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Zolpidem arouses patients in vegetative state after brain injury

11/16/2014
12:01 | Author: Brandon Powell

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Zolpidem arouses patients in vegetative state after brain injury

Zolpidem arouses patients in vegetative state after brain injury: quantitative evaluation and indications. Du B, Shan A, Zhang Y, Zhong X, Chen D, Cai K.

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To investigate the efficacy and indications of zolpidem, a nonbenzodiazepine hypnotic, inducing arousal in vegetative state patients after brain injury.

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).

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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.

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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.

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Brain activity in severely brain injured patients who 39wake up39 with

9/15/2014
02:58 | Author: David Perry

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Brain activity in severely brain injured patients who 39wake up39 with

The three patients in the study suffered brain damage in different ways. zolpidem further activates the brain after it's affected the idling cells.

This proposed "mesocircuit" links the cortical regions of the brain to the central thalamus and striatum. Neurons in the central thalamus are highly connected to other parts of the brain, "so damage in one part of the brain or another will affect the thalamus, which is key to consciousness," Dr. Schiff says. Neurons in the striatum "will only fire if there is a lot of electrical input coming to them quickly," he says.

"Now that we have uncovered important insight into fundamental mechanisms underlying the dramatic and rare response of some severely brain-injured patients to Ambien, we hope to systematically explore ways to achieve such kick-starts in other patients -- that is our goal," Dr.

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Common resting brain dynamics indicate a possible mechanism

7/14/2014
04:37 | Author: Nick Jenkins

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Common resting brain dynamics indicate a possible mechanism

Zolpidem produces paradoxical recovery of speech, cognitive and motor functions in select subjects with severe brain injury but underlying.

All three subjects showed reproducible behavioral improvements following zolpidem. Figure 1 shows CRS-R ratings (total and subscale) for Subject 1, following five doses (red lines) of the medication (four doses with concomitant video/EEG recordings studied here are labeled on Figure with red arrows). For assessments in the OFF-drug period (the first assessment, which followed a 62-hr washout, and at every time point that was at least 4 hr after zolpidem administration), the total CRS-R score ranged from 10–15.

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New evidence that zolpidem is effective in brain damage including

5/13/2014
06:36 | Author: Emma Coleman

Zolpidem overnight
New evidence that zolpidem is effective in brain damage including

study adds further evidence to previous reports of zolpidem efficacy in patients with established brain damage". The first vegetative state (PVS).

16. Whyte J, Myers R. Incidence of clinically significant responses to zolpidem among patients with Disorders of Consciousness: A preliminary placebo controlled trial. American Journal of Physical Medicine and Rehabilitation. 2009, 88 (5): 410-418.

12. Glasziou P et al. 2007. When is Randomised trial unnecessary? Picking signal from noise. BMJ 344, 349-51, 17th February.

Conducted by the University of Pretoria, South Africa the study found efficacy in 10 out of 23 patients with brain damage who had been identified as neurologically disabled by scoring less than 100/100 on the Barthel Index.

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Zolpidem Treatment of Disorders of Consciousness - International

3/12/2014
08:55 | Author: Kayla Henderson

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Zolpidem Treatment of Disorders of Consciousness - International

International Brain Injury Association - IBIA One intriguing treatment possibility for chronic DOC is zolpidem, an omega-1 GABA agonist.

Oct 27th 2014 For more information Click Here.

The formal definition of the minimally conscious state (MCS) in 2002, while not directly altering prognosis, encouraged clinicians and researchers to scrutinize the cognitive status of patients with DOC, and highlighted the problem of misdiagnosis. It is now clear that as many as 40% of patients carrying a diagnosis of the vegetative state (VS) are actually in the MCS. The problem of misdiagnosis, in turn, has highlighted the value of assessment tools and expertise in trying to lower this error rate.

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Finally, there are intriguing reports of treatments that may enhance the level of consciousness of certain patients with DOC.

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