Brain Glucose Metabolism in Postanoxic Syndrome

Volder, Anne De; Goffinet, André M.; Bol, Anne; Michel, Christian; Barsy, Thierry de; Laterre, Emile-Christian

doi:10.1001/archneur.1990.00530020103022

Cited by 127 publications

(65 citation statements)

References 43 publications

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“…10 To our knowledge there is only one other case published where PET scanning was performed during VS and after recovery of consciousness. 12 Again, global gray matter CMRGlu did not show a substantial increase after recovery (5.0 mg/100g.min versus 5.2 mg/100g.min). Although no SPM analysis was performed, region of interest (ROI) analysis showed the largest regional increase in parieto-occipital cortices.…”

Section: Global Impairment In Cerebral Metab Olismmentioning

confidence: 80%

“…In VS of various etiologies and durations, studies from our own 4 -10 and other centers [11][12][13][14][15] have shown that cerebral metabolic rates for glucose (CMRGlu) are approximately 40 percent of normal values, whereas in patients in coma of hypoxic and traumatic origin, values are approximately 50 percent of normal. 16,17 Compared to cerebral glucose metabolism, cerebral blood flow seems to show a larger interpatient variability in VS. 13 In long-standing post-hypoxic vegetative state, CMRGlu values decrease even further, 11,14 probably due to progressive Wallerian and transsynaptic degeneration.…”

Section: Global Impairment In Cerebral Metab Olismmentioning

confidence: 92%

“…12 By means of SPM analysis 23 we were able to identify the regional pattern of metabolic impairment common to our patients in VS. 9 The prefrontal, premotor and parietotemporal association cortices and the posterior cingulate/precuneus region showed the most severe functional impairment (Fig. 3B).…”

Section: Relatively Most Impaired Brain Areasmentioning

confidence: 97%

“…Using ROI analysis, previous PET studies have shown a reduction in overall cortical metabolism [11][12][13][14] with most profound reductions in the parieto-occipital and mesial frontal cortices. 12 By means of SPM analysis 23 we were able to identify the regional pattern of metabolic impairment common to our patients in VS. 9 The prefrontal, premotor and parietotemporal association cortices and the posterior cingulate/precuneus region showed the most severe functional impairment (Fig.…”

Section: Relatively Most Impaired Brain Areasmentioning

confidence: 99%

See 3 more Smart Citations

Brain Function in the Vegetative State

Laureys

Antoine

Boly

et al. 2004

Advances in Experimental Medicine and Biology

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Section: Global Impairment In Cerebral Metab Olismmentioning

confidence: 80%

Section: Global Impairment In Cerebral Metab Olismmentioning

confidence: 92%

Section: Relatively Most Impaired Brain Areasmentioning

confidence: 97%

Section: Relatively Most Impaired Brain Areasmentioning

confidence: 99%

See 2 more Smart Citations

Brain Function in the Vegetative State

Laureys

Antoine

Boly

et al. 2004

Advances in Experimental Medicine and Biology

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“…PET measures of glucose metabolism may reveal a number of divergent and individual variants of brain damage in patients with anoxic symptoms (De VoIder et al, 1990). PET outcome may be indicative of diffuse disseminating brain diseases such as the beginning of a primary degenerative disease (Alzheimer's disease) or in cases with so-called pseudodementia.…”

Section: Diffuse Brain Damagementioning

confidence: 99%

Commonalities and Discrepancies in the Relationships between Behavioural Outcome and the Results of Neuroimaging in Brain-Damaged Patients

Markowitsch

Calabrese

1996

Behavioural Neurology

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Variables which are of influence in establishing clear predictions of neuropsychological alterations from neuroradiological data (and vice versa) are documented and discussed. It is concluded that personality factors and the kind and locus of brain lesions are the most crucial determinants. The locus of the brain damage may have cumulative effects either when it is situated in a strategic place (usually within the white matter, affecting interneuronal communication) or when various types of lesions appear superimposed (combination of focal and diffuse lesions). Consequently, the consideration of the patient's personality background and of as many neuropsychological facts as possible may considerably increase the validity of outcome predictions. When static or dynamic neuroimaging fails to show abnormalities in spite of obvious psychological alterations, an intensive neuropsychological documentation may even replace neuroradiology. Keywords: Brain damage -Magnetic resonance imaging -Computer tomography -Neuropsychological assessment INTRODUCTIONThe availability of cranial computer tomography (CT) has revolutionized the diagnostic power for patients with brain damage, and the subsequent appearance of magnetic resonance imaging (MRI), positron emission tomography (PET) and functional magnetic resonance imaging has further increased and refined the power of relating brain tissue changes to behavioural alterations. Nevertheless, there are numerous case reports in which neuroimaging and neuropsychological data indicate a different prognosis, thereby leading to an improper rehabilitation treatment of the patient.Part of the discrepancy may be explained by the false assumption of linear relationships between lesion size and behavioural outcome (e.g. Irle, 1987Irle, , 1990Grafman et al., 1986), but other parts are most likely due to insensitive measurement on the imaging or the psychological level. Alesch et al. (1991), for instance, found that CT is quite insensitive to the identification of lymphomas although gliomas are readily detected. Similarly, although subdural empyemas and most sterile effusions and chronic subdural haematomas appear similar in CT scans, they are (~ 1996 Rapid Science Publishers much more readily distinguishable on the basis of signal intensity differences in MRI (Takamura et al., 1995);and Kertesz et al. (1987) concluded from their analyses that MRI surpasses CT scanning in the early detection of cerebral infarcts. CT on the other hand should be the method of choice to rule out intracerebral bleeding when a patient is screened initially. For detecting anatomical correlates of abnormal behavioural functioning, such as in psychogenic amnesia, conventional static imaging techniques have been useless up to now, although dynamic methods, such as PET imaging, may reveal cerebral blood flow changes indicative of abnormal processing (Amsterdam and Mozley, 1992;Markus et al., 1992).Congruence and incongruence of neuropsychology and neuroradiology are the topics of this commentary. We will first illustr...

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