Effects of ionic and non-ionic paramagnetic contrast media on brain bio-electric activity.
The potential neurotoxic effects of gadolinium (Gd)-based compounds for enhanced MRI are not completely understood. We investigated electroencephalography changes induced by ionic and non-ionic Gd-based compounds administered intravenously in patients affected by lesions of the central nervous system (CNS) characterized by breakdown of the blood-brain barrier. This double-blind, randomized, study of two parallel groups involved 40 patients scheduled for an MRI examination with contrast medium for known CNS lesions. Twenty patients were randomly allocated to receive non-ionic Gd-DTPA-BMA/gadodiamide and 20 patients were randomly allocated to receive ionic Gd-DTPA/gadopentetate. For both groups the intravenous dose was 0.1 mmol/kg body weight. Three electroencephalography recordings were performed: immediately before, during, and 15 min after contrast medium injection. Mean and peak frequencies of the beta band and absolute power of the delta and/or theta bands of the electroencephalograms (EEGs) were noted. Each EEG was also evaluated to detect any alterations. The values of the 8-12 Hz band showed a significant increase during and after injection versus baseline in the gadopentetate group (P<0.05) and a significant decrease during injection in the gadodiamide group (P<0.05). The values of the 12-16 Hz band showed a significant increase versus baseline during and after injection in the gadopentetate group (P<0.05). The electrophysiological method based on computerised spectral analysis is a sensitive tool for evaluating effects of contrast media on brain bio-electric activity. EEG changes are detectable, even in the absence of any clinical evidence. It would appear that there might be clinical advantages in the use of non-ionic compounds.
Messori
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A
Department of Neuroradiology, Umberto I Hospital and University of Ancona, Via Conca, Torrette, 60020 , Ancona, Italy.
Polonara
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G
Regnicolo
L
L
Provinciali
L
L
Signorino
M
M
Salvolini
U
U
D000704:Analysis of Variance; D001812:Blood-Brain Barrier; D001921:Brain / Q000187:drug effects*; D001932:Brain Neoplasms / Q000175:diagnosis*; D003287:Contrast Media / Q000009:adverse effects / Q000494:pharmacology*; D004311:Double-Blind Method; D004569:Electroencephalography; D019786:Gadolinium DTPA / Q000009:adverse effects / Q000494:pharmacology*; D006801:Humans; D007275:Injections, Intravenous; D008279:Magnetic Resonance Imaging; D018709:Statistics, Nonparametric
D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA