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. (Korean J Nucl Med 2000;34:183-98) |