Clinical and imaging evidence of zolpidem effect in hypoxic encephalopathy

Ann Neurol. 2007 Jul;62(1):102-5. doi: 10.1002/ana.21110.


We conducted a randomized, double-blind, placebo-controlled, single-patient (N = 1) trial to evaluate the efficacy of zolpidem in a 48-year-old woman with an akinetic mutism. Motor and cognitive examinations and functional imaging were performed. Acute administration of zolpidem markedly improved motor performance and neuropsychological status. Cerebral metabolism ((18)F-fluorodeoxyglucose positron emission tomography) increased in postrolandic territories and in frontal cortex. Using the H(2) (15)O positron emission tomography, we found a drug-induced activation in the anterior cingulate and orbitofrontal cortices. Zolpidem induced a transient improvement in motor and cognitive performances. This paradoxical effect could result from an activation of limbic loops modulating motivational processes.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Double-Blind Method
  • Female
  • Fluorodeoxyglucose F18 / pharmacokinetics
  • GABA Agonists / therapeutic use*
  • Humans
  • Hypoxia, Brain / diagnostic imaging*
  • Hypoxia, Brain / drug therapy*
  • Middle Aged
  • Neuropsychological Tests
  • Positron-Emission Tomography*
  • Pyridines / therapeutic use*
  • Zolpidem


  • GABA Agonists
  • Pyridines
  • Fluorodeoxyglucose F18
  • Zolpidem