Abstract

BackgroundTraumatic brain injury (TBI) causes brain dysfunction in many patients. Using C-11 flumazenil (FMZ) positron emission tomography (PET), we have detected and reported the loss of neuronal integrity, leading to brain dysfunction in TBI patients. Similarly to FMZ PET, I-123 iomazenil (IMZ) single photon emission computed tomography (SPECT) is widely used to determine the distribution of the benzodiazepine receptor (BZR) in the brain cortex. The purpose of this study is to examine whether IMZ SPECT is as useful as FMZ PET for evaluating the loss of neuronal integrity in TBI patients.The subjects of this study were seven patients who suffered from neurobehavioral disability. They underwent IMZ SPECT and FMZ PET. Nondisplaceable binding potential (BPND) was calculated from FMZ PET images. The uptake of IMZ was evaluated on the basis of lesion-to-pons ratio (LPR). The locations of low uptake levels were visually evaluated both in IMZ SPECT and FMZ PET images. We compared FMZ BPND and (LPR-1) of IMZ SPECT.ResultsIn the visual assessment, FMZ BPND decreased in 11 regions. In IMZ SPECT, low uptake levels were observed in eight of the 11 regions. The rate of concordance between FMZ PET and IMZ SPECT was 72.7%. The mean values IMZ (LPR-1) (1.95 ± 1.01) was significantly lower than that of FMZ BPND (2.95 ± 0.80 mL/mL). There was good correlation between FMZ BPND and IMZ (LPR-1) (r = 0.80).ConclusionsIMZ SPECT findings were almost the same as FMZ PET findings in TBI patients. The results indicated that IMZ SPECT is useful for evaluating the loss of neuronal integrity. Because IMZ SPECT can be performed in various facilities, IMZ SPECT may become widely adopted for evaluating the loss of neuronal integrity.

Highlights

  • Traumatic brain injury (TBI) causes brain dysfunction in many patients

  • Because many of neurobehavioral disability caused by TBI cannot be explained only by the site of the brain injury detected by magnetic resonance imaging (MRI), it is difficult to diagnose neurobehavioral disability caused by TBI in many patients

  • The purpose of this study is to examine whether IMZ single photon emission computed tomography (SPECT) is as useful as FMZ positron emission tomography (PET) for evaluating the loss of neuronal integrity in patients with neurobehavioral disability after TBI

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Summary

Introduction

Traumatic brain injury (TBI) causes brain dysfunction in many patients. Using C-11 flumazenil (FMZ) positron emission tomography (PET), we have detected and reported the loss of neuronal integrity, leading to brain dysfunction in TBI patients. The purpose of this study is to examine whether IMZ SPECT is as useful as FMZ PET for evaluating the loss of neuronal integrity in TBI patients. The subjects of this study were seven patients who suffered from neurobehavioral disability They underwent IMZ SPECT and FMZ PET. Even patients who had suffered a mild head injury may experience after-effects including fatigue, memory disorder, and poor concentration, which significantly and adversely affect their daily life [1,2,3] Neurobehavioral disability such as impaired attention, memory disorder, and executive function disorder will interfere with patients’ education and employment opportunities, causing serious economic losses and significant decrease in the quality of their daily life. The visualization of the lesions responsible for neurobehavioral disability is essential for

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