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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.

Authors
Kim, YW; Shin, JC; An, YS
Citation
Clinical neuropharmacology, 33(4):209-211, 2010
Journal Title
Clinical neuropharmacology
ISSN
0362-56641537-162X
Abstract
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.
MeSH terms
Akinetic Mutism/*drug therapy/metabolism/radionuclide imagingAneurysm, Ruptured/complicationsCognition/drug effectsFluorodeoxyglucose F18/diagnostic use/metabolismFrontal Lobe/drug effects/metabolism/*radionuclide imagingGlucose/metabolismHumansMaleMiddle AgedNorepinephrine Plasma Membrane Transport Proteins/antagonists & inhibitorsOccipital Lobe/drug effects/metabolism/*radionuclide imagingPositron-Emission TomographyPropylamines/*therapeutic useSubarachnoid Hemorrhage/etiologySubtraction TechniqueTime Factors
DOI
10.1097/WNF.0b013e3181dca948
PMID
20661027
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Nuclear Medicine & Molecular Imaging
AJOU Authors
안, 영실
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