Midazolam changes cerebral blood flow in discrete brain regions: An H(2)(15)O positron emission tomography study Journal Article
| Authors: | Veselis, R. A.; Reinsel, R. A.; Beattie, B. J.; Mawlawi, O. R.; Feshchenko, V. A.; DiResta, G. R.; Larson, S. M.; Blasberg, R. G. |
| Article Title: | Midazolam changes cerebral blood flow in discrete brain regions: An H(2)(15)O positron emission tomography study |
| Abstract: | Background: Changes in regional cerebral blood flow (rCBF) determined with H2 15O positron emission tomographic imaging can identify neural circuits affected by centrally acting drugs. Methods: Fourteen volunteers received one of two midazolain infusions adjusted according to electroencephalographic response. Low or high midazolam effects were identified using post-hoc spectral analysis of the electroencephalographic response obtained during positron emission tomographic imaging based on the absence or presence of 14-Hz spindle activity. The absolute change in global CBF was calculated, and relative changes in rCBF were determined using statistical parametric mapping with localization to standard stereotactic coordinates. Results: The low-effect group received 7.5 ± 1.7 mg midazolam (serum concentrations, 74 ± 24 ng/ml), and the higheffect group received 9.7 ± 1.3 mg midazolam (serum concentrations, 129 ± 48 ng/ml). Midazolam decreased global CBF by 12% from 39.2 ± 4.1 to 34.4 ± 6.1 ml·100 g- 1·min-1 (P < 0.02 at a partial pressure of carbon dioxide of 40 mmHg). The rCBF changes in the low-effect group were a subset of the high-effect group. Decreased rCBF (P < 0.001) occurred in the insula, the cingulate gyrus, multiple areas in the prefrontal cortex, the thalamus, and parietal and temporal association areas. Asymmetric changes occurred, particularly in the low-effect group, and were more significant in the left frontal cortex and thalamus and the right insula. Relative rCBF was increased in the occipital areas. Conclusion: Midazolam causes dose-related changes in rGBF in brain regions associated with the normal functioning of arousal, attention, and memory. |
| Keywords: | adult; positron emission tomography; midazolam; sedation; brain blood flow; cerebrovascular circulation; electroencephalogram; intravenous drug administration; normal human; hypnotics and sedatives; electroencephalography; frontal cortex; human experiment; cingulate gyrus; insula; parietal lobe; benzodiazepine; tomography, emission-computed; prefrontal cortex; cerebral blood flow; thalamus; brain circulation; humans; human; male; priority journal; article; association cortex; radionuclide imaging: h2 15o; sleep: drug effects; tomography: emission computed; oxygen radioisotopes |
| Journal Title: | Anesthesiology |
| Volume: | 87 |
| Issue: | 5 |
| ISSN: | 0003-3022 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 1997-11-01 |
| Start Page: | 1106 |
| End Page: | 1117 |
| Language: | English |
| DOI: | 10.1097/00000542-199711000-00015 |
| PUBMED: | 9366463 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Presented in part at the Annual Meeting of the American Society of Anesthesiologists that took place 1995 Oct 21-25 in Atlanta, GA -- Export Date: 17 March 2017 -- Source: Scopus |
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