Clonidine infusion increases uptake of 99mTc-Exametazime in anterior cingulate cortex in Korsakoff's psychosis

Psychol Med. 1994 Feb;24(1):53-61. doi: 10.1017/s0033291700026829.

Abstract

The effects upon regional brain function of infusing either saline or clonidine (1.5 microgram/kg) has been examined in 18 patients with alcoholic Korsakoff's psychosis using 99mTc-hexamethylpropyleneamineoxime (99mTc-HMPAO or 99mTc-Exametazime) and Single Photon Emission Tomography (SPET or SPECT). The hypothesis tested was that frontal lobe function would be increased by adrenoceptor stimulation. This was confirmed by an increase in the uptake of 99mTc-Exametazime into anterior cingulate regions of the frontal lobes. Patients were scanned before and after saline or clonidine infusion during performance of a verbal fluency task. There was a significantly increased performance of verbal fluency in patients given clonidine. This effect was variable and could not be unequivocably distinguished from increases in performance in the saline treated group. Nevertheless, the increase in neuropsychological performance was also correlated with increased function in left dorsolateral frontal cortex within the clonidine treated group. An exploratory examination of other brain areas suggested that relative increases in posterior cingulate cortex and changes in the symmetry of function within the thalamus may also be produced by acute infusion of clonidine in Korsakoff patients. The findings support the idea that adrenergic mechanisms may modulate cognitive performance by actions on attentional systems within the brain. These appear to be located primarily within limbic cortex. It is, of course, notable that this can occur in patients with profound and disabling amnesia.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Alcohol Amnestic Disorder / complications
  • Alcohol Amnestic Disorder / diagnosis*
  • Alcohol Amnestic Disorder / metabolism
  • Cerebrovascular Circulation
  • Clonidine / pharmacology*
  • Cognition Disorders / diagnosis
  • Cognition Disorders / etiology
  • Frontal Lobe / diagnostic imaging
  • Frontal Lobe / drug effects
  • Frontal Lobe / metabolism
  • Gyrus Cinguli / diagnostic imaging
  • Gyrus Cinguli / drug effects
  • Gyrus Cinguli / metabolism*
  • Humans
  • Middle Aged
  • Psychiatric Status Rating Scales
  • Receptors, Adrenergic / drug effects
  • Single-Blind Method
  • Sodium Chloride / pharmacology*
  • Technetium Compounds* / pharmacokinetics
  • Tomography, Emission-Computed, Single-Photon
  • Verbal Behavior / drug effects

Substances

  • Receptors, Adrenergic
  • Technetium Compounds
  • Sodium Chloride
  • Clonidine