Alterations in cerebral glucose metabolism as measured by 18F-fluorodeoxyglucose-PET in patients with persistent postconcussion syndrome.

Autor:	Teichner EM; Department of Integrative Medicine and Nutritional Sciences, Marcus Institute of Integrative Health, Thomas Jefferson University, Philadelphia, Pennsylvania., You JC; Partners Neurology, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard Medical School, Boston., Hriso C; Department of Integrative Medicine and Nutritional Sciences, Marcus Institute of Integrative Health, Thomas Jefferson University, Philadelphia, Pennsylvania., Wintering NA; Department of Integrative Medicine and Nutritional Sciences, Marcus Institute of Integrative Health, Thomas Jefferson University, Philadelphia, Pennsylvania., Zabrecky GP; Department of Integrative Medicine and Nutritional Sciences, Marcus Institute of Integrative Health, Thomas Jefferson University, Philadelphia, Pennsylvania., Alavi A; Department of Radiology, University of Pennsylvania., Bazzan AJ; Department of Integrative Medicine and Nutritional Sciences, Marcus Institute of Integrative Health, Thomas Jefferson University, Philadelphia, Pennsylvania., Monti DA; Department of Integrative Medicine and Nutritional Sciences, Marcus Institute of Integrative Health, Thomas Jefferson University, Philadelphia, Pennsylvania., Newberg AB; Department of Integrative Medicine and Nutritional Sciences, Marcus Institute of Integrative Health, Thomas Jefferson University, Philadelphia, Pennsylvania.; Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Jazyk:	angličtina
Zdroj:	Nuclear medicine communications [Nucl Med Commun] 2021 Jul 01; Vol. 42 (7), pp. 772-781.
DOI:	10.1097/MNM.0000000000001397
Abstrakt:	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. (Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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