A Systematic Review of the Literature on the Effects of Dexamethasone on the Brain From In Vivo Human-Based Studies: Implications for Physiological Brain Imaging of Patients With Intracranial Tumors
- 1 December 2010
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Neurosurgery
- Vol. 67 (6), 1799-1815
- https://doi.org/10.1227/neu.0b013e3181fa775b
Abstract
Among glucocorticoids, dexamethasone is most widely used for treatment of cerebral edema because of its long biological half-life and its low mineralocorticoid activity (sodium retaining). A systematic review of the literature on the effects of dexamethasone on the brain from in vivo studies in humans. A MEDLINE database search (via the PubMed interface) and an EMBASE database search (via the Dialog interface) of the past 35 years was performed. Every article relating to human use reported in English was included. In addition, references of all eligible articles were searched to identify other possible sources. Twenty-four articles matched the eligibility criteria. There were disparate methodologies and conflicting results, although they tended to indicate a decrease in blood-tumor barrier permeability, decreased tumoral perfusion, decreased tumoral diffusivity, and the possibility of decreased perfusion in contralateral normal-appearing brain tissue. Treatment with dexamethasone may alter imaging parameters from cerebral perfusion studies used in the management of brain tumors. In adequately powered studies, it may be possible to assess the longer term effects of dexamethasone on normal brain tissue to help optimize use with longer term survivors that are emerging as improvements in glioma treatment are made.Keywords
This publication has 111 references indexed in Scilit:
- Glucocorticoids shift arachidonic acid metabolism toward endocannabinoid synthesis: A non-genomic anti-inflammatory switchEuropean Journal of Pharmacology, 2008
- The use and toxicity of steroids in the management of patients with brain metastasesSupportive Care in Cancer, 2008
- Diffusion tensor imaging in children and adolescents: Reproducibility, hemispheric, and age-related differencesNeuroImage, 2007
- Assessing DTI data quality using bootstrap analysisMagnetic Resonance in Medicine, 2004
- Reproducibility of localized 2D correlated MR spectroscopyMagnetic Resonance in Medicine, 2002
- Diffusion‐tensor MRI: theory, experimental design and data analysis – a technical reviewNMR in Biomedicine, 2002
- High resolution measurement of cerebral blood flow using intravascular tracer bolus passages. Part I: Mathematical approach and statistical analysisMagnetic Resonance in Medicine, 1996
- The effect of steroid on thallium-201 uptake by malignant gliomasEuropean Journal of Nuclear Medicine and Molecular Imaging, 1996
- The effects of dexamethasone on experimental brain tumors: I. Transcapillary transport and blood flow in RG-2 rat gliomasJournal of Neuro-Oncology, 1995
- The effects of dexamethasone on transcapillary transport in experimental brain tumors: II. Canine brain tumorsJournal of Neuro-Oncology, 1995