Archive of stories pre April 2007 | A severely brain damaged woman has shown dramatic improvement in mental function after taking an insomnia drug, doctors say. The result may offer hope to millions of people living with serious brain damage. It is the first reported case of the drug zolpidem helping an alert, non-comatose patient in this way. The woman, from the south of France, was left unable to eat, speak or move unaided - although she did understand single words - after her brain was deprived of oxygen (hypoxia) during an attempted suicide by hanging.
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After two years in this condition, she was given zolpidem (marketed as Ambien) following a bout of insomnia. Just 20 minutes later, as the drug hit her bloodstream, she was suddenly communicating with her family, eating and moving. Three hours later, as the drug waned, she returned to her usual state.
Circuit Loops
The patient's carers started giving her three pills a day. Christine Brefel-Courbon and colleagues at Toulouse University Hospital tested the woman and found the drug allowed her to stand and walk, repeat and read words, and name objects, although she was still unable to speak spontaneously.
"The patient has been maintained on zolpidem every day," Brefel-Courbon told New Scientist. "Up to now, she has always improved," without any sign that she is losing sensitivity to the drug.
Meanwhile, PET scans, which measure the blood flow and metabolic rate in different areas of the brain, showed the drug boosted activity in brain regions which showed no activity without the drug. The team thinks zolpidem turned on specific "loops" of circuitry in the brain associated with motivation, movement and speech.
However, Ralf Clauss at Royal Surrey County Hospital in Guildford, UK, who has treated a number of such patients (see Sleeping pill may rouse coma patients), thinks the drug's effect may be more generalised throughout the brain.
"Silent" Areas
"The work agrees with our findings," Clauss told New Scientist. PET scans of people with persistent brain damage often reveal areas that are "silent", or inactive, sometimes far from the actual damaged tissue.
"We find there's no obvious pattern to where these turn up," he says, but he suggests that they may be due to depletion of the neurotransmitter GABA. Zolpidem stimulates GABA receptors, which are active in different parts of the brain, not just the circuitry that triggers sleep.
Clauss's team has used zolpidem to successfully restore function in patients with hypoxia-induced brain damage resulting from stroke, injury and birth trauma. "We have one adult who suffered from birth trauma, who is now holding down a job for the first time after the drug improved their cognitive function," says Clauss.
Furthermore, New Scientist has learned that clinical trials are currently underway in South Africa by the drug company Regen Therapeutics, to see if the zolpidem can help other people with brain injuries.
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