| Imaging of Subacute Blood-Brain Barrier Disruption After Methadone Overdose. | |
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MedLine Citation:
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PMID: 22211853 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Methadone intoxication can cause respiratory depression, leading to hypoxia with subsequent coma and death. Delayed postanoxic leukoencephalopathy (DAL) has been reported with intoxication by carbon monoxide, narcotics, and other toxins. OBJECTIVE: To investigate the metabolic derangement of the white matter (WM) and blood-brain barrier (BBB) after DAL caused by methadone overdose. DESIGN, SETTING, AND PATIENTS: Case report of 2 patients with DAL after a single dose of "diverted" methadone used for pain control. RESULTS: In both cases brain magnetic resonance imaging (MRI) revealed initial extensive bilateral restricted diffusion lesions within the WM. Follow-up MRI using proton magnetic resonance spectroscopic imaging ((1) H-MRSI) showed markedly lower N-acetylaspartate and higher choline within the WM. BBB permeability, calculated by Patlak graphical analysis of MRI T1 data obtained after contrast agent injection, showed disruption of the BBB within the WM lesions, which persisted longer than a year in 1 patient. Neuropsychological evaluation showed executive dysfunction in both patients. After 1 year, one patient recovered whereas the second remained impaired. CONCLUSIONS: Methadone overdose can cause DAL with profound disturbances of neural metabolism and the BBB. The time course of these disturbances can be monitored with MR methods. J Neuroimaging 2011;XX:1-4. |
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Authors:
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Branko N Huisa; Charles Gasparovic; Saeid Taheri; Jillian L Prestopnik; Gary A Rosenberg |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-12-30 |
Journal Detail:
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Title: Journal of neuroimaging : official journal of the American Society of Neuroimaging Volume: - ISSN: 1552-6569 ISO Abbreviation: - Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2012-1-3 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9102705 Medline TA: J Neuroimaging Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2011 by the American Society of Neuroimaging. |
Affiliation:
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From the Departments of Neurology (BNH, ST, JLP), Neurosciences (CG, GAR), Cell Biology and Physiology (GAR), University of New Mexico, Health Sciences Center, Albuquerque, NM. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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