Separating functional and structural damage in persistent vegetative state using combined voxel-based analysis of 3-D MRI and FDG-PET

J Neurol Sci. 2005 Feb 15;228(2):179-84. doi: 10.1016/j.jns.2004.11.052. Epub 2005 Jan 6.


Functional and structural damage in postanoxic persistent vegetative state (PVS) was analysed using 18fluorodeoxyglucose PET (FDG-PET) coregistered to 3-D MRI in combination with morphometric 3-D MRI analysis (voxel-based morphometry, VBM). In five patients in late stages of non-traumatic PVS, combined analysis using statistical parametric mapping (SPM2) was performed to compare metabolic impairment and structural loss. FDG-PET showed widespread hypometabolism at p<0.001 (corrected) in the parietal, parietooccipital and frontotemporal cortices, cingulum, frontal medial and precentral gyrus, and within the bilateral thalamus. VBM revealed multilocal structural loss at p<0.001 (corrected) in the inferior parietal and superior/medial frontal cortices, insula and operculum, superior and medial temporal lobes, cingulum and fusiform gyrus, caudate, midbrain, dorsal pons, and the cerebellum, but to a lesser extent in the thalamus. The selective vulnerability of the brain in a sample of PVS patients could be mapped in vivo, indicating that a complex structural and functional lesion pattern of the cerebral networks seems to be associated with this condition.

MeSH terms

  • Adult
  • Atrophy / diagnosis*
  • Atrophy / diagnostic imaging
  • Brain / diagnostic imaging
  • Brain / metabolism
  • Brain / pathology*
  • Cerebrovascular Circulation / physiology
  • Energy Metabolism / physiology
  • Female
  • Fluorodeoxyglucose F18*
  • Functional Laterality / physiology
  • Humans
  • Hypoxia-Ischemia, Brain / complications*
  • Image Processing, Computer-Assisted / methods
  • Imaging, Three-Dimensional
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Nerve Net / diagnostic imaging
  • Nerve Net / metabolism
  • Nerve Net / pathology
  • Persistent Vegetative State / diagnosis*
  • Persistent Vegetative State / diagnostic imaging
  • Persistent Vegetative State / etiology
  • Positron-Emission Tomography / methods


  • Fluorodeoxyglucose F18