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Cortical neuron loss in post-traumatic higher brain dysfunction using (123)I-iomazenil SPECT.

Abstract
In patients with higher brain dysfunction (HBD) after mild traumatic brain injury (MTBI), diagnostic imaging of cortical neuron loss in the frontal lobes was studied using SPECT with (123)I-iomazenil (IMZ), as a radioligand for central benzodiazepine receptor (BZR). Statistical imaging analysis using three-dimensional stereotactic surface projections (3D-SSP) for (123)I-IMZ SPECT was performed in 17 patients. In all patients with HBD defined by neuropsychological tests, cortical neuron loss was indicated in the bilateral medial frontal lobes in 14 patients (83 %). A comparison between the group of 17 patients and the normal database demonstrated common areas of cortical neuron loss in the bilateral medial frontal lobes involving the medial frontal gyrus (MFG) and the anterior cingulate gyrus (ACG). In an assessment of cortical neuron loss in the frontal medial cortex using the stereotactic extraction estimation (SEE) method (level 3), significant cortical neuron loss was observed within bilateral MFG in 9 patients and unilateral MFG in 4, and bilateral ACG in 12 and unilateral ACG in 3. Fourteen patients showed significant cortical neuron loss in bilateral MFG or ACG. In patients with MTBI, HBD seemed to correlate with selective cortical neuron loss within the bilateral MFG or ACG where the responsible lesion could be. 3D-SSP and SEE level 3 analysis for (123)I-IMZ SPECT could be valuable for diagnostic imaging of HBD after MTBI.
AuthorsJyoji Nakagawara, Kenji Kamiyama, Masaaki Takahashi, Hirohiko Nakamura
JournalActa neurochirurgica. Supplement (Acta Neurochir Suppl) Vol. 118 Pg. 245-50 ( 2013) ISSN: 0065-1419 [Print] Austria
PMID23564141 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Flumazenil
  • iomazenil
Topics
  • Adult
  • Aged
  • Brain (diagnostic imaging, pathology)
  • Brain Injuries (diagnostic imaging, pathology)
  • Brain Mapping
  • Cell Death (physiology)
  • Female
  • Flumazenil (analogs & derivatives)
  • Humans
  • Male
  • Middle Aged
  • Neurons (pathology)
  • Tomography, Emission-Computed, Single-Photon

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