine GABA agonist hypnotic, has been shown to induce paradoxical responses in some patients with disorders of consciousness (DOC), leading to recovery of arousal and cognitive abilities. We here assessed zolpidem-induced changes in regional brain metabolism in three patients with known zolpidem response in chronic post-anoxic minimally conscious state (MCS). METHODS: [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) and standardized clinical assessments using the Coma Recovery Scale-Revised were performed after administration of 10 mg zolpidem or placebo in a randomized double blind 2-day protocol. PET data preprocessing and comparison with a healthy age-matched control group were performed using statistical parametric mapping (SPM8). RESULTS: Behaviorally, all patients recovered functional communication after administration of zolpidem (i.e., emergence from the MCS). FDG-PET showed increased metabolism in dorsolateral prefrontal and mesiofrontal cortices after zolpidem but not after placebo administration. CONCLUSION: Our data show a metabolic activation of prefrontal areas, corroborating the proposed mesocircuit hypothesis to explain the paradoxical effect of zolpidem observed in some patients with DOC. It also suggests the key role of the prefrontal cortices in the recovery of functional communication and object use in hypoxic patients with chronic MCS.
Disciplines :
Neurology
Author, co-author :
Chatelle, Camille  ;  Université de Liège - ULiège > Centre de recherches du cyclotron
Thibaut, Aurore  ;  Université de Liège - ULiège > Centre de recherches du cyclotron
Gosseries, Olivia  ;  Université de Liège - ULiège > Centre de recherches du cyclotron
Bruno, Marie-Aurélie ;  Université de Liège - ULiège > Centre de recherches du cyclotron
Demertzi, Athina  ;  Université de Liège - ULiège > Centre de recherches du cyclotron
BERNARD, Claire ;  Centre Hospitalier Universitaire de Liège - CHU > Service médical de médecine nucléaire et imagerie onco
HUSTINX, Roland  ;  Centre Hospitalier Universitaire de Liège - CHU > Service médical de médecine nucléaire et imagerie onco
TSHIBANDA, Luaba ;  Centre Hospitalier Universitaire de Liège - CHU > Service médical de radiodiagnostic
Bahri, Mohamed Ali  ;  Université de Liège - ULiège > Centre de recherches du cyclotron
Laureys, Steven  ;  Université de Liège - ULiège > Centre de recherches du cyclotron
 These authors have contributed equally to this work.
Language :
English
Title :
Changes in cerebral metabolism in patients with a minimally conscious state responding to zolpidem.
Publication date :
2014
Journal title :
Frontiers in Neuroscience
ISSN :
1662-4548
eISSN :
1662-453X
Publisher :
Frontiers Research Foundation, Lausanne, Switzerland
Volume :
8
Pages :
917
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 28 January 2015

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