EFFECTS OF BIFEMELANE HYDROCHLORIDE ON CEREBRAL-CIRCULATION AND METABOLISM IN PATIENTS WITH APHASIA

The effects of bifemelane hydrochloride on aphasia and on cerebral cir culation and metabolism were studied using positron emission tomograph y (PET) in 10 aphasic patients with cerebrovascular disease. After the first PET scan, bifemelane was administered orally three times in a d aily dose of 150 mg. Aphasic features, such as fluency, auditory compr ehension, object naming, and repetition, were evaluated by using the W estern Aphasia Battery (Japanese edition) before and at least 2 months after bifemelane treatment. Simultaneous with the evaluation of aphas ia, the PET scans were performed by using the steady-state method with O-15 gases inhalation. All aphasic features, except fluency, improved significantly after bifemelane treatment. Regional cerebral blood flo w (rCBF) and the cerebral metabolic rate for oxygen (CMRO2) were incre ased at every brain region of interest, and the oxygen extraction frac tion was decreased. Both rCBF and CMRO2 were significantly increased o n the left inferior frontal gyrus, superior temporal gyrus, white matt er of the parietal lobe, and insula. These results suggest that bifeme lane improves both cerebral oxygen metabolism and cerebral circulation and contributes to the improvement of aphasia caused by cerebrovascul ar disease.