Effect of cervical spinal cord stimulation (cSCS) on cerebral glucose metabolism and blood flow in a vegetative patient assessed by positron emission tomography (PET) and single photon emission computed tomography (SPECT)

This paper presents, for the first time, assessments of cerebral glucose metabolism and cerebral blood flow before and after cervical spinal cord stimulation (cSCS) in a vegetative patient. Regional cerebral metabolic rates for glucose (rCMRglc) were measured with positron emission tomography and 18F-fluoro-2-deoxy-D-glucose. Regional cerebral blood flow (rCBF) was determined with single photon emission computed tomography and N-isopropyl p-123I-iodoamphetamine. Global CMRglc in the patient was less than one-third of that in normal control subjects. An increase in rCMRglc after one week of cSCS was observed in the cerebral cortex, predominantly on the right side, where the baseline level of rCMRglc before cSCS was more severely depressed. The pattern of increase in rCBF was almost the same as that in rCMRglc. The results suggest that cSCS activates glucose metabolism and that this is followed by an increase in cerebral blood flow. (author)