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A study of persistent post-concussion symptoms in mild head trauma using positron emission tomography

¹ Department of Psychology, Indiana University – Purdue University Indianapolis (IUPUI), Indianapolis, Indiana, USA
² Department of Neurology, Indiana University School of Medicine, Indianapolis
³ Departments of Radiology, Indiana University School of Medicine, Indianapolis
⁴ Center of Neuropsychological Rehabilitation, Indianapolis

Correspondence to:
Correspondence to:
Dr S H Annabel Chen, Stanford School of Medicine, Radiology, Lucas MRS Imaging Center, 1201 Welch Road, MC: 5488, Stanford, CA 94305, USA;
annabel.chen{at}stanford.edu

Objective: To investigate, using positron emission tomography (PET), the in vivo changes in regional cerebral uptake of 2-[¹⁸F]fluoro-2-deoxy-D-glucose (FDG) and regional cerebral blood flow (rCBF) in patients with persistent symptoms following mild head trauma.

Methods: Five patients with mild head trauma and five age and education matched healthy controls were imaged using FDG-PET to measure differences in resting regional cerebral glucose metabolism. Oxygen-15 labelled water (H₂¹⁵O)-PET was also used to measure group differences in rCBF changes during a spatial working memory task. In addition, neuropsychological testing and self report of dysexecutive function and post-concussion symptoms were acquired to characterise the sample.

Results: There was no difference between patients and controls in normalised regional cerebral FDG uptake in the resting state in frontal and temporal regions selected a priori. However, during the spatial working memory task, patients had a smaller increase in rCBF than controls in the right prefrontal cortex.

Conclusions: Persistent post-concussive symptoms may not be associated with resting state hypometabolism. A cognitive challenge may be necessary to detect cerebral changes associated with mild head trauma.

Keywords: mild head trauma; positron emission tomography; post-concussion syndrome

Abbreviations: CVLT, California verbal learning test; FLOPS, frontal lobe personality scale; PCSC, postconcussion syndrome checklist; ROI, region of interest

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