Opiate intoxication has been associated with life-threatening effects of sympathetic suppression and respiratory depression, but current literature is limited in describing its neurotoxic effects on the central nervous system. Here, we present the case of an otherwise high-functioning adolescent male who was found unresponsive after ingestion of approximately 3–4 fake oxycodone 10–325 mg pills laced with fentanyl. Magnetic resonance imaging showed evidence of diffuse T2 hyperintensities in the corpus callosum and bilateral frontal, parietal, and cerebellum indicative of diffuse white matter injury. In addition, there were distinct areas of restricted diffusion in the bilateral basal ganglia concerning for oxidative stress-mediated neuronal loss. His neurological exam improved with supportive treatment over the course of his hospitalization. Although limited literature has shown leukoencephalopathy to be associated with opioid overdose, we present a case of additional involvement of subcortical gray matter.
Methylphenidate is one of the most common pharmaceutical treatments for Attention Deficit Hyperactive Disorder (ADHD). It is also gaining popularity as a cognitive enhancement and recreational substance. The current study assesses the long-term effects of methylphenidate (MPD) on the circadian rhythm activity pattern of adolescent and adult male Sprague-Dawley (SD) rats. The experiment lasted for 11 days of non-stop recording, the evaluation was divided into 4 phases: acute, induction, washout, and expression phases. Circadian rhythm changes in each phase were compared between the adolescent and adult rats using the following parameters MESOR (midline estimating statistic of rhythm) or average activity, amplitude (distance from MESOR to the peak activity), and acrophase (time at which peak amplitude occurs). Overall, more significant changes in circadian rhythm pattern among adult rats were observed as compared to adolescent rats. As the circadian rhythm governs the diurnal locomotor activity pattern, changes in the locomotor pattern induced by chronic treatment MPD indicate that the drug exerts a long-term effect on the circadian rhythm.
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