title: Zolpidem arouses patients in vegetative state after brain injury: quantitative evaluation and indications.
abstract: BACKGROUND
  To investigate the efficacy and indications of zolpidem, a nonbenzodiazepine hypnotic, inducing arousal in vegetative state patients after brain injury.
  
  
  METHODS
  One hundred sixty-five patients were divided into 4 groups, according to area of brain damage and injury mechanism. All patients' brains were imaged by Tc-ECD single-photon emission computerized tomography (SPECT), before and 1 hour after treatment with 10 mg of zolpidem. Simultaneously, 3 quantitative indicators of brain function and damage were obtained using cerebral state monitor. Thirty-eight patients withdrew from the study after the first zolpidem dose. The remaining 127 patients received a daily dose of 10 mg of zolpidem for 1 week and were monitored again at the end of this week.
  
  
  RESULTS
  One hour after treatment with zolpidem, cerebral state index was increased and burst suppression reduced in both brain contrecoup contusion and space-occupying brain compression groups (P < 0.05). SPECT showed, 1 hour after medication, that cerebral perfusion was improved in both brain contrecoup contusion and space-occupying brain compression groups, but no changes were seen in primary and secondary brain stem injury groups. In the 127 patients' group, after 1 week of zolpidem treatment, all parameters obtained from cerebral state monitor were not statistically different compared with those after the initial medication (P > 0.05).
  
  
  CONCLUSIONS
  Zolpidem is an effective medicine to restore brain function in patients in vegetative state after brain injury, especially for those whose brain injuries are mainly in non-brain-stem areas. Improvement of brain function is sudden rather than gradual.
authors: Department of Emergency (BD, AS, XZ), Neurosurgery (DC, KC), and Ultrasound (YZ), Shenzhen People's Hospital, Jinan University, Shenzhen, China.
authors: Bo
authors: B
authors: Du
authors: Aijun
authors: A
authors: Shan
authors: Yujuan
authors: Y
authors: Zhang
authors: Xianliang
authors: X
authors: Zhong
authors: Dong
authors: D
authors: Chen
authors: Kunhao
authors: K
authors: Cai
mesh_terms: D000328:Adult; D001921:Brain / Q000098:blood supply; D001930:Brain Injuries / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000187:drug effects; D003545:Cysteine / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D018458:Persistent Vegetative State / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D011725:Pyridines / Q000627:therapeutic use*; D015899:Tomography, Emission-Computed, Single-Photon; D000077334:Zolpidem
chemical_list: D006993:Hypnotics and Sedatives; D015609:Organotechnetium Compounds; D011725:Pyridines; D000077334:Zolpidem; C059659:technetium Tc 99m bicisate; D003545:Cysteine