rss
J Neurol Neurosurg Psychiatry 2006;77:856-862 doi:10.1136/jnnp.2005.080523
  • Paper

Relationship between regional cerebral metabolism and consciousness disturbance in traumatic diffuse brain injury without large focal lesions: an FDG-PET study with statistical parametric mapping analysis

  1. N Nakayama1,
  2. A Okumura2,
  3. J Shinoda2,
  4. T Nakashima3,
  5. T Iwama4
  1. 1Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Kizawa Memorial Hospital, Minokamo City, Gifu
  2. 2Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Kizawa Memorial Hospital, Minokamo City, Gifu, Japan
  3. 3Department of Neurosurgery, Gifu Prefectural Gifu Hospital, Gifu
  4. 4Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu
  1. Correspondence to:
 Dr Noriyuki Nakayama
 Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Kizawa Memorial Hospital, 630 Shimokobi, Kobi-cho, Minokamo City, Gifu 505-0034, Japan; doctor.1{at}jasmine.ocn.ne.jp
  • Received 16 September 2005
  • Accepted 23 February 2006
  • Revised 23 January 2006
  • Published Online First 20 March 2006

Abstract

Background: The cerebral metabolism of patients in the chronic stage of traumatic diffuse brain injury (TDBI) has not been fully investigated.

Aim: To study the relationship between regional cerebral metabolism (rCM) and consciousness disturbance in patients with TDBI.

Methods: 52 patients with TDBI in the chronic stage without large focal lesions were enrolled, and rCM was evaluated by fluorine-18-fluorodeoxyglucose positron emission tomography (FDG-PET) with statistical parametric mapping (SPM). All the patients were found to have disturbed consciousness or cognitive function and were divided into the following three groups: group A (n = 22), patients in a state with higher brain dysfunction; group B (n = 13), patients in a minimally conscious state; and group C (n = 17), patients in a vegetative state. rCM patterns on FDG-PET among these groups were evaluated and compared with those of normal control subjects on statistical parametric maps.

Results: Hypometabolism was consistently indicated bilaterally in the medial prefrontal regions, the medial frontobasal regions, the cingulate gyrus and the thalamus. Hypometabolism in these regions was the most widespread and prominent in group C, and that in group B was more widespread and prominent than that in group A.

Conclusions: Bilateral hypometabolism in the medial prefrontal regions, the medial frontobasal regions, the cingulate gyrus and the thalamus may reflect the clinical deterioration of TDBI, which is due to functional and structural disconnections of neural networks rather than due to direct cerebral focal contusion.

Footnotes

  • Published Online First 20 March 2006

  • Competing interests: None declared.

This Article

  1. Abstract
  2. Full text
  3. PDF
  4. All versions of this article:
    1. jnnp.2005.080523v1
    2. 77/7/856 most recent

Responses

  1. Submit a response
  2. No responses published

Register for free content

The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.

BMJ Careers - Latest neurology and neurosurgery jobs