Regional changes with global brain hypometabolism indicates a physiological triage phenomenon and can explain shared pathophysiological events in Alzheimer's & small vessel diseases and delirium.

Authors :: Gupta SK
Rutherford N
Dolja-Gore X
Watson T
Nair BR
Source :: American journal of nuclear medicine and molecular imaging [Am J Nucl Med Mol Imaging] 2021 Dec 15; Vol. 11 (6), pp. 492-506. Date of Electronic Publication: 2021 Dec 15 (Print Publication: 2021).
Publication Year :: 2021
Abstract: While reduced global brain metabolism is known in aging, Alzheimer's disease (AD), small vessel disease (SVD) and delirium, explanation of regional brain metabolic (rBM) changes is a challenge. We hypothesized that this may be explained by "triage phenomenon", to preserve metabolic supply to vital brain areas. We studied changes in rBM in 69 patients with at least 5% decline in global brain metabolism during active lymphoma. There was significant decline in the rBM of the inferior parietal, precuneus, superior parietal, lateral occipital, primary visual cortices (P<0.001) and in the right lateral prefrontal cortex (P=0.01). Some areas showed no change; multiple areas had significantly increased rBM (e.g. medial prefrontal, anterior cingulate, pons, cerebellum and mesial temporal cortices; P<0.001). We conclude the existence of a physiological triage phenomenon and argue a new hypothetical model to explain the shared events in the pathophysiology of aging, AD, SVD and delirium.<br />Competing Interests: None.<br /> (AJNMMI Copyright © 2021.)

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