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Loss of neuronal integrity: a cause of hypometabolism in patients with traumatic brain injury without MRI abnormality in the chronic stage

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Traumatic brain injury (TBI) causes brain dysfunction in many patients. However, some patients have severe brain dysfunction but display no abnormalities on magnetic resonance imaging (MRI). There have been some reports of hypometabolism even in such patients. The purpose of this study was to investigate the relationship between metabolic abnormality and loss of neuronal integrity in TBI patients with some symptoms but without MRI abnormalities.

Methods

The study population comprised ten patients with TBI and ten normal volunteers. All of the patients were examined at least 1 year after the injury. 15O-labelled gas PET and [11C]flumazenil (FMZ) positron emission tomography (PET) were carried out. The cerebral metabolic rate of oxygen (CMRO2) and binding potential (BP) images of FMZ were calculated. Axial T2WI, T2*WI and FLAIR images were obtained. Coronal images were added in some cases.

Results

All of the patients had normal MRI findings, and all showed areas with abnormally low CMRO2. Low uptake on BP images was observed in six patients (60%). No lesions that showed low uptake on BP images were without low CMRO2. On the other hand, there were 14 lesions with low CMRO2 but without BP abnormalities.

Conclusion

These results indicate that there are metabolic abnormalities in TBI patients with some symptoms after brain injury but without abnormalities on MRI. Some of the hypometabolic lesions showed low BP, indicating a loss of neuronal integrity. Thus, FMZ PET may have potential to distinguish hypometabolism caused by neuronal loss from that caused by other factors.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Hokkaido University School of Medicine, North 15th, West 7th, Kitaku Sapporo, 060-8638, Japan

    Tohru Shiga, Tetsuaki Matsuyama, Hiroyuki Kageyama, Tomoya Kohno & Nagara Tamaki

  2. Department of Rehabilitation, Hokkaido University,, Sapporo, Japan

    Katsunori Ikoma & Hirotaka Isoyama

  3. Department of Tracer kinetics, Hokkaido University,, Sapporo, Japan

    Chietsugu Katoh & Yuji Kuge

  4. Department of Radiology, Hokkaido University,, Sapporo, Japan

    Satoshi Terae

Authors
  1. Tohru Shiga
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  2. Katsunori Ikoma
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  3. Chietsugu Katoh
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  4. Hirotaka Isoyama
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  5. Tetsuaki Matsuyama
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  6. Yuji Kuge
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  7. Hiroyuki Kageyama
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  8. Tomoya Kohno
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  9. Satoshi Terae
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  10. Nagara Tamaki
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Correspondence to Tohru Shiga.

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Shiga, T., Ikoma, K., Katoh, C. et al. Loss of neuronal integrity: a cause of hypometabolism in patients with traumatic brain injury without MRI abnormality in the chronic stage. Eur J Nucl Med Mol Imaging 33, 817–822 (2006). https://doi.org/10.1007/s00259-005-0033-y

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  • DOI: https://doi.org/10.1007/s00259-005-0033-y

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