RESUMO
PURPOSE: The participation in concussive susceptible sports such as boxing may cause chronic traumatic brain injury. The objective of this study was to determine whether there are unique patterns of reduced brain glucose metabolism in professional and amateur boxers. METHOD: We compared the fluorine-18 fluorodeoxyglucose (F-18 FDG) PET brain scans of boxers (group) (N=19) with those of controls (group) (N=7) using both statistical parametric mapping and region of interest analysis. RESULTS: Boxers showed decreased F-18 FDG uptake by 8-15% in the following brain areas: posterior cingulate cortex, parieto-occipito, frontal lobes (Broca's area) bilaterally, and the cerebellum (P<0.005) as compared with controls. CONCLUSION: Our results suggest that F-18 FDG PET scans of boxers suspected of chronic traumatic brain injury show unique patterns of hypometabolism, and that these patterns may reflect the mechanisms of repeated traumatic brain injury unique to boxers.
Assuntos
Boxe/lesões , Lesões Encefálicas/diagnóstico por imagem , Lesão Encefálica Crônica/diagnóstico por imagem , Fluordesoxiglucose F18 , Tomografia por Emissão de Pósitrons/métodos , Adulto , Lesões Encefálicas/metabolismo , Lesão Encefálica Crônica/metabolismo , Estudos de Casos e Controles , Análise por Conglomerados , Interpretação Estatística de Dados , Feminino , Fluordesoxiglucose F18/metabolismo , Humanos , Masculino , Estudos Retrospectivos , Adulto JovemRESUMO
OBJECTIVE: [(18)F]Fluorodeoxyglucose positron emission tomography ([(18)F]FDG-PET) is a valuable method for detecting focal brain dysfunction associated with epilepsy. Evidence suggests that a progressive decrease in [(18)F]FDG uptake occurs in the epileptogenic cortex with an increase in the duration of epilepsy. In this study, our aim was to use statistical parametric mapping (SPM) to test the validity of this relationship in a retrospective study of patients with temporal lobe epilepsy (TLE). METHODS: [(18)F]FDG-PET scans of 46 adult patients with pharmacoresistant unilateral TLE (25 RTLE and 21 LTLE) were subjected to SPM analysis. RESULTS: Forty-six patients were diagnosed with nonlesional TLE, 16 of whom had hippocampal sclerosis (HS). The average duration of epilepsy was 17.4 +/- 12.3 years (3-46 years), <5 years in 10 patients and >or=10 years in 30 patients. Visual analysis of [(18)F]FDG-PET scans revealed hypometabolism in the epileptogenic temporal cortex in 31 (67%) patients. After SPM analysis of all [(18)F]FDG-PET images, hypometabolism was unilateral and reported in lateral and mesial structures of the epileptogenic temporal cortex in addition to the ipsilateral fusiform and middle occipital gyrus. Subsequent analysis revealed that temporal lobe hypometabolism was present only in patients with longer epilepsy duration (>or=10 years) in parahippocampal gyrus, uncus, and middle and superior temporal gyrus (P < 0.05 corrected). Epilepsy duration was inversely correlated with decreased glucose uptake in the inferior temporal gyrus, hippocampus, and parahippocampal gyrus of the epileptogenic temporal cortex (P < 0.05). Age at seizure onset did not affect the correlation between epilepsy duration and glucose uptake except in the inferior temporal gyrus (P < 0.05). CONCLUSION: Voxel-based mapping supports the assertion that glucose hypometabolism of the epileptogenic temporal lobe cortex and other neighboring cortical regions increases with longer epilepsy duration in TLE.
Assuntos
Mapeamento Encefálico , Encéfalo/metabolismo , Epilepsia do Lobo Temporal/patologia , Glucose/metabolismo , Adulto , Encéfalo/diagnóstico por imagem , Eletroencefalografia , Epilepsia do Lobo Temporal/diagnóstico por imagem , Epilepsia do Lobo Temporal/cirurgia , Feminino , Fluordesoxiglucose F18 , Lateralidade Funcional , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neurocirurgia/métodos , Tomografia por Emissão de Pósitrons/métodos , Compostos Radiofarmacêuticos , Estudos Retrospectivos , Estatística como Assunto , Adulto JovemRESUMO
A number of very significant advances in the field of positron emission tomography (PET) imaging are now beginning to have an impact on clinical PET brain imaging. Among the most significant advances are further improvements in PET scanner detectors and computers. Increasingly, more sophisticated methods of image analysis and quantitation are also beginning to emerge. In addition, there has been a very rapid introduction of newer PET radiotracers that will ultimately work their way into the clinical environment. Finally, there is an expanding interest in the potential of PET brain imaging in the evaluation of a wide variety of clinical neuropsychiatric conditions.
Assuntos
Mapeamento Encefálico/métodos , Neoplasias Encefálicas/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Transtornos Cerebrovasculares/diagnóstico por imagem , Demência/diagnóstico por imagem , Fluordesoxiglucose F18 , Interpretação de Imagem Assistida por Computador/métodos , Tomografia por Emissão de Pósitrons/métodos , Traumatismos Craniocerebrais/diagnóstico por imagem , Humanos , Tomografia por Emissão de Pósitrons/tendências , Guias de Prática Clínica como Assunto , Padrões de Prática Médica , Prognóstico , Compostos RadiofarmacêuticosRESUMO
The role of PET and SPECT brain imaging in the initial assessment and differential diagnosis of dementia is beginning to evolve rapidly. Numerous studies confirm the value of functional brain imaging, particularly with FDG-PET imaging, as a potentially cost-effective means of establishing an earlier diagnosis of Alzheimer's disease. Such an approach should allow for a more objective means of establishing which patients will benefit from treatment with cholinesterase inhibitors. In the future, neuroreceptor and plaque burden imaging studies should further enhance the sensitivity and specificity of dementia detection and patient management.