title: Early metabolic crisis-related brain atrophy and cognition in traumatic brain injury.
abstract: Traumatic brain injury often results in acute metabolic crisis. We recently demonstrated that this is associated with chronic brain atrophy, which is most prominent in the frontal and temporal lobes. Interestingly, the neuropsychological profile of traumatic brain injury is often characterized as 'frontal-temporal' in nature, suggesting a possible link between acute metabolic crisis-related brain atrophy and neurocognitive impairment in this population. While focal lesions and diffuse axonal injury have a well-established role in the neuropsychological deficits observed following traumatic brain injury, no studies to date have examined the possible contribution of acute metabolic crisis-related atrophy in the neuropsychological sequelae of traumatic brain injury. In the current study we employed positron emission tomography, magnetic resonance imaging, and neuropsychological assessments to ascertain the relationship between acute metabolic crisis-related brain atrophy and neurocognitive outcome in a sample of 14 right-handed traumatic brain injury survivors. We found that acute metabolic crisis-related atrophy in the frontal and temporal lobes was associated with poorer attention, executive functioning, and psychomotor abilities at 12 months post-injury. Furthermore, participants with gross frontal and/or temporal lobe atrophy exhibited numerous clinically significant neuropsychological deficits in contrast to participants with other patterns of brain atrophy. Our findings suggest that interventions that reduce acute metabolic crisis may lead to improved functional outcomes for traumatic brain injury survivors.
authors: Los Angeles Biomedical Research Institute, Psychology Division, Department of Psychiatry, Harbor-University of California, Los Angeles Medical Center, 1124 W. Carson St., B-4 South (Box 490), Torrance, CA, 90502, USA, mwright@labiomed.org.
authors: Matthew J
authors: MJ
authors: Wright
authors: David L
authors: DL
authors: McArthur
authors: Jeffry R
authors: JR
authors: Alger
authors: Jack
authors: J
authors: Van Horn
authors: Andrei
authors: A
authors: Irimia
authors: Maria
authors: M
authors: Filippou
authors: Thomas C
authors: TC
authors: Glenn
authors: David A
authors: DA
authors: Hovda
authors: Paul
authors: P
authors: Vespa
mesh_terms: D000328:Adult; D001284:Atrophy / Q000473:pathology / Q000503:physiopathology; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D001928:Brain Diseases, Metabolic / Q000473:pathology* / Q000503:physiopathology*; D001930:Brain Injuries / Q000150:complications / Q000473:pathology* / Q000503:physiopathology*; D003071:Cognition; D003072:Cognition Disorders / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D017741:Survivors
references: J Neurol Neurosurg Psychiatry. 2001 Oct;71(4):521-4
references: 11561038
references: Front Neuroinform. 2009 Jul 20;3:22
references: 19649168
references: Trends Cogn Sci. 2003 Jun;7(6):241-245
references: 12804689
references: Brain Inj. 2005 Feb;19(2):101-8
references: 15841754
references: Neurosurgery. 1992 Nov;31(5):975-8
references: 1436429
references: Neuropsychologia. 1980;18(3):369-72
references: 7413071
references: J Neurol Neurosurg Psychiatry. 2002 Aug;73(2):173-81
references: 12122177
references: J Clin Exp Neuropsychol. 2003 Oct;25(7):933-48
references: 13680441
references: Brain. 2007 Oct;130(Pt 10):2508-19
references: 17872928
references: Med Image Anal. 2002 Jun;6(2):129-42
references: 12045000
references: Brain Inj. 2001 May;15(5):401-12
references: 11350654
references: J Clin Exp Neuropsychol. 2009 Oct;31(7):790-802
references: 19142773
references: Neuropsychology. 2004 Jan;18(1):104-14
references: 14744193
references: Crit Care Med. 2008 Oct;36(10):2871-7
references: 18766106
references: J Clin Exp Neuropsychol. 2005 Nov;27(8):977-1021
references: 16207622
references: Hippocampus. 1998;8(3):205-11
references: 9662135
references: Neuroreport. 1994 Jul 21;5(12):1517-21
references: 7948852
references: J Neurol Neurosurg Psychiatry. 1995 Sep;59(3):328-31
references: 7673970
references: J Cereb Blood Flow Metab. 2010 Apr;30(4):883-94
references: 20029449
references: Neuroreport. 1997 Sep 8;8(13):2893-6
references: 9376526
references: Crit Care Med. 2007 Dec;35(12):2830-6
references: 18074483
references: J Nucl Med. 2003 Nov;44(11):1709-16
references: 14602850
references: Histopathology. 1989 Jul;15(1):49-59
references: 2767623
references: J Neurol Sci. 2000 Dec 1;181(1-2):19-28
references: 11099707
references: Clin Neuropsychol. 2000 Feb;14(1):110-8
references: 10855064
references: Cereb Cortex. 2004 Apr;14(4):410-23
references: 15028645
references: JAMA. 1999 Sep 8;282(10):974-83
references: 10485684
references: J Cereb Blood Flow Metab. 1992 Mar;12(2):179-92
references: 1548291
references: J Cereb Blood Flow Metab. 2005 Jun;25(6):763-74
references: 15716852
references: J Head Trauma Rehabil. 2011 May-Jun;26(3):182-91
references: 21552067
references: J Clin Exp Neuropsychol. 2010 Aug;32(7):728-36
references: 20175012
references: Neuropsychology. 2004 Apr;18(2):353-61
references: 15099157
references: J Cereb Blood Flow Metab. 2003 Oct;23(10):1239-50
references: 14526234
references: J Clin Pathol. 1980 Dec;33(12):1132-45
references: 7451661
references: J Clin Exp Neuropsychol. 1985 Jun;7(3):251-63
references: 3998090
references: Brain Inj. 2005 Apr;19(4):239-56
references: 15832870
references: Eur J Neurosci. 2004 Jun;19(12):3365-70
references: 15217392
references: Brain Pathol. 2004 Apr;14(2):210-4
references: 15193034
references: Int Rev Neurobiol. 1994;37:243-69; discussion 285-8
references: 7883480
references: J Neurol Neurosurg Psychiatry. 2002 Sep;73(3):289-93
references: 12185160
references: J Head Trauma Rehabil. 2001 Apr;16(2):117-34
references: 11275574