Differences in cerebral blood flow and glucose utilization in vegetative versus locked-in patients
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 vegetati...
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| Veröffentlicht in: | Annals of neurology 1987-12, Vol.22 (6), p.673-682 |
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| container_title | Annals of neurology |
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| creator | Levy, David E. Sidtis, John J. Rottenberg, David A. Jarden, Jens O. Strother, Stephen C. Dhawan, Vijay Ginos, James Z. Tramo, Mark J. Evans, Alan C. Plum, Fred |
| description | 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. |
| doi_str_mv | 10.1002/ana.410220602 |
| format | Article |
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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.</description><identifier>ISSN: 0364-5134</identifier><identifier>EISSN: 1531-8249</identifier><identifier>DOI: 10.1002/ana.410220602</identifier><identifier>PMID: 3501694</identifier><identifier>CODEN: ANNED3</identifier><language>eng</language><publisher>Boston: American Neurological Association</publisher><subject>Adolescent ; Adult ; Biological and medical sciences ; Brain Diseases - diagnostic imaging ; Brain Diseases - metabolism ; Brain Diseases - physiopathology ; Cerebrovascular Circulation ; Coma - diagnostic imaging ; Coma - metabolism ; Coma - physiopathology ; Deoxyglucose - analogs & derivatives ; Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes ; Female ; Fluorodeoxyglucose F18 ; Glucose - metabolism ; Humans ; Male ; Medical sciences ; Middle Aged ; Nervous system (semeiology, syndromes) ; Neurology ; Tomography, Emission-Computed</subject><ispartof>Annals of neurology, 1987-12, Vol.22 (6), p.673-682</ispartof><rights>Copyright © 1987 American Neurological Association</rights><rights>1988 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4032-dfcd27baa2d14be5c147fcea532a864a8cbc409b9778d5292a3d8bfedf8448663</citedby><cites>FETCH-LOGICAL-c4032-dfcd27baa2d14be5c147fcea532a864a8cbc409b9778d5292a3d8bfedf8448663</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fana.410220602$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fana.410220602$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=7544771$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/3501694$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Levy, David E.</creatorcontrib><creatorcontrib>Sidtis, John J.</creatorcontrib><creatorcontrib>Rottenberg, David A.</creatorcontrib><creatorcontrib>Jarden, Jens O.</creatorcontrib><creatorcontrib>Strother, Stephen C.</creatorcontrib><creatorcontrib>Dhawan, Vijay</creatorcontrib><creatorcontrib>Ginos, James Z.</creatorcontrib><creatorcontrib>Tramo, Mark J.</creatorcontrib><creatorcontrib>Evans, Alan C.</creatorcontrib><creatorcontrib>Plum, Fred</creatorcontrib><title>Differences in cerebral blood flow and glucose utilization in vegetative versus locked-in patients</title><title>Annals of neurology</title><addtitle>Ann Neurol</addtitle><description>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.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Brain Diseases - diagnostic imaging</subject><subject>Brain Diseases - metabolism</subject><subject>Brain Diseases - physiopathology</subject><subject>Cerebrovascular Circulation</subject><subject>Coma - diagnostic imaging</subject><subject>Coma - metabolism</subject><subject>Coma - physiopathology</subject><subject>Deoxyglucose - analogs & derivatives</subject><subject>Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes</subject><subject>Female</subject><subject>Fluorodeoxyglucose F18</subject><subject>Glucose - metabolism</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Tomography, Emission-Computed</subject><issn>0364-5134</issn><issn>1531-8249</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1987</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMlv1DAUxi0EKkPhyBEpB8QtxWucHKeFDoiqSKgIbpaX58rUEw920oW_HlcTjThxesv3e4s-hF4TfEIwpu_1qE84wZTiDtMnaEUEI21P-fAUrTDreCsI48_Ri1J-YYyHjuAjdMQEJt3AV8h8CN5DhtFCacLY2JqbrGNjYkqu8THdNXp0zXWcbSrQzFOI4Y-eQhof8Vu4hqlWt1DTXObSxGRvwLVV29U-jFN5iZ55HQu8WuIx-n7-8ersU3vxdfP5bH3RWo4ZbZ23jkqjNXWEGxCWcOktaMGo7juue2sqOJhByt4JOlDNXG88ON9z3ncdO0bv9nt3Of2eoUxqG4qFGPUIaS5KyoEOkvcVbPegzamUDF7tctjq_KAIVo-equqpOnha-TfL4tlswR3oxcSqv110XayOPuvRhnLApOBcSlIxucfuQoSH_99U68v1vw8sD4cywf1hUucb1UkmhfpxuVHi288vm1N2pU7ZX7i4n70</recordid><startdate>198712</startdate><enddate>198712</enddate><creator>Levy, David E.</creator><creator>Sidtis, John J.</creator><creator>Rottenberg, David A.</creator><creator>Jarden, Jens O.</creator><creator>Strother, Stephen C.</creator><creator>Dhawan, Vijay</creator><creator>Ginos, James Z.</creator><creator>Tramo, Mark J.</creator><creator>Evans, Alan C.</creator><creator>Plum, Fred</creator><general>American Neurological Association</general><general>Willey-Liss</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>198712</creationdate><title>Differences in cerebral blood flow and glucose utilization in vegetative versus locked-in patients</title><author>Levy, David E. ; Sidtis, John J. ; Rottenberg, David A. ; Jarden, Jens O. ; Strother, Stephen C. ; Dhawan, Vijay ; Ginos, James Z. ; Tramo, Mark J. ; Evans, Alan C. ; Plum, Fred</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4032-dfcd27baa2d14be5c147fcea532a864a8cbc409b9778d5292a3d8bfedf8448663</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1987</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Brain Diseases - diagnostic imaging</topic><topic>Brain Diseases - metabolism</topic><topic>Brain Diseases - physiopathology</topic><topic>Cerebrovascular Circulation</topic><topic>Coma - diagnostic imaging</topic><topic>Coma - metabolism</topic><topic>Coma - physiopathology</topic><topic>Deoxyglucose - analogs & derivatives</topic><topic>Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes</topic><topic>Female</topic><topic>Fluorodeoxyglucose F18</topic><topic>Glucose - metabolism</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>Tomography, Emission-Computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Levy, David E.</creatorcontrib><creatorcontrib>Sidtis, John J.</creatorcontrib><creatorcontrib>Rottenberg, David A.</creatorcontrib><creatorcontrib>Jarden, Jens O.</creatorcontrib><creatorcontrib>Strother, Stephen C.</creatorcontrib><creatorcontrib>Dhawan, Vijay</creatorcontrib><creatorcontrib>Ginos, James Z.</creatorcontrib><creatorcontrib>Tramo, Mark J.</creatorcontrib><creatorcontrib>Evans, Alan C.</creatorcontrib><creatorcontrib>Plum, Fred</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Levy, David E.</au><au>Sidtis, John J.</au><au>Rottenberg, David A.</au><au>Jarden, Jens O.</au><au>Strother, Stephen C.</au><au>Dhawan, Vijay</au><au>Ginos, James Z.</au><au>Tramo, Mark J.</au><au>Evans, Alan C.</au><au>Plum, Fred</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Differences in cerebral blood flow and glucose utilization in vegetative versus locked-in patients</atitle><jtitle>Annals of neurology</jtitle><addtitle>Ann Neurol</addtitle><date>1987-12</date><risdate>1987</risdate><volume>22</volume><issue>6</issue><spage>673</spage><epage>682</epage><pages>673-682</pages><issn>0364-5134</issn><eissn>1531-8249</eissn><coden>ANNED3</coden><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.</abstract><cop>Boston</cop><pub>American Neurological Association</pub><pmid>3501694</pmid><doi>10.1002/ana.410220602</doi><tpages>10</tpages></addata></record> |
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| ispartof | Annals of neurology, 1987-12, Vol.22 (6), p.673-682 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adolescent Adult Biological and medical sciences Brain Diseases - diagnostic imaging Brain Diseases - metabolism Brain Diseases - physiopathology Cerebrovascular Circulation Coma - diagnostic imaging Coma - metabolism Coma - physiopathology Deoxyglucose - analogs & derivatives Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes Female Fluorodeoxyglucose F18 Glucose - metabolism Humans Male Medical sciences Middle Aged Nervous system (semeiology, syndromes) Neurology Tomography, Emission-Computed |
| title | Differences in cerebral blood flow and glucose utilization in vegetative versus locked-in patients |
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