Voxel-based statistical analysis of thalamic glucose metabolism in traumatic brain injury: relationship with consciousness and cognition.
OBJECTIVE
To study the relationship between thalamic glucose metabolism and neurological outcome after severe traumatic brain injury (TBI).


METHODS
Forty-nine patients with severe and closed TBI and 10 healthy control subjects with (18)F-FDG PET were studied. Patients were divided into three groups: MCS&VS group (n = 17), patients in a vegetative or a minimally conscious state; In-PTA group (n = 12), patients in a state of post-traumatic amnesia (PTA); and Out-PTA group (n = 20), patients who had emerged from PTA. SPM5 software implemented in MATLAB 7 was used to determine the quantitative differences between patients and controls. FDG-PET images were spatially normalized and an automated thalamic ROI mask was generated. Group differences were analysed with two sample voxel-wise t-tests.


RESULTS
Thalamic hypometabolism was the most prominent in patients with low consciousness (MCS&VS group) and the thalamic hypometabolism in the In-PTA group was more prominent than that in the Out-PTA group. Healthy control subjects showed the greatest thalamic metabolism. These differences in metabolism were more pronounced in the internal regions of the thalamus.


CONCLUSIONS
The results confirm the vulnerability of the thalamus to suffer the effect of the dynamic forces generated during a TBI. Patients with thalamic hypometabolism could represent a sub-set of subjects that are highly vulnerable to neurological disability after TBI.
Lull
Nuria
N
Grupo de Informática Biomédica, Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA), Universidad Politécnica de Valencia, Valencia, Spain.
Noé
Enrique
E
Lull
Juan José
JJ
García-Panach
Javier
J
Chirivella
Javier
J
Ferri
Joan
J
López-Aznar
Diego
D
Sopena
Pablo
P
Robles
Montse
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000647:Amnesia / Q000000981:diagnostic imaging / Q000378:metabolism; D001930:Brain Injuries / Q000000981:diagnostic imaging / Q000378:metabolism*; D016022:Case-Control Studies; D003243:Consciousness / Q000502:physiology*; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018458:Persistent Vegetative State / Q000000981:diagnostic imaging / Q000378:metabolism; D011877:Radionuclide Imaging; D020127:Recovery of Function / Q000502:physiology*; D013788:Thalamus / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000503:physiopathology; D055815:Young Adult
D005947:Glucose