Statistical parametric mapping in brain single photon computed emission tomography after carbon monoxide intoxication

Area of Science:

• Neurology
• Radiology
• Neuroimaging

Background:

• Carbon monoxide (CO) intoxication is a significant cause of acquired brain injury.
• Delayed neuropsychiatric sequelae (DNS) can occur weeks after CO exposure.
• Understanding the neurophysiological basis of DNS is crucial for effective management.

Purpose of the Study:

• To evaluate regional cerebral blood flow (rCBF) in patients with and without DNS after CO intoxication.
• To compare rCBF patterns between patient groups and healthy controls.
• To assess the utility of statistical parametric mapping (SPM) in identifying rCBF abnormalities.

Main Methods:

• Retrospective study involving 8 patients with DNS, 10 patients without symptoms, and 44 healthy controls.
• Brain single-photon emission computed tomography (SPECT) imaging using 99mTc-hexamethyl-propyleneamine oxime.
• Analysis of adjusted rCBF images using statistical parametric mapping (SPM) for group comparisons.

Main Results:

• Patients with DNS exhibited significantly decreased rCBF in bilateral frontal lobes, bilateral insula, and the right temporal lobe compared to controls (P<0.005).
• Patients without symptoms showed reduced rCBF in bilateral frontal lobes, especially the left.
• Significantly lower rCBF in the right frontal lobe and insula was observed in patients with DNS compared to those without.

Conclusions:

• Statistical parametric mapping is effective in detecting rCBF differences in CO-intoxicated patients.
• Reduced frontal lobe blood flow may be a prolonged consequence of CO intoxication, potentially worsening over time.
• This study aids in characterizing the pathophysiology underlying delayed neuropsychiatric sequelae after CO exposure.