0
0

Chapter 6. Functional Imaging

Karen E. Anderson, M.D.; Robin A. Hurley, M.D.; Katherine H. Taber, Ph.D.
DOI: 10.1176/appi.books.9781585624201.673855

Sections

Excerpt

Technological advances in the last century have allowed us unprecedented access to brain structure and function. Structural imaging techniques such as skull X rays, computed tomography (CT), and magnetic resonance imaging (MRI) have proved immensely helpful in assessment of extent of brain injury and in following the medical sequelae of traumatic brain injury (TBI), such as edema, intracranial bleeding, and degeneration. These tools provide increasing detail about bone and tissue injury sustained in TBI and many other medical conditions. However, these methods cannot assess the "function" or underlying cerebral metabolic rate (CMR) and cerebral blood flow (CBF) in the brain. Subtle brain changes after traumatic brain injury (TBI), although sufficient to affect a patient's ability to function at a normal level, may not be visible on structural imaging. The majority of mild TBI patients have normal CT and MRI scans (for review, see Belanger et al. 2007). Functional imaging techniques promise to help elucidate brain injury in these particularly challenging cases.

Your session has timed out. Please sign back in to continue.
Sign In Your Session has timed out. Please sign back in to continue.
Sign In to Access Full Content
 
Username
Password
Sign in via Athens (What is this?)
Athens is a service for single sign-on which enables access to all of an institution's subscriptions on- or off-site.
Not a subscriber?

Subscribe Now/Learn More

PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing PsychiatryOnline@psych.org or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

Figure 6–1. Procedure for obtaining a single-photon emission computed tomography (SPECT) scan.The same scanner is used for imaging many body systems, including brain, heart, bone, and lung. Details of the procedure differ. Before brain imaging, the patient receives an intravenous injection of the radioactive tracer while lying in a darkened room. After a short period in the darkened room to allow the tracer to distribute through the brain, the patient is ready to be scanned. The tracer distribution is stable for several hours, thus allowing a considerable time window for scanning to occur. After the patient is positioned on the scanner table, the gamma camera heads are moved in as close to the patient's head as possible. Illustrated is a multidetector system (IREX, Philips Medical Systems, Andover, MA), with three cameras (arrows). The cameras rotate around the patient's head during the imaging examination, and data are collected from multiple positions. The data are transmitted to a computer that produces tomographic images in the desired plane(s) of section.Source. Picture courtesy of Philips Medical Systems, Andover, MA.

Figure 6–2. SPECT imaging then and now.Axial single-photon emission computed tomography (SPECT) images of normal brain acquired in 1982, early 1990s, and 2009. Note the significant improvement in resolution since the 1980s.Source. SPECT image (1982) reprinted from Hill TC, Holman, BL, Lovett RD, et al.: "Initial Experience With SPECT (Single Photon Computerized Tomography) of the Brain Using N-isopropyl I-123p-iodoamphetamine: Concise Communication." Journal of Nuclear Medicine 23:193, 1982. Used with permission of the Society of Nuclear Medicine.

Figure 6–3. Serial axial SPECT images of a normal adult brain.Reference numbers for brain slice order are shown next to each slice. SPECT = single-photon emission computed tomography.

Figure 6–4. Current SPECT imaging capabilities.Three-dimensional reconstruction of single-photon emission computed tomography (SPECT) results obtained 2 months post traumatic brain injury (A). Areas of normal blood flow are red. Note the absence of flow in the right anterior temporal and frontal lobes (foreground), resulting in visualization of the left temporal and frontal lobes from the medial side. Seeing blood flow deficits in three dimensions improves appreciation of the extent of lesions. Merging blood flow data with anatomical imaging also improves identification of areas of abnormality. Sectional SPECT images overlaid on T1-weighted magnetic resonance axial (B) and coronal (C) images.Source. Pictures courtesy of Philips Medical Systems, Andover, MA.

Figure 6–5. Early subacute presentation of traumatic brain injury on SPECT.A 61-year-old man had a motor vehicle collision with a tree. This resulted in severe trauma with loss of consciousness requiring neurosurgical interventions. After several weeks of hospitalization, the patient was released. Within a few days, the patient'€™s family brought him to a psychiatric emergency service with agitation, incoherence, cognitive impairment, and psychosis. Two different sectional levels in the brain are illustrated with companion axial CT, T2-weighted MR, FLAIR MR, and SPECT. Note that the injury is more apparent on the FLAIR images than on the T2- weighted MR and CT images. The true extent of the injury, however, can be appreciated only on the SPECT images.CT = computed tomography; FLAIR = fluid-attenuated inversion recovery; MR = magnetic resonance; SPECT = single-photon emission computed tomography.

Figure 6–6. Late subacute presentation of traumatic brain injury.A 24-year-old man had a motor vehicle accident with no loss of consciousness 10 years after a mild head injury. Shortly thereafter, the patient presented with severe cognitive deficits, depression, agitation, aggression, and psychosis. Symptoms were sufficiently severe to require prolonged psychiatric hospitalization. MR examination during this time was normal. Numerous perfusion abnormalities were evident on SPECT scans acquired 2 years later (a single sagittal and three coronal sections are illustrated). The most pronounced abnormality was moderately reduced perfusion in the left parietal lobe near the posterior Sylvian fissure and in both temporal lobes. Mildly reduced perfusion was noted in the occipital lobes (left greater than right) and basal ganglia (particularly near the caudate heads). Some of these abnormalities are visible on both the sagittal and coronal images (arrows). MR = magnetic resonance; SPECT = single-photon emission computed tomography.

Figure 6–7. Chronic presentation of traumatic brain injury.A 52-year-old man had a high-impact closed-head injury 30 years before scanning. He presented with a 30-year history of emotional incontinence and depression. The patient also reported a loss of singing ability after the accident. Two different sectional levels in the brain are illustrated with companion axial T2-weighted MR and SPECT. There are minimal white matter changes in the parietal region apparent on the MR image. Mildly decreased perfusion is evident in the medial frontal lobes (left greater than right, arrowhead). Moderately decreased perfusion is evident in the right anterior temporal lobe adjacent to the Sylvian fissure (arrow). MR = magnetic resonance; SPECT = single-photon emission computed tomography.

Figure 6–8. Procedure for obtaining a PET scan.The patient receives an intravenous injection of the radioactive tracer while lying in a darkened room. After 20–30 minutes are spent in the darkened room to allow the tracer to distribute through the brain, the patient is ready to be scanned (A). Scanning usually begins within 1 hour of tracer injection and requires 30–45 minutes to complete. A headholder is often used to prevent head motion (B). PET = positron emission tomography.Source. Pictures courtesy of CTI Molecular Imaging, Inc., Knoxville, TN.

Figure 6–9. PET imaging then and now.Axial positron emission tomography (PET) images acquired in 1983 and 2010 of normal brain. Note the significant improvement in resolution since the 1980s.Source. 1983 pictures courtesy of CTI Molecular Imaging, Inc., Knoxville, TN.

Figure 6–10. Serial axial fluoride-18 fluorodeoxyglucose PET images of a normal adult brain.PET = positron emission tomography.Source. Case contributed by Dr. Donald P. Eknoyan, W.G. (Bill) Hefner VA Medical Center, Salisbury, NC.

Figure 6–11. Current PET imaging capabilities.Three-dimensional reconstruction of positron emission tomography (PET) results (A) and fusion of computed tomography and PET (B) improve appreciation of the extent of functional abnormalities. Neurotransmitter systems may also be imaged with PET. Presynaptic dopamine terminals can be labeled with 18F-fluorodopa (C). Dopamine D2 receptors can be labeled with 11C-N-methylspiperone (D).Source. Pictures courtesy of CTI Molecular Imaging, Inc.

Figure 6–12. Procedure for obtaining a xenon-enhanced computed tomography (Xe/CT) scan.Normal clinical CT scans are acquired as the first stage in an Xe/CT study. The patient then inhales a mixture of xenon gas and oxygen via a face mask (A) for several minutes. Xe/CT images are acquired during inhalation. A solid headholder may be used to minimize motion of the head.Source. Picture courtesy of NeuroLogica Corporation, Danvers, MA. Used with permission.
Table Reference Number
Table 6–1. Brain imaging techniques
Table Reference Number
Table 6–2. Commonly used U.S. Food and Drug Administration–approved tracers for SPECT
Table Reference Number
Table 6–3. U.S. Food and Drug Administration–approved, commonly used tracers/radioligands for PET

References

Abate MG, Trivedi M, Fryer TD, et al: Early derangements in oxygen and glucose metabolism following head injury: the ischemic penumbra and pathophysiological heterogeneity. Neurocrit Care 9:319–325, 2008
[PubMed]
 
Abu-Judeh HH, Singh M, Masdeu JC, et al: Discordance between FDG uptake and technetium-99m-HMPAO brain perfusion in acute traumatic brain injury. J Nucl Med 39:1357–1359, 1998
[PubMed]
 
Agrawal D, Gowda NK, Bal CS, et al: Is medial temporal injury responsible for pediatric postconcussion syndrome? a prospective controlled study with single-photon emission computerized tomography. J Neurosurg 102:167–171, 2005
[PubMed]
 
Atighechi S, Salari H, Baradarantar MH, et al: A comparative study of brain perfusion single-photon emission computed tomography and magnetic resonance imaging in patients with post-traumatic anosmia. Am J Rhinol Allergy 23:409–412, 2009
[PubMed]
 
Audenaert K, Jansen HM, Otte A, et al: Imaging of mild traumatic brain injury using 57Co and 99mTc HMPAO SPECT as compared to other diagnostic procedures. Med Sci Monit 9:112–117, 2003
 
Barkai G, Goshen E, Tzila Zwas S, et al: Acetazolamide-enhanced neuroSPECT scan reveals functional impairment after minimal traumatic brain injury not otherwise discernible. Psychiatry Res 132:279–283, 2004
[PubMed]
 
Barrett KF, Masel B, Patterson J, et al: Regional CBF in chronic stable TBI treated with hyperbaric oxygen. Undersea Hyperb Med 31:395–406, 2004
[PubMed]
 
Belanger HG, Vanderploeg RD, Curtiss G, et al: Recent neuroimaging techniques in mild traumatic brain injury. J Neuropsychiatry Clin Neurosci 19:5–20, 2007
[PubMed]
 
Bergsneider M, Hovda DA, McArthur DL, et al: Metabolic recovery following human traumatic brain injury based on FDG-PET: time course and relationship to neurological disability. J Head Trauma Rehabil 16:135–148, 2001
[PubMed]
 
Bonne O, Gilboa A, Louzoun Y, et al: Cerebral blood flow in chronic symptomatic mild traumatic brain injury. Psychiatry Res 124:141–152, 2003
[PubMed]
 
Caeyenberghs K, Wenderoth N, Smits-Engelsman BC, et al: Neural correlates of motor dysfunction in children with traumatic brain injury: exploration of compensatory recruitment patterns. Brain 132:684–694, 2009
[PubMed]
 
Chen JK, Johnston KM, Petrides M, et al: Recovery from mild head injury in sports: evidence from serial functional magnetic resonance imaging studies in male athletes. Clin J Sports Med 18:241–247, 2008
[PubMed]
 
Chen SHA, Kareken DA, Fastenau PS, et al: A study of persistent post-concussion symptoms in mild head trauma using positron emission tomography. J Neurol Neurosurg Psychiatry 74:326–332, 2003
[PubMed]
 
Chiu Wong SB, Chapman SB, Cook LG, et al: A SPECT study of language and brain reorganization three years after pediatric brain injury. Prog Brain Res 157:173–185, 2006
 
Clauss RP, Nel WH: Effect of zolpidem on brain injury and diaschisis as detected by 99mTc HMPAO brain SPECT in humans. Arzneimittelforschung 54:641–646, 2004
[PubMed]
 
Coles JP: Imaging of cerebral blood flow and metabolism. Curr Opin Anaesthesiol 19:473–480, 2006
[PubMed]
 
Coles JP, Cunningham AS, Salvador R, et al: Early metabolic characteristics of lesion and nonlesion tissue after head injury. J Cereb Blood Flow Metab 29:965–975, 2009
[PubMed]
 
Diringer MN, Aiyagari V, Zuzulia AR, et al: Effect of hyperoxia on cerebral metabolic rate for oxygen measured using positron emission tomography in patients with acute severe head injury. J Neurosurg 106:526–529, 2007
[PubMed]
 
Dubroff JG, Newberg A: Neuroimaging of traumatic brain injury. Semin Neurol 28:548–557, 2008
[PubMed]
 
Duckworth JL, Stevens RD: Imaging brain trauma. Curr Opin Crit Care 16:92–97, 2010
 
Eftekhari M, Assadi M, Kazemi M, et al: A preliminary study of neuroSPECT evaluation of patients with post-traumatic smell impairment. BMC Nucl Med 28:5–6, 2005
 
Eftekhari M, Assadi M, Kazemi M, et al: Brain perfusion single photon emission computed tomography findings in patients with posttraumatic anosmia and comparison with radiological imaging. Am J Rhinol 20:577–581, 2006
[PubMed]
 
Fontaine A, Azouvi P, Remy P, et al: Functional anatomy of neuropsychological deficits after severe traumatic brain injury. Neurology 53:1963–1968, 1999
[PubMed]
 
Goethals I, Audenaert K, Jacobs F, et al: Cognitive neuroactivation using SPECT and the Stroop Colored Word Test in patients with diffuse brain injury. J Neurotrauma 21:1059–1069, 2004
[PubMed]
 
Gowda NK, Agrawal D, Bal C, et al: Technetium Tc-99m ethyl cysteinate dimer brain single-photon emission CT in mild traumatic brain injury: a prospective study. Am J Neuroradiol 27:447–451, 2006
[PubMed]
 
Gross H, Kling A, Henry G, et al: Local cerebral glucose metabolism in patients with long-term behavioral and cognitive deficits following mild traumatic brain injury. J Neuropsychiatry Clin Neurosci 8:324–334, 1996
[PubMed]
 
Harch PG, Fogarty EF, Staab PK, et al: Low pressure hyperbaric oxygen therapy and SPECT brain imaging in the treatment of blast-induced chronic traumatic brain injury (post-concussion syndrome) and post traumatic stress disorder: a case report. Cases J 9:6538, 2009
 
Hattori N, Huang SC, Wu HM, et al: Acute changes in regional cerebral 18F-FDG kinetics in patients with traumatic brain injury. J Nucl Med Technol 45:775–783, 2004
[PubMed]
 
Hattori N, Swan M, Stobbe GA, et al: Differential SPECT activation patterns associated with PASAT performance may indicate frontocerebellar functional dissociation in chronic mild traumatic brain injury. J Nucl Med 50:1054–1061, 2009
[PubMed]
 
Hofman PA, Stapert SZ, van Kroonenburgh MJ, et al: MR imaging, single-photon emission CT, and neurocognitive performance after mild traumatic brain injury. Am J Neuroradiol 22:441–449, 2001
[PubMed]
 
Huang M, Theilmann RJ, Robb A, et al: Integrated imaging approach with MEG and DTI to detect mild traumatic brain injury in military and civilian patients. J Neurotrauma 26:1213–1226, 2009
[PubMed]
 
Hutchinson PJ, Gupta AK, Fryer TF, et al: Correlation between cerebral blood flow, substrate delivery, and metabolism in head injury: a combined microdialysis and triple oxygen positron emission tomography study. J Cereb Blood Flow Metab 22:735–745, 2002
[PubMed]
 
Hutchinson PJ, O'Connell MT, Seal A, et al: A combined microdialysis and FDG-PET study of glucose metabolism in head injury. Acta Neurochir 151:51–61, 2009
[PubMed]
 
Ichise M, Chung DG, Wang P, et al: Technetium-99m-HMPAO SPECT, CT and MRI in the evaluation of patients with chronic traumatic brain injury: a correlation with neuropsychological performance. J Nucl Med 35:217–226, 1994
[PubMed]
 
Inoue Y, Shiozaki T, Tasaki O, et al: Changes in cerebral blood flow from the acute to the chronic phase of severe head injury. J Neurotrauma 22:1411–1418, 2005
[PubMed]
 
Iwasaki M, Nakasato N, Kanno A, et al: Somatosensory evoked fields in comatose survivors after severe traumatic brain injury. Clin Neurophysiol 112:205–211, 2001
[PubMed]
 
Jacobs A, Put E, Ingels M, et al: Prospective evaluation of technetium-99m-HMPAO SPECT in mild and moderate traumatic brain injury. J Nucl Med 35:942–947, 1994
[PubMed]
 
Jacobs A, Put E, Ingels M, et al: One-year follow-up of technetium-99m-HMPAO SPECT in mild head injury. J Nucl Med 37:1605–1609, 1996
[PubMed]
 
Jantzen KJ, Anderson B, Steinberg FL, et al: A prospective functional MR imaging study of mild traumatic brain injury in college football players. Am J Neuroradiol 25:738–745, 2004
[PubMed]
 
Karunanayaka PR, Holland SK, Yuan W, et al: Neural substrate differences in language networks and associated language-related behavioral impairments in children with TBI: a preliminary fMRI investigation. NeuroRehabilitation 22:355–369, 2007
[PubMed]
 
Kato T, Nakayama N, Yasokawa Y, et al: Statistical image analysis of cerebral glucose metabolism in patients with cognitive impairment following diffuse traumatic brain injury. J Neurotrauma 24:919–926, 2007
[PubMed]
 
Kawai N, Nakamura T, Nagao S: Metabolic disturbance without brain ischemia in traumatic brain injury: a positron emission tomography study. Acta Neurochir Suppl 102:241–245, 2008
[PubMed]
 
Kim YH, Yoo WK, Ko MH, et al: Plasticity of the attentional network after brain injury and cognitive rehabilitation. Neurorehabil Neural Repair 23:468–477, 2009
[PubMed]
 
Kohl AD, Wylie GR, Genova HM, et al: The neural correlates of cognitive fatigue in traumatic brain injury using functional MRI. Brain Inj 23:420–432, 2009
[PubMed]
 
Kramer ME, Chui CY, Walz NC, et al: Long-term neural processing of attention following early childhood traumatic brain injury: fMRI and neurobehavioral outcomes. J Int Neuropsychol Soc 14:424–435, 2008
[PubMed]
 
Kraus MF, Smith GS, Butters M, et al: Effects of the dopaminergic and NMDA receptor antagonist amantadine on cognitive function, cerebral glucose metabolism and D2 receptor availability in chronic traumatic brain injury: a study using positron emission tomography (PET). Brain Inj 19:471–479, 2005
[PubMed]
 
Kremer S, Nicolas-Ong C, Schunck T, et al: Usefulness of functional MRI associated with PET scan and evoked potentials in the evaluation of brain functions after severe brain injury: preliminary results. J Neuroradiol 2009, September 23 [Epub ahead of print]
 
Laatsch L, Jobe T, Sychra J, et al: Impact of cognitive rehabilitation therapy on neuropsychological impairments as measured by brain perfusion SPECT: a longitudinal study. Brain Inj 11:851–863, 1997
[PubMed]
 
Laatsch L, Pavel D, Jobe T, et al: Incorporation of SPECT imaging in a longitudinal cognitive rehabilitation therapy programme. Brain Inj 13:555–570, 1999
[PubMed]
 
Levine B, Cabeza R, McIntosh AR, et al: Functional reorganisatioin of memory after traumatic brain injury: a study with H2 15O positron emission tomography. J Neurol Neurosurg Psychiatry 73:173–181, 2002
[PubMed]
 
Lewine JD, Davis JT, Sloan JH, et al: Neuromagnetic assessment of pathophysiologic brain activity induced by minor head trauma. Am J Neuroradiol 20:857–866, 1999
[PubMed]
 
Lewine JD, Davis JT, Bigler ED, et al: Objective documentation of traumatic brain injury subsequent to mild head trauma: multimodal brain imaging with MEG, SPECT, and MRI. J Head Trauma Rehabil 22:141–155, 2007
[PubMed]
 
Lewis DH, Bluestone JP, Savina M, et al: Imaging cerebral activity in recovery from chronic traumatic brain injury: a preliminary report. J Neuroimaging 16:272–277, 2006
[PubMed]
 
Lotze M, Grodd W, Rodden FA, et al: Neuroimaging patterns associated with motor control in traumatic brain injury. Neurorehabil Neural Repair 20:14–23, 2006
[PubMed]
 
Lovell MR, Pardini JE, Welling J, et al: Functional brain abnormalities are related to clinical recovery and time to return-to-play in athletes. Neurosurgery 61:352–359, 2007
[PubMed]
 
Mann NM, Vento JA: A study comparing SPECT and MRI in patients with anosmia after traumatic brain injury. Clin Nucl Med 31:458–462, 2006
[PubMed]
 
Maruishi M, Miyatani M, Nakao T: Compensatory cortical activation during performance of an attention task by patients with diffuse axonal injury: a functional magnetic resonance imaging study. J Neurol Neurosurg Psychiatry 78:168–173, 2007
[PubMed]
 
Mayer AR, Mannell MV, Ling J, et al: Auditory orienting and inhibition of return in mild traumatic brain injury: a FMRI study. Hum Brain Mapp 31:4152–4166, 2009
 
McAllister TW, Sparling MB, Flashman LA, et al: Neuroimaging findings in mild traumatic brain injury. J Clin Exp Neuropsychol 23:775–791, 2001
[PubMed]
 
McAllister TW, Flashman LA, McDonald BC, et al: Mechanisms of working memory dysfunction after mild and moderate TBI: evidence from functional MRI and neurogenetics. J Neurotrauma 23:1450–1467, 2006
[PubMed]
 
Metting Z, Rodiger LA, De Keyser J, et al: Structural and functional neuroimaging in mild-to-moderate head injury. Lancet Neurol 6:699–710, 2007
[PubMed]
 
Munson S, Schroth BA, Ernst M: The role of functional neuroimaging in pediatric brain injury. Pediatrics 117:1372–1381, 2006
[PubMed]
 
Nakamura T, Hillary FG, Biswal BB: Resting network plasticity following brain injury. PLoS One 4:e8220, 2009
 
Nakashima T, Nakayama N, Miwa K, et al: Focal brain glucose, hypometabolism in patients with neuropsychologic deficits after diffuse axonal injury. Am J Neuroradiol 28:236–242, 2007
[PubMed]
 
Nakayama N, Okumura J, Shinoda J, et al: Relationship between regional cerebral metabolism and consciousness disturbance in traumatic diffuse brain injury without large focal lesions: an FDG-PET study with statistical parametric mapping analysis. J Neurol Neurosurg Psychiatry 77:856–862, 2006
[PubMed]
 
Newsome MR, Scheibel RS, Hunter JV, et al: Brain activation during working memory after traumatic brain injury in children. Neurocase 13:16–24, 2007
[PubMed]
 
Newsome MR, Scheibel RS, Hanten G, et al: Brain activation while thinking about the self from another person's perspective after traumatic brain injury in adolescents. Neuropsychology 24:139–147, 2010
[PubMed]
 
Nortje J, Coles JP, Timofeev I, et al: Effect of hyperoxia on regional oxygenation and metabolism after severe traumatic brain injury: preliminary findings. Crit Care Med 36:273–281, 2008
[PubMed]
 
Oder W, Goldenberg G, Spatt J, et al: Behavioural and psychosocial sequelae of severe closed head injury and regional cerebral blood flow: a SPECT study. J Neurol Neurosurg Psychiatry 55:475–480, 1992
[PubMed]
 
Okamoto T, Hashimoto K, Aoki S, et al: Cerebral blood flow in patients with diffuse axonal injury: examination of the easy Z-score imaging system utility. Eur J Neurol 14:540–547, 2007
[PubMed]
 
Peskind ER, Petrie EC, Cross DJ, et al: Cerebrocerebellar hypometabolism associated with repetitive blast exposure mild traumatic brain injury in 12 Iraq war veterans with persistent post-concussive symptoms. Neuroimage 2010, April 10 [Epub ahead of print]
 
Ptito A, Chen JK, Johnston KM: Contributions of functional magnetic resonance imaging (fMRI) to sport concussion evaluation. NeuroRehabilitation 22:217–227, 2007
[PubMed]
 
Rasmussen IA, Xu J, Antonsen IK, et al: Simple dual tasking recruits prefrontal cortices in chronic severe traumatic brain injury patients, but not in controls. J Neurotrauma 25:1057–1070, 2008
[PubMed]
 
Ricker JH, Muller RA, Zafonte RD, et al: Verbal recall and recognition following traumatic brain injury: a [O-15]-water positron emission tomography study. J Clin Exp Neuropsychol 23:196–206, 2001
[PubMed]
 
Sanchez-Carrion R, Fernandez-Espejo D, Junque C, et al: A longitudinal fMRI study of working memory in severe TBI patients with diffuse axonal injury. Neuroimage 43:421–429, 2008a
 
Sanchez-Carrion R, Gomez PV, Junque C, et al: Frontal hypoactivation on functional magnetic resonance imaging in working memory after severe diffuse traumatic brain injury. J Neurotrauma 25:479–494, 2008b
 
Scheibel RS, Newsome MR, Troyanskaya M, et al: Effects of severity of traumatic brain injury and brain reserve on cognitive-control related brain activation. J Neurotrauma 26:1447–1461, 2009
[PubMed]
 
Schiff ND, Ribary U, Moreno DR, et al: Residual cerebral activity and behavioural fragments can remain in the persistently vegetative brain. Brain 125:1210–1234, 2002
[PubMed]
 
Shi XY, Tang ZQ, Sun D, et al: Evaluation of hyperbaric oxygen treatment of neuropsychiatric disorders following traumatic brain injury. Chin Med J 119:1978–1982, 2006
[PubMed]
 
Shiga T, Ikoma K, Katoh C, et al: Loss of neuronal integrity: a cause of hypometabolism in patients with traumatic brain injury without MRI abnormality in the chronic stage. Eur J Nucl Med Mol Imaging 33:817–822, 2006
[PubMed]
 
Shin YB, Kim SJ, Kim IJ, et al: Voxel-based statistical analysis of cerebral blood flow using Tc-99m ECD brain SPECT in patients with traumatic brain injury: group and individual analyses. Brain Inj 20:661–667, 2006
[PubMed]
 
Slobounov SM, Zhang K, Pennell D, et al: Functional abnormalities in normally appearing athletes following mild traumatic brain injury: a functional MRI study. Exp Brain Res 202:341–354, 2010
[PubMed]
 
Smits M, Dippel DW, Houston GC, et al: Postconcussion syndrome after minor head injury: brain activation of working memory and attention. Hum Brain Mapp 30:2789–2803, 2009
[PubMed]
 
Stamatakis EA, Wilson JT, Hadley DM, et al: SPECT imaging in head injury interpreted with statistical parametric mapping. J Nucl Med 43:476–483, 2002
[PubMed]
 
Starkstein SE, Mayberg HS, Berthier ML, et al: Mania after brain injury: neuroradiological and metabolic findings. Ann Neurol 27:652–659, 1990
[PubMed]
 
Steiner LA, Coles JP, Johnston AJ, et al: Responses of posttraumatic pericontusional cerebral blood flow and blood volume to an increase in cerebral perfusion pressure. J Cereb Blood Flow Metab 23:1371–1377, 2003
[PubMed]
 
Strangman GE, O'Neil-Pirozzi TM, Goldstein R, et al: Prediction of memory rehabilitation outcomes in traumatic brain injury by using functional magnetic resonance imaging. Arch Phys Med Rehabil 89:974–981, 2008
[PubMed]
 
Strangman GE, Goldstein R, O'Neil-Pirozzi TM, et al: Neurophysiological alterations during strategy-based verbal learning in traumatic brain injury. Neurorehabil Neural Repair 23:226–236, 2009
[PubMed]
 
Turner GR, Levine B: Augmented neural activity during executive control processing following diffuse axonal injury. Neurology 71:812–818, 2008
[PubMed]
 
Ueno H, Maruishi M, Miyatani M, et al: Brain activations in errorless and errorful learning in patients with diffuse axonal injury: a functional MRI study. Brain Inj 23:291–298, 2009
[PubMed]
 
Umile EM, Plotkin RC, Sandel ME:. Functional assessment of mild traumatic brain injury using SPECT and neuropsychological testing. Brain Inj 12:577–594, 1998
[PubMed]
 
Van Boven RW, Harrington GS, Hackney DB, et al: Advances in neuroimaging of traumatic brain injury and posttraumatic stress disorder. J Rehabil Res Dev 46:717–756, 2009
 
Vanhaudenhuyse A, Noirhomme Q, Tshibanda LJ, et al: Default network connectivity reflects the level of consciousness in non-communicative brain-damaged patients. Brain 133:161–171, 2010
[PubMed]
 
Varney NR, Bushnell DL, Nathan M, et al: NeuroSPECT correlates of disabling mild head injury: preliminary findings. J Head Trauma Rehabil 10:18–28, 1995
 
Vespa P, Bergsneider M, Hattori N, et al: Metabolic crisis without brain ischemia is common after traumatic brain injury: a combined microdialysis and positron emission tomography study. J Cereb Blood Flow Metab 25:763–774, 2005
[PubMed]
 
von Oettingen G, Bergholt B, Gyldensted C, et al: Blood flow and ischemia within traumatic cerebral contusions. Neurosurgery 50:781–788, 2002
 
Weidmann KD, Wilson JTL, Wyper D, et al: SPECT cerebral blood flow, MR imaging, and neuropsychological findings in traumatic head injury. Neuropsychology 3:267–281, 1989
 
Wu HM, Huang SC, Hattori N, et al: Subcortical white matter metabolic changes remote from focal hemorrhagic lesions suggest diffuse injury after human traumatic brain injury. Neurosurgery 55:1306–1317, 2004
[PubMed]
 
Xu Y, McArthur DL, Alger JR, et al: Early nonischemic oxidative metabolic dysfunction leads to chronic brain atrophy in traumatic brain injury. J Cereb Blood Flow Metab 30:883–894, 2010
[PubMed]
 
Zhang J, Mitsis EM, Chu K, et al: Statistical parametric mapping and cluster counting analysis of [18F] FDG-PET imaging in traumatic brain injury. J Neurotrauma 27:35–49, 2010
[PubMed]
 
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Related Content
Articles
Books
Textbook of Traumatic Brain Injury, 2nd Edition > Chapter 4.  >
Textbook of Traumatic Brain Injury, 2nd Edition > Chapter 5.  >
Textbook of Traumatic Brain Injury, 2nd Edition > Chapter 7.  >
Textbook of Traumatic Brain Injury, 2nd Edition > Chapter 2.  >
Textbook of Traumatic Brain Injury, 2nd Edition > Chapter 12.  >
Topic Collections
Psychiatric News
PubMed Articles
 
  • Print
  • PDF
  • E-mail
  • Chapter Alerts
  • Get Citation