Application of brain perfusion SPECT in the evaluation of response to zolpidem therapy in consciousness disorder due to traumatic brain injury

Khalili, Hosseinali; Rakhsha, Abbas; Ghaedian, Tahereh; Niakan, Amin; Masoudi, Nahid

doi:10.4103/ijnm.ijnm_97_20

Cited by 6 publications

(6 citation statements)

References 12 publications

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“…This makes it a global health problem 2,4,7,13,27,28,36) . In order to minimise cerebral injury after TBI, numerous studies have been conducted to prevent the initial impact injury and to seek treatment to prevent subsequent neuronal damage, to increase neuronal reorganisation and functional recovery 12,26,29) . Currently, there is no effective treatment for first impact injury.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have been mainly aimed at preventing secondary pathophysiological events after diffuse TBI and developing medical treatment, and promising results have been obtained from these studies 12,26,29) . Based on these promising studies, we aimed to investigate the neuroprotective efficacy of DXP, which was previously known to have anti-inflammatory and anti-cytotoxic properties.…”

Section: Discussionmentioning

confidence: 99%

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Investigation of Neuroprotective Efficacy of Dexpanthenol in an Experimental Head Injury Model

Karatoprak,

Engin,

Sahin

et al. 2024

J Korean Neurosurg Soc

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Objective : Dexpanthenol (DXP), which has known neuroprotective effects, has been shown to be beneficial in various experimental models and ischaemic diseases. The aim of this study was to investigate the possible neuroprotective effects of DXP in a traumatic brain injury (TBI) model. Methods : Thirty-six Wistar-Albino female rats, approximately 6 months old, weighing 220-285 g were used. All rats were subjected to closed head trauma by dropping a weight of 350 g on the parietal region from a height of 50 cm at an angle of 180 degrees in the prepared head trauma model setup. The rats were divided into four groups as control (group 1), trauma (group 2), trauma + DXP (group 3), and DXP (group 4). In group 3, DXP was administered intraperitoneally at a dose of 500 mg/kg for six times at 30 minutes, 6, 12, 24, 36, and 48 hours. In group 4, DXP was administered intraperitoneally simultaneously with group 3 without causing head trauma. Blood samples were taken from all rats 72 hours later for biochemical examination. After blood samples were taken, rats were decapitated under general anaesthesia. Cerebral tissue samples were taken from decapitated rats for immunohistochemical and histopathological examination. Results : Cytokine markers were found to be increased in posttraumatic brain tissue. Malondialdehyde and glutathione reductase levels were lower in group 3 compared to group 2. In addition, superoxide dismutase, glutathione peroxidase and catalase levels were significantly higher in group 3 compared to group 2. In histological evaluation, congestion in the piamater layer, cell infiltration, vascular congestion, hemorrhage and neuronal degeneration were significantly decreased in group 3 compared to group 2. DXP seems to be beneficial in neurological recovery in terms of histological and oxidative changes after head trauma in rats. Conclusion : DXP should be further evaluated for its possible therapeutic effect in TBI.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Investigation of Neuroprotective Efficacy of Dexpanthenol in an Experimental Head Injury Model

Karatoprak,

Engin,

Sahin

et al. 2024

J Korean Neurosurg Soc

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“…Apomorphine is a dopamine agonist with a high affinity for D2 receptors, feeding into the indirect pathway [54]. Zolpidem is a GABA agonist and may inhibit the GABAergic projections reducing inhibitory tone to hypoactive areas of the brain and enhancing thalamocortical pathways [57,60], Dopamine Receptor 1 (D 1 ) and Dopamine Receptor 2 (D 2 ).…”

Section: Discussionmentioning

confidence: 99%

“…An EEG study suggested it acts on cortical, striatal, and thalamic neuronal populations to potentially produce this spontaneous awakening phenomenon [57]. Controlled studies have shown zolpidem to be safe, but again showed variable effectiveness [58][59][60][61]. Lorazepam was also shown to be safe, albeit ineffective in a single study for TBI, but showed some effectiveness for patients with anoxic brain injury [61].…”

Section: Pharmaceuticalsmentioning

confidence: 99%

“…This circuit is interru by severe TBI, resulting in lower output from the central thalamus. Inhibition of the bus pallidus internus by zolpidem may result in a more normal function of the ce thalamus and thus explain the paradoxical observation with zolpidem treatment resu in spontaneous awakenings [15,55,[57][58][59][60][61] (Figure 3). Diagram of the cortico-striatal-thalamic-cortical loop and potential impacts of apom phine, amantadine, and zolpidem on spontaneous awakenings.…”

Section: Neuroanatomy Of Consciousnessmentioning

confidence: 99%

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Treating Traumatic Brain Injuries with Electroceuticals: Implications for the Neuroanatomy of Consciousness

et al. 2021

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According to the Centers for Disease Control and Prevention (CDC), traumatic brain injury (TBI) is the leading cause of loss of consciousness, long-term disability, and death in children and young adults (age 1 to 44). Currently, there are no United States Food and Drug Administration (FDA) approved pharmacological treatments for post-TBI regeneration and recovery, particularly related to permanent disability and level of consciousness. In some cases, long-term disorders of consciousness (DoC) exist, including the vegetative state/unresponsive wakefulness syndrome (VS/UWS) characterized by the exhibition of reflexive behaviors only or a minimally conscious state (MCS) with few purposeful movements and reflexive behaviors. Electroceuticals, including non-invasive brain stimulation (NIBS), vagus nerve stimulation (VNS), and deep brain stimulation (DBS) have proved efficacious in some patients with TBI and DoC. In this review, we examine how electroceuticals have improved our understanding of the neuroanatomy of consciousness. However, the level of improvements in general arousal or basic bodily and visual pursuit that constitute clinically meaningful recovery on the Coma Recovery Scale-Revised (CRS-R) remain undefined. Nevertheless, these advancements demonstrate the importance of the vagal nerve, thalamus, reticular activating system, and cortico-striatal-thalamic-cortical loop in the process of consciousness recovery.

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Clinical Decision on Disorders of Consciousness After Acquired Brain Injury: Stepping Forward

Zheng

Wang

et al. 2022

Neurosci. Bull.

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Application of brain perfusion SPECT in the evaluation of response to zolpidem therapy in consciousness disorder due to traumatic brain injury

Cited by 6 publications

References 12 publications

Investigation of Neuroprotective Efficacy of Dexpanthenol in an Experimental Head Injury Model

Investigation of Neuroprotective Efficacy of Dexpanthenol in an Experimental Head Injury Model

Treating Traumatic Brain Injuries with Electroceuticals: Implications for the Neuroanatomy of Consciousness

Clinical Decision on Disorders of Consciousness After Acquired Brain Injury: Stepping Forward

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