Document Detail


Treatment of chronic akinetic mutism with atomoxetine: subtraction analysis of brain f-18 fluorodeoxyglucose positron emission tomographic images before and after medication: a case report.
MedLine Citation:
PMID:  20661027     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Akinetic mutism is a rare, complex neuropathologic disorder. The pharmaceutical treatment of akinetic mutism typically includes dopaminergic agents, but the resulting therapeutic effects are often unsatisfactory, and it remains unclear whether late treatment using these medications is effective. We present a case study of a 53-year-old male patient who developed akinetic mutism for a period of 7 months after a subarachnoid hemorrhage. The hemorrhage was caused by a ruptured aneurysm in the right anterior communicating artery, followed by a secondary infarction in the territory of the right anterior cerebral artery. Baseline brain F-18 fluorodeoxyglucose positron emission tomographic images revealed decreased glucose metabolism in both frontal lobes. Treatment with atomoxetine, a selective norepinephrine reuptake inhibitor, for a period of 8 weeks led to a clinically significant improvement in the patient's cognitive function and activities of daily living. A subtraction brain positron emission tomographic analysis after atomoxetine medication revealed increased cerebral glucose metabolism in both the premotor and visual association cortices. Thus, we suggest that atomoxetine can be a useful therapeutic option in the treatment of chronic akinetic mutism.
Authors:
Yong Wook Kim; Ji-Cheol Shin; Young-Sil An
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Clinical neuropharmacology     Volume:  33     ISSN:  1537-162X     ISO Abbreviation:  Clin Neuropharmacol     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-27     Completed Date:  2010-12-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7607910     Medline TA:  Clin Neuropharmacol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  209-11     Citation Subset:  IM    
Affiliation:
Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. ywkim1@yuhs.ac
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MeSH Terms
Descriptor/Qualifier:
Akinetic Mutism / drug therapy*,  metabolism,  radionuclide imaging
Aneurysm, Ruptured / complications
Cognition / drug effects
Fluorodeoxyglucose F18 / diagnostic use,  metabolism
Frontal Lobe / drug effects,  metabolism,  radionuclide imaging*
Glucose / metabolism
Humans
Male
Middle Aged
Norepinephrine Plasma Membrane Transport Proteins / antagonists & inhibitors
Occipital Lobe / drug effects,  metabolism,  radionuclide imaging*
Positron-Emission Tomography
Propylamines / therapeutic use*
Subarachnoid Hemorrhage / etiology
Subtraction Technique
Time Factors
Chemical
Reg. No./Substance:
0/Norepinephrine Plasma Membrane Transport Proteins; 0/Propylamines; 0/SLC6A2 protein, human; 50-99-7/Glucose; 63503-12-8/Fluorodeoxyglucose F18; 83015-26-3/atomoxetine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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