Abstract
BackgroundThe positron emission tomography (PET) radioligand 18F-THK5351 is now used to evaluate monoamine oxidase B expression in the reactive astrogliosis seen in various central nervous diseases. Traumatic brain injury (TBI) is known to induce reactive astrogliosis in the lesion site. This is a first report to examine the spatial and temporal changes in reactive astrogliosis as evaluated by 18F-THK5351 after a severe TBI.Case presentationA 27-year-old man suffering from a severe TBI with multiple brain contusions was examined using 18F-THK5351 PET/CT in the subacute and chronic phases after the injury. The first PET scan, performed 46 days after the TBI, showed intense uptake of 18F-THK5351 in and around the brain contusions. The second PET scan, performed 271 days after the TBI, showed reduced uptake of 18F-THK5351 at the original sites of the brain contusions and increased uptakes in the white matter surrounding the contusions and the corpus callosum. The patient exhibited sustained improvement of neuropsychological impairment between the two PET examinations and remarkable recovery from the severe TBI.ConclusionsThere were evident temporal and spatial changes in 18F-THK5351 uptake in the traumatized brain between the two PET examinations. These changes may have been related to the remarkable neurological recovery in this patient. The degree and distribution of reactive astrogliosis detected by 18F-THK5351 PET may be useful in assessing pathophysiology and predicting prognosis in TBI patients.
Highlights
The positron emission tomography (PET) radioligand 18F-THK5351 is used to evaluate monoamine oxidase B expression in the reactive astrogliosis seen in various central nervous diseases
The positron emission tomography (PET) radioligand 18F-THK5351 was developed for imaging tau aggregates in neurofibrillary tangles (NFTs) in patients suffering from Alzheimer disease (AD; Harada et al 2016)
Increased uptake of 18F-THK5351 within the corpus callosum in the chronic phase is of particular interest, as this structure represents a region highly susceptible to Traumatic brain injury (TBI), suggesting that active neuroinflammatory events driven by reactive astrogliosis are continued at this time
Summary
The positron emission tomography (PET) radioligand 18F-THK5351 is used to evaluate monoamine oxidase B expression in the reactive astrogliosis seen in various central nervous diseases. In a study comparing antemortem 18F-THK5351 PET images and postmortem pathological specimens in a patient with AD, in vivo 18FTHK5351 uptakes were significantly correlated with both the density of tau aggregates in the neocortex and regional MAO-B concentrations in the whole brain (Harada et al 2018). Takami et al reported a case, in which 18F-THK5351 PET could identify lesions based on the reactive astrogliosis in a brain contusion 18 days after TBI (Takami et al 2020).
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