title: Separating functional and structural damage in persistent vegetative state using combined voxel-based analysis of 3-D MRI and FDG-PET.
abstract: Functional and structural damage in postanoxic persistent vegetative state (PVS) was analysed using 18fluorodeoxyglucose PET (FDG-PET) coregistered to 3-D MRI in combination with morphometric 3-D MRI analysis (voxel-based morphometry, VBM). In five patients in late stages of non-traumatic PVS, combined analysis using statistical parametric mapping (SPM2) was performed to compare metabolic impairment and structural loss. FDG-PET showed widespread hypometabolism at p<0.001 (corrected) in the parietal, parietooccipital and frontotemporal cortices, cingulum, frontal medial and precentral gyrus, and within the bilateral thalamus. VBM revealed multilocal structural loss at p<0.001 (corrected) in the inferior parietal and superior/medial frontal cortices, insula and operculum, superior and medial temporal lobes, cingulum and fusiform gyrus, caudate, midbrain, dorsal pons, and the cerebellum, but to a lesser extent in the thalamus. The selective vulnerability of the brain in a sample of PVS patients could be mapped in vivo, indicating that a complex structural and functional lesion pattern of the cerebral networks seems to be associated with this condition.
authors.affiliation: Department of Nuclear Medicine, University of Bern, Switzerland.
authors.forename: Freimut D
authors.initials: FD
authors.lastname: Juengling
authors.forename: Jan
authors.initials: J
authors.lastname: Kassubek
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Huppertz
authors.forename: Thomas
authors.initials: T
authors.lastname: Krause
authors.forename: Thomas
authors.initials: T
authors.lastname: Els
mesh_terms: D000328:Adult; D001284:Atrophy / Q000175:diagnosis* / Q000000981:diagnostic imaging; D001921:Brain / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology*; D002560:Cerebrovascular Circulation / Q000502:physiology; D004734:Energy Metabolism / Q000502:physiology; D005260:Female; D019788:Fluorodeoxyglucose F18; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000150:complications*; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009415:Nerve Net / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D018458:Persistent Vegetative State / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D049268:Positron-Emission Tomography / Q000379:methods
chemical_list: D019788:Fluorodeoxyglucose F18