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PubMed1996

Amobarbital evaluation of neurobehavioral function prior to therapeutic occlusion of brain arteriovenous malformations: a new neuropsychological procedure.

Because untreated arteriovenous malformations (AVMs) frequently result in some form of permanent neurological complication, treatment of AVMs is aggressively pursued A relatively new treatment consists of sending micropellets into blood vessels supplying the AVM core to block blood flow and "shrink" the AVM When vessels supplying the AVM are thought to also irrigate vital portions of brain, evaluations of neurobehavioral function after injection of amobarbital into intracranial vessels (Wada testing) may be performed to prevent significant complications folIowing embolization This study details our preliminary experience with Wada testing and electroencephalography (EEG) prior to AVM embolization in seven patients Neurobehavioral functions were continuously monitored after injection of 50-75 mg of amobarbital into target cerebral vessels No change in sensorimotor, cognitive, or EEG functions were detected in any of the superselective Wada examinations Embolization was performed following all negative Wada evaluations The only irreversible complication after embolization was a superior quadrantanopia No other permanent neurobehavioral sequelae resulted from embolization These preliminary findings suggest that simultaneous Wada/EEG monitoring may be useful in predicting neurobehavioral complications prior to AVM embolization.

Journal Article↗
PubMed1963

FEAR AND PAIN: THEIR EFFECT ON SELF-INJECTION OF AMOBARBITAL SODIUM BY RATS.

Rats receiving occasional brief electric shocks pressed a bar, which caused them to be injected with amobarbital sodium, more frequently than the control rats to which they were yoked and which were injected when their partners pressed but whose own bar activated only a recorder. This differential effect was not shown by pairs run without shocks.

Amobarbital↗
PubMed1989

The intracarotid amobarbital sodium procedure. False-positive errors during recognition memory assessment.

Memory performance during the intracarotid amobarbital sodium (Amytal sodium) procedure was examined in 40 patients as part of their diagnostic work-up as candidates for epilepsy surgery. Free recall was significantly better following right hemisphere injection although no left/right difference was present during recognition assessment. However, the occurrence of false-positive (FP) recognition errors was significantly more frequent following left hemisphere injection. In all conditions, no relationship to seizure focus was observed. Patients with FP errors displayed poorer delayed verbal memory during baseline neuropsychological assessment compared with patients without FP errors. Data indicate an inverse relationship between FP errors and recent verbal memory function, and they suggest that impaired memory rather than failure to suppress incorrect responses secondary to poor self-monitoring capacity is responsible for the generation of FP and intrusion errors.

Adult↗
PubMed1984

Resumption of behavior following intracarotid sodium amobarbital injection.

Recovery rates of selected behaviors following intracarotid sodium amobarbital injection were examined in 17 patients with unilateral focal temporal lobe epilepsy. Left hemisphere injections resulted in more prolonged disruption of naming (p less than 0.00001), reading (p less than 0.0001), matching-to-sample behaviors (p less than 0.05), and short-term recognition memory for pictures (p less than 0.0001) and words (p less than 0.0003) than did right hemisphere injections. In addition, recovery of behaviors was prolonged if the injection was administered to the hemisphere contralateral to that with the primary seizure focus (p less than 0.005). A trend toward a similar pattern was seen in the postinjection electroencephalogram with the maximum slowing found in the injected hemisphere prolonged if the epileptic focus was in the contralateral hemisphere (p = 0.06). These findings suggest a negative effect of an epileptic lesion on the contralateral hemisphere.

Amobarbital↗
PubMed1977

A case of deficiency of N-hydroxylation of amobarbital.

It has been shown recently that the overall metabolism of amobarbital in man is essentially under genetic control. The drug normally undergoes two hydroxylation reactions, leading to 3'-hydroxyamobarbital (C-OH) and N-hydroxyamobarbital (N-OH). This paper describes a sibship in which two mothers who are identical twins show a gross deficiency on N-OH elimination in urine. The whole set of sibship data suggests that this deficiency represents a recessive trait controlled by a single pair of allelic autosomal genes which regulate N-OH formation. Several methodical approaches to assess an individual's capacity for N-OH formation are illustrated. There was no evidence of compensatory or concordant regulation of the two hydroxylation reactions. The case of this family illustrates that the functional lack of a biotransformation reaction is almost certain to be overlooked if one measures only the disappearance of a multimetabolized drug and not the appearance of metabolites.

Adolescent↗
PubMedDate not supplied

Efficacy and side effects of flurazepam and a combination of amobarbital and secobarbital in insomniac patients.

Flurazepam, 30 mg, was not more effective in inducing sleep than placebo. Barbiturates (100 mg amobarbital plus 100 mg secobarbital) were more effective in inducing and maintaining sleep than flurazepam or placebo. Contrary to work conducted in the sleep laboratory, the barbiturate hypnotics were still effective on the 14th night. Insomniacs performed poorly on psychomotor tests, but as a group they did not show statistically significant psychomotor impairment after the use of the hypnotics.

Adult↗
PubMed1997

The intracarotid amobarbital procedure: an historical perspective.

The intracarotid sodium amobarbital procedure (IAP) is currently regarded as the best method of the determination of hemispheric specialization for speech, and it is universally relied on as a prognostic test for patients with medically refractory epilepsy who are candidates for neurosurgical intervention. Since its initial development, the IAP also has been adapted for assessing lateralized mesiotemporal contributions to memory functioning in this patient population, and it is now in wide use for both basic and applied research in behavioral neuroscience on language, memory, visuospatial functions, emotion, attention, and consciousness. Despite the IAP's wide range of applications, little has been said about its history and development. This essay recounts and discusses this history.

Amobarbital↗
PubMed1997

A reconsideration of bilateral language representation based on the intracarotid amobarbital procedure.

Hemispheric language dominance was established for 368 epilepsy surgery candidates based on results of objective language performance during the intracarotid amobarbital procedure. Eight-three percent of patients were found to be left hemisphere dominant, while six percent were right dominant, and eleven percent demonstrated some degree of bilateral language representation. Bilateral patients were grouped according to modality-specific patterns of language performance in each hemisphere, with a majority demonstrating left hemisphere superiority in overall language processing. Variables affecting atypical language development are reviewed and results are considered in the context of previous research.

Adolescent↗
PubMed1997

Sodium amobarbital memory tests: what do they predict?

Severe transient postoperative memory deficits among epilepsy patients with resection from one temporal lobe may be indicative of increased risk for amnesia had more extensive removal of mesial structures occurred. Immediate postoperative testing may provide some validation for risk of amnesia as predicted by the intracarotid sodium amobarbital memory test (IAP-M). Thirty patients (24 not considered at risk for amnesia and 5 who failed the IAP-M) were tested on the first, second, and third days following resection from the right or left temporal lobe. Results suggest that the IAP-M paradigm used does not necessarily predict postoperative memory performance.

Amnesia↗
PubMed1997

Reading errors following right hemisphere injection of sodium amobarbital.

The role of the nondominant hemisphere in reading is controversial. We characterized the reading errors made by 64 right-handed adults with complex partial seizures (half with seizure foci on the right and half on the left), after right hemisphere injection of sodium amobarbital. Subjects were presented with 20 six-word sentences and all were found to have speech associated with the left hemisphere only. A variety of reading errors occurred, most of which fell under the syndrome of "neglect dyslexia" including deletions and substitutions of whole words on the left side of a line of text as well as within-word neglect errors. The nature of these errors indicated that they may have been caused by an interaction between a peripheral processing deficit and more centrally located conceptual knowledge of linguistic structure. Other errors could be attributed to a general decrease in attentional mechanisms. Neglect errors at the level of the sentence occurred in the absence of neglect errors at the level of the word although the converse was not true. This suggests that the latter may represent a more severe deficit in the mechanism that causes the former. A double dissociation existed between single word neglect dyslexia errors and "visual" errors, indicating separate processing mechanisms.

Adult↗
PubMed1980

Amobarbital sodium reduces successive gustatory contrast.

Amobarbital sodium (17.5 mg/kg) produced equivalent reductions in negative contrast when injected for the first time on either day 1 or 2 following a shift from 32% to 4% sucrose. These results differed from those obtained in earlier studies with chlordiazepoxide.

Amobarbital↗
PubMed1975

Binding of amobarbital, pentobarbital and diphenylhydantoin to blood cells and plasma proteins in healthy volunteers and uraemic patients.

By equilibrium dialysis of human plasma it has been shown that the binding of pentobarbital and diphenylhydantoin to plasma proteins is decreased in uraemic patients (46 and 74 per cent bound, respectively) compared to healthy volunteers (61 and 88 per cent bound). The degree of binding of pentobarbital was significantly correlated with that of diphenylhydantoin and amobarbital, which suggests similarity of their binding sites. Appreciable proportions of the drugs were found in blood cells both in healthy and uraemic subjects. As expected, the distribution of drugs in whole blood was different in the uraemics from healthy subjects, because of the decreased plasma protein binding and the lowered red cell count in uraemia. Analysis of the data showed that the ratio between the concentrations in blood cells and plasma water in uraemic patients was not significantly different from that in healthy subjects.

Adult↗
PubMed1975

Comparative drug elimination in man-diphenylhydantoin and amobarbital.

The concentration of 5,5-diphenylhydantoin (DPH) in serum was determined at selected time intervals in seven healthy male volunteers starting 10 h after an oral dose of 400 mg sodium DPH was given. The data were analyzed according to a one-compartment model assuming first-order kinetics. The mean serum half-life was 19.28 h +/- 5.87 (SD). A positive correlation coefficient (r=0.84, p less than 0.05) was found between the serum DPH half-life and the serum amobarbital half-life in the seven subjects. The urinary levels of free plus conjugated 5-(p-hydroxyphenyl)-5-phenyl-hydantoin were determined for 12 h periods over a minimum of two days following the 400 mg oral dose of sodium DPH. Subjects with a short DPH half-life tended to excrete in urine a greater amount of p-HPPH as compared to subjects with a long DPH half-life. In the case of one subject, the urinary excretion of p-HPPH plateaued five days after DPH administration and the apparent elimination half-life determined from the p-HPPH urinary excretion data was 19.16 h as compared to the value of 19.53 h calculated from the DPH serum levels.

Adult↗
PubMed1994

Quantitative analysis of the EEG in the intracarotid amobarbital procedure. I. Amplitude analysis.

Thirty-seven subjects underwent bilateral internal carotid artery injections of amobarbital prior to surgery for intractable epilepsy. The electroencephalogram (EEG) of these patients was continuously monitored during these 74 procedures and was later subjected to quantitative analysis. Topographic mapping of these data suggested that the areas of inactivation were largely restricted to the anterior 2/3 of the hemisphere injected, corresponding to the vascular distributions of the anterior and middle cerebral arteries. Graphical representation of the data demonstrated that delta and theta band activity peaked in the first 2 min post injection and decreased gradually thereafter, becoming stable at around 12 min post injection. Examination of the alpha, beta 1, and beta 2 bands suggested that activity increased and decreased more gradually than that for delta and theta, with perhaps a longer latency. Although EEG changes were most prominent in the anterior 2/3 of the inactivated hemisphere, similar (though smaller) changes were also observed in both ipsilateral and contralateral zones thought to be outside of the vascular distribution of the internal carotid artery.

Adolescent↗
PubMed1992

Interhemispheric dissociation of expressive and receptive language functions in patients with complex-partial seizures: an amobarbital study.

Bilateral intracarotid amobarbital procedures (IAP) were performed in 144 patients with medically intractable complex-partial seizures. As a result of language testing, 29 patients (20.1%) were found to have bilateral language representation to different degrees. In four (2.8%) of these patients--all right-handers with early onset of epilepsy and/or evidence of early brain damage--there was strong evidence of an interhemispheric dissociation of expressive and receptive language functions. Two of these patients had circumscribed temporal foci (one left, one right), and receptive language functions were represented in the hemisphere contralateral to the focus. One patient with a right frontal focus showed left-hemisphere dominance for expressive functions, while the fourth patient exhibited left-hemisphere dominance for receptive functions associated with a right temporo-parietal focus. It is argued that in these four cases the circumscribed functional and/or structural impairments have led to a shift of the anatomically associated language functions to the opposite hemisphere (rather than to neighboring regions of the same hemisphere). These findings substantiate the hypothesis that in special circumstances the anterior (expressive) language area can be located in one hemisphere and the posterior (receptive) area in the other.

Adolescent↗
PubMed1988

The amobarbital interview in a general hospital setting, friend or foe: a case report.

The amobarbital interview has been in use for over 50 years. Its clinical indications have been primarily as an aid in determining a diagnosis and in conducting psychotherapy. This article presents an overview of the procedure along with a brief historic perspective. A case is presented which highlights its potential clinical utility and shortcomings.

Adult↗
PubMed1984

Inhibition by phenobarbital and lack of effect of amobarbital on the development of liver tumors induced by N-nitrosodiethylamine in juvenile B6C3F1 mice.

The effects of phenobarbital (PB) and amobarbital (AB) on the rate of development of hepatocarcinogenesis induced by N-nitrosodiethylamine (DEN) were studied in mice. Groups of 40 B6C3F1 male mice were injected i.p. at 15 days of age with 5 micrograms DEN/g body wt. Beginning at 4 weeks of age, DEN treated groups were given either normal drinking water or water containing either 0.05% PB or AB for up to 36 weeks. DEN alone induced multiple focal hepatic lesions including hepatocellular foci, hepatocellular adenomas and trabecular carcinomas. Subsequent exposure to PB had a suppressing effect on DEN-induced hepatocarcinogenesis. Hepatocellular foci in PB-exposed mice were significantly smaller in size (area) and fewer in number throughout the study. Also, PB treatment either prolonged the latency period or significantly slowed the rate at which hepatocellular tumors developed in these mice. No such effects were seen in AB-exposed mice; AB neither inhibited nor promoted the development of focal hepatic lesions in DEN-pretreated mice. Possible mechanisms responsible for the inhibition of DEN-induced hepatocarcinogenesis include the feminizing effects of perinatal administration of PB.

Adenocarcinoma↗
PubMed1992

A compound score for estimating the influence of inattention and somnolence during the intracarotid amobarbital test.

Alterations in the level of consciousness may render the interpretation of the memory test results from the intracarotid amobarbital procedure difficult. The present study was designed to investigate the impact of inattention and somnolence on memory performance during the Amytal test. Nineteen consecutive patients undergoing the test were investigated. The memory test was constructed to comprise two consecutive parts with identical design, so as to make possible comparisons over time in the same patients. Reaction level and somnolence were continuously assessed during the procedure and a stimulus-task response test to evaluate the degree of attention was used. On the basis of these parameters a compound 'inattention score' was constructed. The results indicate that inattention and somnolence negatively influence memory performance and should be taken into account when evaluating the Amytal memory test results. In cases with poor memory results high inattention scores may speak in favour of preoperative hemisphere memory testing or a repeat injection with reduced Amytal dosage before deciding upon the extent of a planned resection. On the other hand, low inattention scores together with amnesia for the testing procedure may indicate that the memory test results can be relied on.

Adult↗