Humayun M S, Presty S K, Lafrance N D, Holcomb H H, Loats H, Long D M, Wagner H N, Gordon B
Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205.
Nucl Med Commun. 1989 May;10(5):335-44. doi: 10.1097/00006231-198905000-00004.
Mild-moderate closed head injury (CHI) can be followed by neuropsychological impairments in recent memory and attention, despite the absence of discernible structural abnormalities in a significant number of patients. To determine whether CHI may result in cerebral glucose metabolic abnormalities, we used fluorodeoxyglucose (FDG) technique with PET imaging to measure local cerebral metabolic rates for glucose (LCMRGlu) in three CHI patients and three matched normal controls. The CHI patients were between 3-12 months post-injury. All had deficits in attention and recent memory shown by neuropsychological testing. CT, MRI, EEG and drug screens were negative at the time of PET scanning. Subjects were engaged in a vigilance task throughout the initial 30 min following FDG administration. Group comparisons were made using t tests. There were no significant group differences found in global glucose metabolic rate. Nevertheless, the CHI group exhibited significantly decreased LCMRGLu in medial temporal, posterior temporal, and posterior frontal cortices, as well as in the left caudate nucleus. LCMRGlu was significantly increased, relative to controls, in anterior temporal and anterior frontal cortices. These results suggest that CHI patients can have regional glucose metabolic abnormalities, indicative of altered neuronal function, despite the absence of discernible anatomic abnormalities.
轻度至中度闭合性颅脑损伤（CHI）之后，尽管许多患者没有明显的结构异常，但近期记忆和注意力方面可能会出现神经心理学损伤。为了确定CHI是否会导致脑葡萄糖代谢异常，我们对3例CHI患者和3名匹配的正常对照者使用氟脱氧葡萄糖（FDG）技术结合正电子发射断层扫描（PET）成像来测量局部脑葡萄糖代谢率（LCMRGlu）。CHI患者受伤后3至12个月。所有患者经神经心理学测试均显示注意力和近期记忆存在缺陷。在进行PET扫描时，CT、MRI、脑电图和药物筛查均为阴性。在注射FDG后的最初30分钟内，受试者一直参与一项警觉任务。使用t检验进行组间比较。在整体葡萄糖代谢率方面未发现显著的组间差异。然而，CHI组在内侧颞叶、颞叶后部、额叶后部皮质以及左侧尾状核的LCMRGLu显著降低。与对照组相比，颞叶前部和额叶前部皮质的LCMRGlu显著升高。这些结果表明，尽管没有明显的解剖学异常，但CHI患者可能存在局部葡萄糖代谢异常，这表明神经元功能发生了改变。
