Zolpidem Arousing Effect In Persistent Vegetative State Patients: Autonomic, Eeg And Behavioral Assessment

Machado, Calixto; Estévez, Mario; Rodríguez, Rafael; Pérez-Nellar, Jesús; Chinchilla, Mauricio; DeFina, Philip A.; Leisman, Gerry; Frederick, Carrick; Melillo, Robert; Schiavi, Adam; Gutiérrez, Joel; Carballo, Maylen; Machado, Andrés; Olivares, Ana; Perez-Cruz, Nuvia

doi:10.2174/13816128113196660646

Cited by 24 publications

(23 citation statements)

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“…22 Another RCT performed on 8 patients in UWS (1-114 months post-injury) only noticed slight clinical changes (i.e., yawns and hiccupsbut no changes on the CRS-R) combined with an activation of electroencephalographic (EEG) activity (i.e., faster frequency and lower amplitude). 23 An additional two-phase study (i.e., open-label and then a placebo-controlled trial if there was a change of CRS-R diagnosis) included 60 patients in UWS and MCS patients (1 month to 24 years post-onset). 16 Twelve patients (20%) showed behavioral improvements (e.g., command following, object localization) without a change of diagnosis.…”

Section: Zolpidemmentioning

confidence: 99%

Therapeutic interventions in patients with prolonged disorders of consciousness

Thibaut

Schiff

Giacino

et al. 2019

The Lancet Neurology

290

229

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The management of patients with severe brain injuries and prolonged disorders of consciousness (DOC) raises important issues particularly with respect to their therapeutic options. The lack of treatment is challenged by new clinical and neuroimaging data indicating that some patients with prolonged DOC may benefit from therapeutic interventions, even years after the injury. The majority of the studies aiming at improving patients' level of consciousness and functional recovery includes behavioural and brain imaging open-label trials and case-reports, but several randomized clinical trials (RCT) have been conducted, especially using non-invasive brain stimulation. Only a couple of RCTs focused on the effects of drugs or sensory stimulation approaches, and only two Class II studies, on amantadine and transcranial direct current stimulation, have been published. While new therapeutic approaches seem to be valuable for patients with prolonged DOC, optimized stimulation parameters, alternative drugs or rehabilitation strategies still need to be tested and validated.

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Section: Zolpidemmentioning

confidence: 99%

Therapeutic interventions in patients with prolonged disorders of consciousness

Thibaut

Schiff

Giacino

et al. 2019

The Lancet Neurology

290

229

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“…[75][76][77] It has been widely supported that that lesions in the medulla can cause respiratory dysfunction, like in congenital central hypoventilation syndrome, 78 or severe brain injury, 79 which results in damage to medullar respiratory control function. 35,[80][81][82][83][84] It is extremely important to remark that the brainstem has been severely infected by SARS-CoV34, 35 or MERS-CoV. It has been reported that viral antigens have been detected in the brainstem, where the infected regions included the nucleus of the solitary tract and nucleus ambiguous.…”

Section: Brainstem Dysfunction In Sars-cov-2 Infection As a Potentialmentioning

confidence: 99%

Brainstem Dysfunction in SARS-COV2 Infection Can Be a Potential Cause of Respiratory Distress

Machado¹,

Gutierrez²

2020

Preprint

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Covid-19 pandemic has captivated scientists to investigate if this new disease can affect the central nervous system (CNS). The most challenging symptoms of Covid-19 are related to respiratory distress, and most patients admitted in intensive care units cannot breathe by their own. Therefore, a crucial question is if respiratory distress can be partially explained by the CNS affection. SARS-Cov-2 is a beta-coronavirus that shares high similarities with SARS-CoV. The infection of SARS‐CoV has been reported in the brains from both patients and experimental animals, where the brainstem was heavily infected. Those coronaviruses have been able to invade the brainstem via a synapse‐connected route to the medullary respiratory center, where the infected regions included the nucleus of the solitary tract and nucleus ambiguous. The vagal afferent nerves from receptors in the lung communicate with the medulla and pons respiratory control centers to coordinate inspiration and expiration. This suggests that neuroinvasion of SARS‐CoV‐2 might play a role in the acute respiratory failure of Covid-19. Therefore, acute respiratory distress in Covid-19 can be partially explained by brainstem dysfunction, suggesting the needs of more specific and aggressive treatments with the direct participation of neurologists and neurointensivists.

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“…In addition, it was reported that zolpidem may induce a symptomatic improvement in a variety of other conditions associated with motor dysfunction, such as restless leg syndrome [ 51 ], postanoxic spasticity [ 52 ], spinocerebellar ataxia [ 53 ], and central pontine myelinolysis [ 54 ]. Furthermore, it has been observed that the administration of zolpidem may induce beneficial effects in some patients with stroke [ 55 ] and in a subset of patients with disorders of consciousness [ 56 – 62 ].…”

Section: Potential Beneficial Effects Of Zolpidem Possibly Througmentioning

confidence: 99%

Can a Positive Allosteric Modulation of GABAergic Receptors Improve Motor Symptoms in Patients with Parkinson’s Disease? The Potential Role of Zolpidem in the Treatment of Parkinson’s Disease

Daniele

Greco

Logroscino

et al. 2016

Parkinson's Disease

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At present, patients with advanced Parkinson's disease (PD) are unsatisfactorily controlled by currently used anti-Parkinsonian dopaminergic drugs. Various studies suggest that therapeutic strategies based on nondopaminergic drugs might be helpful in PD. Zolpidem, an imidazopyridine widely used as sleep inducer, shows high affinity only for GABAA receptors containing the α-1 subunit and facilitates GABAergic neurotransmission through a positive allosteric modulation of GABAA receptors. Various observations, although preliminary, consistently suggest that in PD patients zolpidem may induce beneficial (and sometimes remarkable) effects on motor symptoms even after single doses and may also improve dyskinesias. Since a high density of zolpidem binding sites is in the two main output structures of the basal ganglia which are abnormally overactive in PD (internal globus pallidus, GPi, and substantia nigra pars reticulata, SNr), it was hypothesized that in PD patients zolpidem may induce through GABAA receptors an inhibition of GPi and SNr (and, possibly, of the subthalamic nucleus also), resulting in an increased activity of motor cortical areas (such as supplementary motor area), which may give rise to improvement of motor symptoms of PD. Randomized clinical trials are needed in order to assess the efficacy, safety, and tolerability of zolpidem in treating motor symptoms of PD.

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Zolpidem Arousing Effect In Persistent Vegetative State Patients: Autonomic, Eeg And Behavioral Assessment

Cited by 24 publications

References 0 publications

Therapeutic interventions in patients with prolonged disorders of consciousness

Therapeutic interventions in patients with prolonged disorders of consciousness

Brainstem Dysfunction in SARS-COV2 Infection Can Be a Potential Cause of Respiratory Distress

Can a Positive Allosteric Modulation of GABAergic Receptors Improve Motor Symptoms in Patients with Parkinson’s Disease? The Potential Role of Zolpidem in the Treatment of Parkinson’s Disease

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