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Regional cerebral blood flow in the persistent vegetative state
Neurologia Medico-Chirurgica
|May 1, 1989
Summary
Regional cerebral blood flow (CBF) in patients with disorders of consciousness revealed distinct patterns. Frontal lobe function, assessed via CBF, correlated with awareness, offering insights into vegetative states.
Area of Science:
- Neurology
- Neuroimaging
Background:
- Persistent vegetative state (PVS) presents diagnostic challenges.
- Understanding cerebral blood flow (CBF) alterations is crucial for PVS assessment.
Purpose of the Study:
- To compare regional CBF in patients with PVS and healthy volunteers.
- To investigate the relationship between CBF distribution, particularly in the frontal lobe, and patient awareness.
Main Methods:
- Single photon emission computed tomography (SPECT) was used to measure CBF.
- Radioactive tracers 123I-N-isopropyl-p-iodo-amphetamine and 99mTc-hexamethyl-propyleneamine oxime were utilized.
- Regions of interest included frontal, temporal, parietal, occipital, cerebellar areas, and basal ganglia.
Main Results:
- "Hyperfrontal distribution" of CBF was uncommon in both healthy individuals and PVS patients.
- Asymmetrical frontal CBF (left > right) was observed in volunteers but less frequently in patients.
- Group 1 (locked-in syndrome) showed bilateral high CBF, Group 3 (prolonged coma) had significantly low CBF, and Group 2 (vegetative state) exhibited variable CBF within normal limits.
Conclusions:
- CBF distribution in the frontal lobe varied significantly across patient groups.
- Frontal lobe function and altered CBF are closely linked to patient awareness.
- These findings contribute to understanding the neurobiology of consciousness disorders.