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Developmental changes of cerebral blood flow and oxygen metabolism in children
T Takahashi1, R Shirane, S Sato
1Department of Neurosurgery, Tohoku University School of Medicine, Sendai, Japan.
Insights
Brain blood flow and oxygen metabolism change significantly in children, increasing from infancy to adolescence. These dynamic changes in regional cerebral blood flow (rCBF) and regional cerebral metabolic rate for oxygen (rCMRO2) reflect brain development.
Area of Science:
- Pediatric Neurology
- Neuroscience
- Medical Imaging
Background:
- Established normal values for adult cerebral blood flow (CBF) and metabolism exist.
- Normal values for pediatric CBF and metabolism are not well-established.
Purpose of the Study:
- To clarify functional brain development in children.
- To investigate changes in cerebral blood flow (CBF) and oxygen metabolism during childhood.
Main Methods:
- Positron emission tomography (PET) was used to measure regional CBF (rCBF), regional cerebral metabolic rate for oxygen (rCMRO2), and regional oxygen extraction fraction (rOEF).
- 30 PET studies were conducted on 24 children aged 10 days to 16 years.
- Data were compared between age groups and with healthy adults.
Main Results:
- rCBF and rCMRO2 were lower in neonates, increasing significantly through childhood.
- rCBF peaked around age 7, while rCMRO2 increased later, especially in the frontal cortex.
- Adult values for rCBF and rCMRO2 were reached during adolescence; no significant changes in rOEF were observed.
Conclusions:
- Dynamic changes in rCBF and rCMRO2 in children indicate physiological brain development.
- These findings highlight the evolving nature of brain function during pediatric development.
Background And Purpose:
Normal values for cerebral blood flow (CBF) and metabolism in adults are well established, but not for children. Our goal, therefore, was to clarify functional developmental changes of the brain in children in relation to CBF and oxygen metabolism.
Methods:
We measured regional CBF (rCBF), regional cerebral metabolic rate for oxygen (rCMRO2), and regional oxygen extraction fraction (rOEF), using positron emission tomography (PET). We performed 30 PET studies in 24 children ages 10 days to 16 years (nine boys, 15 girls), using a steady inhalation method with C(15)O2, (15)O2, and 15CO in order to measure rCBF, rCMRO2, and rOEF, respectively. Regions of interest were set in the primary cerebral areas (sensorimotor, visual, temporal, and parietal cortex), cerebral association areas (frontal and visual association), basal ganglia (lenticular and thalamus), and posterior fossa (brain stem and cerebellar cortex). Subjects were grouped by age (< 1, 1 to < 3, 3 to < 8, and > or = 8 years), and the absolute values of the parameters were compared with those obtained from 10 healthy adults.
Results:
rCBF and rCMRO2 were lower in the neonatal period than in older children and adults, and increased significantly during early childhood. rCBF was higher as compared with adults, peaking around age 7, whereas rCMRO2 was relatively high, with the last area to increase being the frontal association cortex. Both rCBF and rCMRO2 reached adult values during adolescence. No difference in rCBF was observed between the basal ganglia and the primary cerebral cortex; however, it was prominent in the occipital lobe in every age bracket. No significant changes in rOEF were found during childhood.
Conclusion:
The dynamic changes of rCBF and rCMRO2 observed in children probably reflect the physiologic developmental state within anatomic areas of the brain.