Clinical and imaging evidence of zolpidem effect in hypoxic encephalopathy.
We conducted a randomized, double-blind, placebo-controlled, single-patient (N = 1) trial to evaluate the efficacy of zolpidem in a 48-year-old woman with an akinetic mutism. Motor and cognitive examinations and functional imaging were performed. Acute administration of zolpidem markedly improved motor performance and neuropsychological status. Cerebral metabolism ((18)F-fluorodeoxyglucose positron emission tomography) increased in postrolandic territories and in frontal cortex. Using the H(2) (15)O positron emission tomography, we found a drug-induced activation in the anterior cingulate and orbitofrontal cortices. Zolpidem induced a transient improvement in motor and cognitive performances. This paradoxical effect could result from an activation of limbic loops modulating motivational processes.
Brefel-Courbon
Christine
C
Department of Pharmacology and Centre Midi-Pyrenees de Pharmacovigilance, de Pharmacoepidemiologie et d'Informations sur le Medicament, Faculty of Medecine, University Toulouse, 37 allées Jules Guesde, 31000 Toulouse, France. brefel@cict.fr
Payoux
Pierre
P
Ory
Fabierine
F
Sommet
Agnes
A
Slaoui
Tarik
T
Raboyeau
Gaelle
G
Lemesle
Beatrice
B
Puel
Michele
M
Montastruc
Jean-Louis
JL
Demonet
Jean-Francois
JF
Cardebat
Dominique
D
D004311:Double-Blind Method; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D018755:GABA Agonists / Q000627:therapeutic use*; D006801:Humans; D002534:Hypoxia, Brain / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D008875:Middle Aged; D009483:Neuropsychological Tests; D049268:Positron-Emission Tomography; D011725:Pyridines / Q000627:therapeutic use*; D000077334:Zolpidem
D018755:GABA Agonists; D011725:Pyridines; D019788:Fluorodeoxyglucose F18; D000077334:Zolpidem