1. Alterations in cerebral glucose metabolism as measured by 18F-fluorodeoxyglucose-PET in patients with persistent postconcussion syndrome
- Author
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George Zabrecky, Andrew B. Newberg, Chloe Hriso, Nancy Wintering, Daniela Monti, Abass Alavi, Eric M Teichner, Jason C You, and Anthony J. Bazzan
- Subjects
Adult ,Male ,cognition ,medicine.medical_specialty ,Traumatic brain injury ,medicine.medical_treatment ,cerebral glucose metabolism ,030218 nuclear medicine & medical imaging ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Text mining ,Fluorodeoxyglucose F18 ,Internal medicine ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Pathological ,Rehabilitation ,business.industry ,Working memory ,18F-fluorodeoxyglucose-PET ,traumatic brain injury ,Postconcussion syndrome ,Brain ,Cognition ,Original Articles ,General Medicine ,Middle Aged ,medicine.disease ,humanities ,Mood ,Positron-Emission Tomography ,030220 oncology & carcinogenesis ,ComputingMethodologies_DOCUMENTANDTEXTPROCESSING ,concussion ,Cardiology ,business - Abstract
Supplemental Digital Content is available in the text., Background Many patients who have traumatic brain injury experience a wide range of psychiatric and neurological symptoms (including impairment in functional status, cognition, and mood), and if persistent are referred to as persistent postconcussion syndrome (PCS). To our knowledge, this is the first study to broadly evaluate metabolic dysregulation in a heterogenous patient population meeting the criteria for PCS. Methods A total of 64 PCS patients and 37 healthy controls underwent 18F-fluorodeoxyglucose-PET (18F-FDG-PET) scanning, and 70 brain structures (including left and right structures where appropriate) were analyzed in each subject. Results Compared to the brains of healthy controls, those of PCS patients demonstrated 15 hypermetabolic and 23 hypometabolic regions. Metabolic changes in the brains of PCS patients were subsequently correlated with various indices of symptom severity, mood, and physical/cognitive function. Among PCS patients, increased metabolism in the right cingulate gyrus correlated with the severity of postconcussion symptoms. Conversely, increased metabolism in the left temporal lobe was associated with both improved mood and measures of adaptability/rehabilitation. Furthermore, increased metabolism in the bilateral orbitofrontal regions correlated with improved working memory. Conclusions Overall, these findings suggest a complex pattern of cerebral metabolism in PCS patients, with a mixture of hypometabolic and hypermetabolic regions that correlate with various symptoms, highlighting both potential pathological and compensatory mechanisms in PCS. The findings also suggest that FDG PET is useful for providing neurophysiological information in the evaluation of patients with PCS and may help guide future targeted therapies.
- Published
- 2021