title: Neurotoxic effects of gadopentetate dimeglumine: behavioral disturbance and morphology after intracerebroventricular injection in rats.
abstract: OBJECTIVE
  To determine the neurotoxic potential of gadopentetate dimeglumine in an animal model that allowed the agent to avoid the blood-brain barrier. Gadopentetate dimeglumine is known to produce functional changes when injected into the cerebrospinal fluid, and we hypothesized that such changes might be associated with morphologic damage.
  
  
  METHODS
  Conscious rats, surgically prepared with a lateral ventricular cannula, were given a slow injection of gadopentetate dimeglumine into the lateral ventricle, and behavioral and neuropathologic changes were noted.
  
  
  RESULTS
  Gadopentetate dimeglumine produced signs of acute neurotoxicity over several hours (stereotyped movements and myoclonus), medium-term signs over several days (ataxia and tremor), and neuropathologic changes over 24 hours, with reactive changes persisting for 42 days. All of the above were dose-dependent over the range of 2.5 to 15 mumol/g brain. The lowest dose producing morphologic or behavioral changes was 5 mu mol/g brain. Iso-osmotic, isovolumetric injections of sucrose produced no such effects. Focal lesions occurred within the thalamus, brain stem, and spinal cord, with necrosis of glia, loss of myelin, and, usually, sparing of neurons and nerve fibers. Persisting ataxia was always associated with brain stem or spinal cord lesions.
  
  
  CONCLUSIONS
  Intraventricular administration of contrast medium allows toxicity to be evaluated in areas such as the spinal cord that are not accessible by osmotic opening. While it is unlikely that these toxic effects would be seen at the doses used for clinical imaging by the intravenous route, gadopentetate dimeglumine clearly has some neurotoxic and neuropathologic potential. Although the acute excitation could be attributed to a transiently high local concentration of the agent at the injection site, the lesions were widely distributed through the brain and spinal cord and may reflect a region-specific neurotoxic action, possibly related to central pontine myelinolysis.
authors.affiliation: MRC Toxicology Unit, University of Leicester, Institute of Psychiatry, London, United Kingdom.
authors.forename: D E
authors.initials: DE
authors.lastname: Ray
authors.forename: J B
authors.initials: JB
authors.lastname: Cavanagh
authors.forename: C C
authors.initials: CC
authors.lastname: Nolan
authors.forename: S C
authors.initials: SC
authors.lastname: Williams
mesh_terms: D000818:Animals; D001522:Behavior, Animal / Q000187:drug effects*; D001921:Brain / Q000187:drug effects* / Q000473:pathology; D001933:Brain Stem / Q000187:drug effects / Q000473:pathology; D003287:Contrast Media / Q000633:toxicity*; D004305:Dose-Response Relationship, Drug; D004338:Drug Combinations; D019786:Gadolinium DTPA; D007276:Injections, Intraventricular; D008279:Magnetic Resonance Imaging; D008297:Male; D008536:Meglumine / Q000633:toxicity*; D009043:Motor Activity / Q000187:drug effects; D009048:Motor Skills / Q000187:drug effects; D009942:Organometallic Compounds / Q000633:toxicity*; D004369:Pentetic Acid / Q000031:analogs & derivatives* / Q000633:toxicity; D051381:Rats; D011916:Rats, Inbred F344; D013116:Spinal Cord / Q000187:drug effects* / Q000473:pathology
chemical_list: D003287:Contrast Media; D004338:Drug Combinations; D009942:Organometallic Compounds; D008536:Meglumine; D004369:Pentetic Acid; D019786:Gadolinium DTPA