만성 외상성 뇌손상환자의 인지 및 정서 증상과 국소 뇌혈류 변화와의 관계

Abstract

Objectives: Although neuropsychiatric symptoms of traumatic brain injury (TBI) patients become relatively stable at the chronic stage, physicians would face difficulties when trying to establish an association between their patient’s symptom and the extent of brain injury. This study investigated regional cerebral blood flow (rCBF) in chronic TBI patients using statistical parametric mapping (SPM) to detect hypoperfusion and find correlation between rCBF and cognitive, emotional symptoms on SPECT scans.

Methods: SPECT images from 14 chronic TBI patients and 14 control subjects were analyzed by SPM2. The Korean-Wechsler Adult Intelligence Scale (K-WAIS) and Symptoms Checklist-90-R (SCL-90-R) were used to evaluate cognitive function and emotional symptoms of the patient group.

Results: Relative to control group, the hypoperfused regions in the patient group were in the cingulate gyrus, caudate nucleus, midbrain, thalamus, insula and prefrontal cortex. There was no significant relationship between rCBF and a full scale intelligence quotient of the K-WAIS in the patient group. However, a significant correlation was found between several emotional symptoms scores on the SCL-90-R and rCBF in specific brain regions interconnected with the limbic system.

Conclusion: The prefrontal and limbic hypoperfusion may play a significant role in the cognitive and emotional symptoms of chronic TBI patients.