A study of persistent post-concussion symptoms in mild head trauma using positron emission tomography
- 1Department of Psychology, Indiana University – Purdue University Indianapolis (IUPUI), Indianapolis, Indiana, USA
- 2Department of Neurology, Indiana University School of Medicine, Indianapolis
- 3Departments of Radiology, Indiana University School of Medicine, Indianapolis
- 4Center of Neuropsychological Rehabilitation, Indianapolis
- Correspondence to: Dr S H Annabel Chen, Stanford School of Medicine, Radiology, Lucas MRS Imaging Center, 1201 Welch Road, MC: 5488, Stanford, CA 94305, USA;
- Received 10 November 2001
- Accepted 12 September 2002
- Revised 13 August 2002
Background: Complaints of persistent cognitive deficits following mild head trauma are often uncorroborated by structural brain imaging and neuropsychological examination.
Objective: To investigate, using positron emission tomography (PET), the in vivo changes in regional cerebral uptake of 2-[18F]fluoro-2-deoxy-D-glucose (FDG) and regional cerebral blood flow (rCBF) in patients with persistent symptoms following mild head trauma.
Methods: Five patients with mild head trauma and five age and education matched healthy controls were imaged using FDG-PET to measure differences in resting regional cerebral glucose metabolism. Oxygen-15 labelled water (H215O)-PET was also used to measure group differences in rCBF changes during a spatial working memory task. In addition, neuropsychological testing and self report of dysexecutive function and post-concussion symptoms were acquired to characterise the sample.
Results: There was no difference between patients and controls in normalised regional cerebral FDG uptake in the resting state in frontal and temporal regions selected a priori. However, during the spatial working memory task, patients had a smaller increase in rCBF than controls in the right prefrontal cortex.
Conclusions: Persistent post-concussive symptoms may not be associated with resting state hypometabolism. A cognitive challenge may be necessary to detect cerebral changes associated with mild head trauma.
- CVLT, California verbal learning test
- FLOPS, frontal lobe personality scale
- PCSC, postconcussion syndrome checklist
- ROI, region of interest
Competing interests: none declared