외상성 뇌손상 환자에서 SPECT 상 전두엽 뇌혈류 변화와 실행기능 간의 상관관계
Relationship between Change in Frontal Lobe Perfusion on Brain SPECT and Executive Function Test in Patients with Traumatic Brain Injury
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목 적 : 본 후향성 연구에서 외상성 뇌손상 환자에서 SPECT상 전두엽 뇌혈류변화와 실행기능간의 상관관계를 조사하였다. 방 법 : MRI상 구조적 이상소견이 없는 26명의 외상성 뇌손상 환자를 대상으로 SPECT 촬영을 시행하였다. 실행기능을 평가하기 위해 SNSB, K-WAIS, Kims 전두엽-관리기능 신경심리검사를 시행하였다. SPECT상 전두엽 뇌혈류 변화와 실행기능간의 상관관계를 평가하기위해 통계적 파라미터 지도(SPM)를 이용한 복셀기반분석(voxel-based analysis)을 시행하였다. 결 과 : 신경심리검사 항목들 중 SPECT상 전두엽 영역의 뇌혈류감소 간에 유의미한 상관관계(p<0.05)를 갖는 항목들은 alternating hand movement, fist-edge-palm,동작성 지능, 스트룹 단순시행, 단어유창성, 인출효율성이었다. 이중에서 인출효율성이 가장 유의한 상관관계를 나타내었다. 결 론 : 본 연구결과에서 인출효율성이 SPECT상 전두엽의관류저하와 연관성을 보였다.
Abstract
Objectives：The aim of this retrospective study was to correlate change in frontal lobe perfusion on brain single photon emission computed tomography(SPECT) with executive function in patients with traumatic brain injury(TBI). Methods：Twenty-six TBI patients without structural abnormality on brain magnetic resonance imaging were scanned by SPECT. Seoul Neuropsychological Screening Battery, K-Wechsler adult intelligence scale, Kims frontalexecutive neuropsychological test were conducted to evaluate executive function. A voxel-based analysis using statistical parametric mapping(SPM) was performed to correlate frontal lobe perfusion on SPECT with executive function. Results：There were significant correlations(p<0.05) between neuropsychological tests, including alternating hand movement, fist-edge-palm, performance IQ, Stroop test-color reading, word fluency and retrieval efficiency,and frontal hypoperfusion on SPECT. retrieval efficiency showed the strongest correlation coefficient. Conclusion：These finding suggests that retrieval efficiency is associated with frontal hypoperfusion on SPECT.
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