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Effects of methylphenidate on cerebral glucose metabolism in patients with impaired consciousness after acquired brain injury.

机译:哌醋甲酯对获得性脑损伤后意识障碍患者脑葡萄糖代谢的影响。

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OBJECTIVES: To evaluate the effects of methylphenidate on cerebral glucose metabolism in patients with impaired consciousness after acquired brain injury. METHODS: Fourteen patients with impaired consciousness after acquired brain injury were enrolled in our study. We evaluated the level of consciousness with the Glasgow Coma Scale upon initial evaluation and at the 6-week follow-up after methylphenidate medication (0.3 mg/kg per day, which was administered twice daily). Positron emission tomography was performed before and after 6 weeks of medication, and the effects of methylphenidate on cerebral glucose metabolism were analyzed using statistical parametric mapping. RESULTS: The statistical parametric mapping analysis indicated that significant increases of the cerebral glucose metabolism after methylphenidate therapy, compared with the initial positron emission tomographic image, were most evident in the left precuneus, the right posterior cingulated and the right retrosplenial cortices, and the right inferior parietal cortex (P < 0.001). In addition, cerebral glucose metabolism was significantly increased in the right precuneus, the right superior and middle temporal gyri, and bilateral middle occipital gyri (P < 0.005). In the correlation analysis, improvement of the Glasgow Coma Scale scores after methylphenidate medication was significantly associated with increased cerebral glucose metabolism in the bilateral precuneus, the bilateral middle occipital gyri, and right middle frontal gyrus. CONCLUSIONS: Our findings suggest that the posteromedial parietal cortex, which is part of the neural network for consciousness, may be the relevant structure for the pharmacological response to methylphenidate treatment in patients with impaired consciousness after acquired brain injury.
机译:目的:评价哌醋甲酯对获得性脑损伤后意识障碍患者脑葡萄糖代谢的影响。方法:本研究纳入了14名获得性脑损伤后意识障碍的患者。我们在首次评估时以及在哌醋甲酯药物治疗后6周的随访中(每天0.3 mg / kg,每天两次)用格拉斯哥昏迷量表评估意识水平。在用药前和用药后6周进行正电子发射断层扫描,并使用统计参数作图分析哌醋甲酯对脑葡萄糖代谢的影响。结果:统计参数作图分析表明,与最初的正电子发射断层扫描图像相比,哌醋甲酯治疗后脑葡萄糖代谢显着增加,最明显于左前脑,右后扣带和右脾后皮质,以及右下顶叶皮层(P <0.001)。此外,右前核,右上颞中回和双枕中回的大脑葡萄糖代谢显着增加(P <0.005)。在相关性分析中,哌醋甲酯治疗后格拉斯哥昏迷量表评分的改善与双侧前神经,双侧枕中回和右中额回的脑葡萄糖代谢增加显着相关。结论:我们的发现表明,后顶叶顶叶皮层是意识神经网络的一部分,可能与获得性脑损伤后意识障碍的患者对哌醋甲酯治疗的药理反应有关。

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