Differences in cerebral blood flow and glucose utilization in vegetative versus locked‐in patients Journal Article

  


Authors: Levy, D. E.; Sidtis, J. J.; Rottenberg, D. A.; Jarden, J. O.; Strother, S. C.; Dhawan, V.; Ginos, J. Z.; Tramo, M. J.; Evans, A. C.; Plum, F.
Article Title: Differences in cerebral blood flow and glucose utilization in vegetative versus locked‐in patients
Abstract: Positron emission tomographic studies of regional cerebral metabolic rate for glucose (rCMRGlc) and cerebral blood flow were performed in 7 vegetative and 3 locked‐in patients to determine objectively the level of brain function underlying these clinical states. Cortical gray rCMRGlc in the vegetative patients was 2.73 ± 0.13 (mean ± SEM) mg/100 gm/min, less than half the normal value of 6.82 ± 0.23 (p < 0.001). Cerebral blood flow exhibited similar but more variable reductions. By contrast, cortical rCMRGlc in the locked‐in patients was 5.08 ± 0.69, a 25% reduction (p < 0.02) from normal. The massive reduction in vegetative rCMRGlc involved not only the cerebral cortex but also the basal nuclei and cerebellum. Such metabolic hypoactivity has precedent only in deep anesthesia and supports clinical evidence that cerebral cognitive function is lost in the vegetative state, leaving a body that can no longer think or experience pain. Copyright © 1987 American Neurological Association
Keywords: adolescent; adult; clinical article; case report; comparative study; positron emission tomography; psychological aspect; brain diseases; behavior; glucose; coma; brain blood flow; cerebrovascular circulation; tomography, emission-computed; computer analysis; middle age; glucose utilization; deoxyglucose; fludeoxyglucose f 18; human; male; female; support, non-u.s. gov't; support, u.s. gov't, p.h.s.; locked in syndrome; glucose brain level
Journal Title: Annals of Neurology
Volume: 22
Issue: 6
ISSN: 0364-5134
Publisher: Wiley Blackwell  
Date Published: 1987-12-01
Start Page: 673
End Page: 682
Language: English
DOI: 10.1002/ana.410220602
PUBMED: 3501694
PROVIDER: scopus
DOI/URL:

https://www.scopus.com/inward/record.uri?eid=2-s2.0-0023581684&doi=10.1002%2fana.410220602&partnerID=40&md5=72d6a87f1566aeb601b21ccd61970e52
Notes: Article -- Export Date: 5 February 2021 -- Source: Scopus
Altmetric
What is Altmetric?
Citation Impact
What is Dimensions Citation Badge?
BMJ Impact Analytics
MSK Authors
  1. David A. Rottenberg
    41 Rottenberg
  2. Stephen C. Strother
    24 Strother
  3. Vijay Dhawan
    22 Dhawan
  4. James Z. Ginos
    15 Ginos
Related MSK Work