{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T15:56:52Z","timestamp":1787673412590,"version":"build-2736575974"},"reference-count":15,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2011,12,30]],"date-time":"2011-12-30T00:00:00Z","timestamp":1325203200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Neuroimaging"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:sec><jats:title>ABSTRACT<\/jats:title><\/jats:sec><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Methadone intoxication can cause respiratory depression, leading to hypoxia with subsequent coma and death. Delayed postanoxic leukoencephalopathy (DAL) has been reported with intoxication by carbon monoxide, narcotics, and other toxins.<\/jats:p><\/jats:sec><jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>To investigate the metabolic derangement of the white matter (WM) and blood\u2013brain barrier (BBB) after DAL caused by methadone overdose.<\/jats:p><\/jats:sec><jats:sec><jats:title>DESIGN, SETTING, AND PATIENTS<\/jats:title><jats:p>Case report of 2 patients with DAL after a single dose of \u201cdiverted\u201d methadone used for pain control.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>In both cases brain magnetic resonance imaging (MRI) revealed initial extensive bilateral restricted diffusion lesions within the WM. Follow\u2010up MRI using proton magnetic resonance spectroscopic imaging (<jats:sup>1<\/jats:sup>H\u2010MRSI) showed markedly lower N\u2010acetylaspartate and higher choline within the WM. BBB permeability, calculated by Patlak graphical analysis of MRI T1 data obtained after contrast agent injection, showed disruption of the BBB within the WM lesions, which persisted longer than a year in 1 patient. Neuropsychological evaluation showed executive dysfunction in both patients. After 1 year, one patient recovered whereas the second remained impaired.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Methadone overdose can cause DAL with profound disturbances of neural metabolism and the BBB. The time course of these disturbances can be monitored with MR methods.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1552-6569.2011.00669.x","type":"journal-article","created":{"date-parts":[[2011,12,30]],"date-time":"2011-12-30T17:15:50Z","timestamp":1325265350000},"page":"441-444","source":"Crossref","is-referenced-by-count":14,"title":["Imaging of Subacute Blood\u2013Brain Barrier Disruption After Methadone Overdose"],"prefix":"10.1111","volume":"23","author":[{"given":"Branko N.","family":"Huisa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Gasparovic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saeid","family":"Taheri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jillian L.","family":"Prestopnik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary A.","family":"Rosenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,12,30]]},"reference":[{"key":"e_1_2_7_2_2","first-page":"1353","article-title":"Methadone treatment for pain states","volume":"71","author":"Toombs JD","year":"2005","journal-title":"Am Fam Physician"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneurol.2007.7"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005072-197301000-00008"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.49.5.1400"},{"key":"e_1_2_7_6_2","first-page":"1763","article-title":"Reversible delayed posthypoxic leukoencephalopathy","volume":"27","author":"Molloy S","year":"2006","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1962.03620190020003"},{"key":"e_1_2_7_8_2","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1176\/jnp.2008.20.4.473","article-title":"Clinical and diagnostic features of delayed hypoxic leukoencephalopathy","volume":"20","author":"Shprecher DR","year":"2008","journal-title":"J Neuropsychiatry Clin Neurosci"},{"key":"e_1_2_7_9_2","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1002\/mrm.22686","article-title":"Quantitative measurement of blood\u2010brain barrier permeability in human using dynamic contrast\u2010enhanced mri with fast t1 mapping","volume":"65","author":"Taheri S","journal-title":"Magn Reson Med"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.29.10.2189"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.brainres.2009.05.025"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-009-5057-y"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.56.8.919"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.jnen.0000235123.05677.4b"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1602\/neurorx.1.1.26"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000221308.94473.14"}],"container-title":["Journal of Neuroimaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1552-6569.2011.00669.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1552-6569.2011.00669.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T07:06:40Z","timestamp":1698649600000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1552-6569.2011.00669.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,12,30]]},"references-count":15,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2013,7]]}},"alternative-id":["10.1111\/j.1552-6569.2011.00669.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1552-6569.2011.00669.x","archive":["Portico"],"relation":{},"ISSN":["1051-2284","1552-6569"],"issn-type":[{"value":"1051-2284","type":"print"},{"value":"1552-6569","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,12,30]]}}}