title: Statistical image analysis of cerebral glucose metabolism in patients with cognitive impairment following diffuse traumatic brain injury.
abstract: The aim of this study was to explore the regional cerebral glucose metabolism (rCM) in patients with chronic stage traumatic brain injury (TBI) compared with normal controls. We also investigated the relationship between regional cerebral glucose metabolism and cognitive function. We performed 2-[(18)F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) study using statistical parametric mapping (SPM) analysis in 36 diffuse axonal injury (DAI) patients (mean age +/- SD, 36.3 +/- 9.8 years). At 6 months or more after head injury, all patients underwent FDG-PET study and neuropsychological batteries to assess cognitive function. Thirty healthy, gender-matched control subjects who were comparable in age were also studied. Between the TBI patients and normal controls, group comparisons showed regional metabolic decreases in the bilateral frontal lobes, temporal lobes, thalamus, as well as the right cerebellum in the TBI group. Only full-scale Intelligence Quotient (IQ) (mean +/- SD, 78.5 +/- 11.9) correlated positively with rCM in the right cingulate gyrus and the bilateral medial frontal gyrus. In other examinations, the correlation was not provided. DAI may induce functional disconnection and decreased neuronal activity, and finally lead to diffuse glucose hypometabolism. Low full-scale IQ scores may be related to significantly different underlying cognitive impairment. In supporting cognitive function following TBI, which showed diffuse cerebral metabolic reduction compared with normal controls, medial prefrontal cortex and anterior cingulate cortex may be an important component.
authors.affiliation: Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Kizawa Memorial Hospital, Minokamo City, Gifu, Japan. nou-taka@a.email.ne.jp
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kato
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Nakayama
authors.forename: Yuto
authors.initials: Y
authors.lastname: Yasokawa
authors.forename: Ayumi
authors.initials: A
authors.lastname: Okumura
authors.forename: Jun
authors.initials: J
authors.lastname: Shinoda
authors.forename: Toru
authors.initials: T
authors.lastname: Iwama
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000150:complications / Q000000981:diagnostic imaging / Q000378:metabolism*; D001931:Brain Mapping / Q000379:methods; D002531:Cerebellum / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000293:injuries* / Q000378:metabolism*; D003072:Cognition Disorders / Q000000981:diagnostic imaging / Q000209:etiology / Q000378:metabolism*; D004185:Disability Evaluation; D015536:Down-Regulation / Q000502:physiology; D005260:Female; D019788:Fluorodeoxyglucose F18; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D005947:Glucose / Q000378:metabolism*; D006179:Gyrus Cinguli / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007360:Intelligence / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D049268:Positron-Emission Tomography / Q000379:methods; D011237:Predictive Value of Tests; D013702:Temporal Lobe / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D013788:Thalamus / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology
chemical_list: D019788:Fluorodeoxyglucose F18; D005947:Glucose