Korean J Nucl Med.  2000 Jun;34(3):183-198.

Alterations of Cerebral Blood Flow and Cerebrovascular Reserve in Patients with Chronic Traumatic Brain Injury Accompanying Deteriorated Intelligence

• Song HC
• Bom HS

Abstract

PURPOSE: The purpose of this study was to evaluate alterations of regional cerebral blood flow (CBF) and cerebrovascular reserve (CVR), and correlation between these alternations and cognitive dysfunction in patients with chronic traumatic brain injury (TRI) and normal brain MRI findings.
MATERIALS AND METHODS
Thirty TBI patients and 19 healthy volunteers underwen1 rest/acerazolamide brain SPECT using Tc-99m HMPAO. Korean-Wechsler Adult Intelligence scale test was also performed in the patient group. Statistical analysis was performed with statistical parametric mapping software (SPM97),
RESULTS
CBF was diminished in the left hemisphere including Wernicke's area in all patients with lower verbal scale scores. In addition, a reduction in CBF in the right frontal, temporal and parietal cortices was related with depressed scores in information, digital span, arithmetic and similarities, In patients with lower performance scale scores. CBF was mainly diminished in the right hemisphere including superior temporal and supramarginal gyri, premotor, primary somatomotor and a port of prefrontal cortices, left frontal lobe and supramarginal gyrus. CVR was diminished in sixty-four Brodmann's areas compared to control. A reduction in CVR was demonstrated bilaterally in the frontal and temporal Iobes in patients with lower scores in both verbal and performance tests, and in addition, both inferior parietal and occipital lobes in information subset.
CONCLUSION
Alterations of CBF and CVR were demonstrated in the symptomatic TBI patients with normal MRI finding. These alterations were correlated with the change of intelligence, of which the complex functions are subserved by multiple interconnected cortical structures.

Keyword

Traumatic brain injury; Cerebral blood flow; Cerebrovascular reserve; Intelligence; Tc-99m HMPAO; Single photon emission computed tomography; Statistical parametric mapping

MeSH Terms

Adult
Brain
Brain Injuries*
Frontal Lobe
Healthy Volunteers
Humans
Intelligence*
Magnetic Resonance Imaging
Occipital Lobe
Rabeprazole
Technetium Tc 99m Exametazime
Tomography, Emission-Computed, Single-Photon
Technetium Tc 99m Exametazime