A Voxel-Based Analysis of FDG-PET in Traumatic Brain Injury: Regional Metabolism and Relationship between the Thalamus and Cortical Areas

被引:51
|
作者
Garcia-Panach, Javier [1 ,2 ]
Lull, Nuria [1 ,3 ]
Jose Lull, Juan [1 ]
Ferri, Joan [2 ]
Martinez, Carlos [4 ]
Sopena, Pablo [4 ]
Robles, Montserrat [1 ]
Chirivella, Javier [2 ]
Noe, Enrique [2 ]
机构
[1] Univ Politecn Valencia, Inst Aplicac Tecnol Informac & Comunicac Avanzada, Grp Informat Biomed, E-46071 Valencia, Spain
[2] Fdn Hosp NISA, Serv Dano Cerebral Hosp NISA, Valencia, Spain
[3] Univ CEU Cardenal Herrera, Valencia, Spain
[4] Hosp 9 Octubre, Serv PET Med Nucl, Valencia, Spain
关键词
cerebral metabolism; consciousness; functional imaging; head injury; image analysis; positron emission tomography; DIFFUSE AXONAL INJURY; CEREBRAL GLUCOSE-METABOLISM; MINIMALLY CONSCIOUS STATES; VEGETATIVE STATE; POSTTRAUMATIC AMNESIA; DEFAULT MODE; HEAD-INJURY; RECOVERY; LESIONS; CONNECTIVITY;
D O I
10.1089/neu.2011.1851
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
The objective was to study the correlations and the differences in glucose metabolism between the thalamus and cortical structures in a sample of severe traumatic brain injury (TBI) patients with different neurological outcomes. We studied 49 patients who had suffered a severe TBI and 10 healthy control subjects using 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET). The patients were divided into three groups: a vegetative or minimally-conscious state (MCS&VS) group (n=17), which included patients who were in a vegetative or a minimally conscious state; an In-post-traumatic amnesia (In-PTA) group (n=12), which included patients in PTA; and an Out-PTA group (n=20), which included patients who had recovered from PTA. SPM5 software was used to determine the metabolic differences between the groups. FDG-PET images were normalized and four regions of interest were generated around the thalamus, precuneus, and the frontal and temporal lobes. The groups were parameterized using Student's t-test. Principal component analysis was used to obtain an intensity-estimated-value per subject to correlate the function between the structures. Differences in glucose metabolism in all structures were related to the neurological outcome, and the most severe patients showed the most severe hypometabolism. We also found a significant correlation between the cortico-thalamocortical metabolism in all groups. Voxel-based analysis suggests a functional correlation between these four areas, and decreased metabolism was associated with less favorable outcomes. Higher levels of activation of the cortico-cortical connections appear to be related to better neurological condition. Differences in the thalamocortical correlations between patients and controls may be related to traumatic dysfunction due to focal or diffuse lesions.
引用
收藏
页码:1707 / 1717
页数:11
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