Effects of Disulfiram on Positron Emission Tomography and Neuropsychological Studies in Severe Chronic Alcoholism

doi:10.1111/j.1530-0277.1996.tb01149.x

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Wiley InterScience

Alcoholism: Clinical and Experimental Research

Volume 20 Issue 8, Pages 1456 - 1461

Published Online: 11 Apr 2006

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Effects of Disulfiram on Positron Emission Tomography and Neuropsychological Studies in Severe Chronic Alcoholism

Sid Gilman ¹ ⁶ , Kenneth M. Adams ¹ ² ⁵ ⁶ , Doug Johnson-Greene ¹ ² ⁵ ⁶ , Robert A. Koeppe ³ , Larry Junck ¹ ⁶ , Karen J. Kluin ¹ ⁴ ⁶ , Susan Martorello ¹ ⁶ , Mary Heumann ¹ Elizabeth Hill ¹ ⁶

¹ Department of Neurology, University of Michigan, Ann Arbor, Michigan. ² Division of Neuropsychology, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan. ³ Division of Nuclear Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan. ⁴ Division of Speech Pathology, Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan. ⁵ Psychology Service, Ann Arbor Veterans Affairs Medical Center, Ann Arbor, Michigan. ⁶ University of Michigan Alcohol Research Center, Ann Arbor, Michigan.

Correspondence to Reprint requests: Sid Gilman MD, Professor and Chair, Department of Neurology, University of Michigan Medical Center, IS00 E. Medical Center Dr., Ann Arbor, MI 48109-0316.

These investigations were supported in part by National Institutes of Health grants AA 07378 (University of Michigan Alcohol Research Center) and AG 08671 (Michigan Alzheimer's Disease Research Center) and by a sharing agreement for positron emission tomography studies between the Ann Arbor Veterans Affairs Medical Center and the University of Michigan.

KEYWORDS

Positron Emission Tomography • Disulfiram • Alcoholism • Fluorodeoxyglucose • Flumazenil

ABSTRACT

Disulfiram is an aldehyde dehydrogenase inhibitor that is widely used as an adjunctive agent in the treatment of patients with severe chronic alcoholism. Recent positron emission tomography (PET) studies of local cerebral metabolic rates for glucose (ICMRglc) and benzodiazepine receptor binding in alcoholic patients have shown regional cerebral abnormalities; however, some of the patients were studied while receiving disulfiram, which could influence the biochemical processes under investigation. In a retrospective investigation, we examined the influence of disulfiram administration on the results of PET studies of ICMRglc and benzodiazepine receptor binding and neuropsychological tests of cognition and executive function in patients with severe chronic alcoholism. [¹⁸F]Fluorodeoxyglucose was used to measure ICMRglc in 48 male patients, including 11 receiving and 37 not receiving disulfiram in therapeutic doses. [¹¹C]Flumazenil was used to measure benzodiazepine receptor binding in 17 male patients, including 3 receiving and 14 not receiving disulfiram. All patients studied with FMZ were also examined with fluorodeoxyglucose. PET studies of ICMRglc revealed significantly decreased global values in the patients receiving disulfiram compared with those not receiving disulfiram. PET studies of benzodiazepine receptor binding revealed decreased flumazenil influx and distribution volume in patients receiving disulfiram. The neuropsychological tests demonstrated no differences between the two groups of subjects. The findings suggest that disulfiram may influence the results of PET studies of glucose metabolism and benzodiazepine receptor binding.

Received for publication May 20, 1996; accepted July 30, 1996

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1530-0277.1996.tb01149.x About DOI