Differential SPECT Activation Patterns Associated with PASAT Performance May Indicate Frontocerebellar Functional Dissociation in Chronic Mild Traumatic Brain Injury

Hattori, Naoya; Swan, Megan; Stobbe, Gary; Uomoto, Jay M.; Minoshima, Shinsei; Djang, David; Krishnananthan, Ruben; Lewis, David H.

doi:10.2967/jnumed.108.060368

Cited by 41 publications

(17 citation statements)

References 26 publications

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“…(Stoodley and Schmahmann, 2009) In addition, cerebellar dysfunction has recently been implicated in the pathogenesis of similar symptoms in civilian mTBI patients. (Hattori et al, 2009; Kato et al, 2007; Park et al, 2007a)…”

Section: Discussionmentioning

confidence: 99%

Cerebrocerebellar hypometabolism associated with repetitive blast exposure mild traumatic brain injury in 12 Iraq war Veterans with persistent post-concussive symptoms

et al. 2011

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Disagreement exists regarding the extent to which persistent post-concussive symptoms (PCS) reported by Iraq combat Veterans with repeated episodes of mild traumatic brain injury (mTBI) from explosive blasts represent structural or functional brain damage or an epiphenomenon of comorbid depression or posttraumatic stress disorder (PTSD). Objective assessment of brain function in this population may clarify the issue. To this end, twelve Iraq war Veterans (32.0 ±8.5 [mean ± standard deviation (SD)] years of age) reporting one or more blast exposures meeting American College of Rehabilitation Medicine criteria for mTBI and persistent PCS and 12 cognitively normal community volunteers (53.0 ±4.6 years of age) without history of head trauma underwent brain fluorodeoxyglucose positron emission tomography (FDG-PET) and neuropsychological assessments and completed PCS and psychiatric symptom rating scales. Compared to controls, Veterans with mTBI (with or without PTSD) exhibited decreased cerebral metabolic rate of glucose in the cerebellum, vermis, pons, and medial temporal lobe. They also exhibited subtle impairments in verbal fluency, cognitive processing speed, attention, and working memory, similar to those reported in the literature for patients with cerebellar lesions. These FDG-PET imaging findings suggest that regional brain hypometabolism may constitute a neurobiological substrate for chronic PCS in Iraq combat Veterans with repetitive blast-trauma mTBI. Given the potential public health implications of these findings, further investigation of brain function in these Veterans appears warranted.

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Section: Discussionmentioning

confidence: 99%

Cerebrocerebellar hypometabolism associated with repetitive blast exposure mild traumatic brain injury in 12 Iraq war Veterans with persistent post-concussive symptoms

et al. 2011

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“…Preclinical studies confirm deficits in emotional decision-making tasks in rodent chronic pain models 140 . Deficits in these tasks are also observed in patients with disorders such as traumatic brain injury and multiple sclerosis who have lesions in brain regions implicated in descending pain modulation, including the medial PFC and rostral ACC 141–145 . Furthermore, the brain regions that are altered in patients with chronic pain are among those that are activated during the tasks in which patients perform poorly 146,147 .…”

Section: Effects Of Chronic Pain On Pain Modulationmentioning

confidence: 97%

Cognitive and emotional control of pain and its disruption in chronic pain

2013

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Chronic pain is one of the most prevalent health problems in our modern world, with millions of people debilitated by conditions such as back pain, headache and arthritis. To address this growing problem, many people are turning to mind–body therapies, including meditation, yoga and cognitive behavioural therapy. This article will review the neural mechanisms underlying the modulation of pain by cognitive and emotional states — important components of mind–body therapies. It will also examine the accumulating evidence that chronic pain itself alters brain circuitry, including that involved in endogenous pain control, suggesting that controlling pain becomes increasingly difficult as pain becomes chronic.

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“…For example, Hattori et al (2009) use SPECT in assessing mTBI patients at rest and during the Paced Auditory Serial Addition Test (PASAT) where, during the PASAT, mTBI patients' performance was different but not at rest. Another interesting technique that can only be done via neuroimaging using SPECT or PET is ligand receptor uptake studies.…”

Section: Functional Neuroimagingmentioning

confidence: 99%

Neuroimaging in Mild Traumatic Brain Injury

Bigler

2010

Psychol. Inj. and Law

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Neuroimaging in mild traumatic brain injury (mTBI) is reviewed. While computed tomography remains the acute standard for neuroimaging of mTBI, it is only sensitive to gross abnormalities and is typically performed as a measure to rule out more serious and life-threatening injury. Magnetic resonance imaging (MRI), especially at field strength of 3.0 T, is the follow-up neuroimaging standard for assessing potential underlying structural injury to the brain. Several MRI sequences are particularly sensitive to subtle hemorrhagic lesions and signal abnormalities in white matter, sensitive enough to detect pathology when present in mTBI. Clinical correlation of neuropsychological outcome with neuroimaging findings is discussed along with the future potential for functional neuroimaging in evaluating the mTBI patient.Keywords Mild traumatic brain injury (mTBI) . Neuroimaging . Neuropsychological outcome . White matter . Magnetic resonance imaging (MRI) . Computed tomography (CT) . Functional neuroimaging A history of positive neuroimaging findings provides important information that assists the clinician in understanding the sequelae and potential effects of a traumatic brain injury (TBI) on neuropsychological test performance. Much has been written about neuroimaging methods and findings in TBI, which are summarized elsewhere (Dubroff and Newberg 2008; Le and Gean 2009). The focus of this article is just on neuroimaging findings in mild traumatic brain injury (mTBI) and how such findings provide additional context about the likely neuropathology of mTBI and its relationship to neurocognitive and neurobehavioral sequelae. This review will be brief and primarily focused on the clinical information that exists in standard radiological reports of mTBI patients and its relevance to neurobehavioral and neurocognitive sequelae. Obviously, psychological and neuropsychological assessments of the mTBI patient typically occur weeks or months post-injury. This circumstance requires that any clinician who sees the patient on follow-up must rely on the medical information, including clinical neuroimaging that has already been performed. This also means that the clinician needs to understand the decision making that takes place in the emergency department (ED) for how a mTBI is triaged and when radiological procedures are performed that typically follow established guidelines (Davis 2007;Jagoda et al. 2008). As such, this review begins with an examination of the literature on acute neuroimaging and what is typically performed in the mTBI patient. Acute Neuroimaging in mTBIA review of the medical literature on acute neuroimaging of TBI shows that, when medically indicated, computed tomography (CT) is typically the first scan performed in any patient who sustains a TBI, including those who meet

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Differential SPECT Activation Patterns Associated with PASAT Performance May Indicate Frontocerebellar Functional Dissociation in Chronic Mild Traumatic Brain Injury

Cited by 41 publications

References 26 publications

Cerebrocerebellar hypometabolism associated with repetitive blast exposure mild traumatic brain injury in 12 Iraq war Veterans with persistent post-concussive symptoms

Cerebrocerebellar hypometabolism associated with repetitive blast exposure mild traumatic brain injury in 12 Iraq war Veterans with persistent post-concussive symptoms

Cognitive and emotional control of pain and its disruption in chronic pain

Neuroimaging in Mild Traumatic Brain Injury

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