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Reduced cerebral glucose metabolism and increased brain capillary permeability following high‐dose methotrexate chemotherapy: A positron emission tomographic study
Author(s) -
Phillips Peter C.,
Dhawan Vijay,
Strother Stephen C.,
Sidtis John J.,
Evans Alan C.,
Allen Jeffrey C.,
Rottenberg David A.
Publication year - 1987
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.410210111
Subject(s) - positron emission tomography , methotrexate , medicine , blood–brain barrier , chemotherapy , endocrinology , metabolism , pharmacology , neurotoxicity , toxicity , anesthesia , nuclear medicine , central nervous system
Regional glucose metabolic rate constants and blood‐to‐brain transport of rubidium were estimated using positron emission tomography in an adolescent patient with a brain tumor, before and after chemotherapy with intravenous high‐dose methotrexate. Widespread depression of cerebral glucose metabolism was apparent 24 hours after drug administration, which may reflect reduced glucose phosphorylation, and the influx rate constant for 82 Rb was increased, indicating a drug‐induced alteration in blood–brain barrier function. Associated changes in neuropsychological performance, electroencephalogram, and plasma amino acid concentration were identified in the absence of evidence of systemic methotrexate toxicity, suggesting primary methotrexate neurotoxicity.