The previous studies on the symptomatic effect of zolpidem on apathy have been reported in neurological disorders such as strokes and post‐anoxic brain injuries. However, such an impact is not explored in the white‐matter disease of the brain. This study was done as a Multimodal neurometabolic investigation of the effects of zolpidem on leukoencephalopathy‐related apathy.
In this study, a 38‐year‐old patient was enrolled. The patient was presenting with severe apathy related to a genetic leukoencephalopathy but showing marked improvement of indifference after taking 10 mg of zolpidem was studied. A multimodal neurometabolic approach using 18F FDG‐PET and undertook MRS sequence for GABA and glutamine + glutamate metabolism was to understand what may mediate such a clinical effect.
In apathy’s cognitive domain, the researchers observed no improvement and no change in metabolism in the dorsolateral frontal cortex. Post‐zolpidem, MRS showed increased GABA and glutamine + glutamate levels in the frontal cortex and pallidum.
This study’s findings suggest that zolpidem’s effects on apathy are related to increased metabolism in the orbitofrontal cortex and basal ganglia secondary to GABA modulation. Zolpidem may improve apathy in other white‐matter disorders.
Reference: https://onlinelibrary.wiley.com/doi/10.1111/ene.14465
