Modification of glucose metabolism in radiation-induced brain injury areas using cervical spinal cord stimulation

Acta Neurochir (Wien). 2009 Nov;151(11):1419-25. doi: 10.1007/s00701-009-0400-8. Epub 2009 Jun 5.


Purpose: Radiation-induced brain injury (RBI) is an insidious side-effect of radiotherapy mediated by vascular alterations, inflammation and ischaemia. In previous studies we had shown potential increases in loco-regional blood flow and glucose metabolism in brain tumours by using electrical cervical spinal cord stimulation (SCS). In this preliminary report we demonstrate the effect of cervical SCS on RBI-tissue metabolism, as assessed using [(18)F]fluorodeoxyglucose-positron emission tomography (FDG-PET).

Methods: SCS devices were inserted in eight patients with diagnosis of potential RBI in previously irradiated areas. While the SCS device was deactivated, each patient underwent an initial FDG-PET study to evaluate the clinical status. A second FDG-PET study was performed later the same day while the SCS device was activated in order to evaluate the effect of cervical SCS on glucose metabolism.

Results: Basal glucose metabolism in RBI areas was 31% lower than peri-RBI areas (p = 0.009) and 32% lower than healthy contra-lateral areas (p = 0.020). There was a significant increase in glucose uptake during SCS in both the RBI (p = 0.005) and the peri-RBI (p = 0.004) areas, with measured increases of 38 and 42%, respectively. The estimated potential maximal residual activity of the first FDG dose's contribution to the activity on the second scan was <or=14.3 +/- 4.6%.

Conclusions: In this study using PET, SCS increased glucose metabolism in RBI and peri-RBI areas. These results warrant further clinical investigation to elucidate more fully the clinical usefulness of SCS in these patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Afferent Pathways / physiology
  • Aged
  • Brain / diagnostic imaging
  • Brain / metabolism*
  • Brain / physiopathology
  • Brain Damage, Chronic / diagnostic imaging
  • Brain Damage, Chronic / metabolism*
  • Brain Damage, Chronic / physiopathology
  • Brain Mapping / methods
  • Brain Neoplasms / radiotherapy
  • Cerebrovascular Circulation / physiology
  • Cervical Vertebrae
  • Electric Stimulation / methods
  • Energy Metabolism / physiology
  • Female
  • Fluorodeoxyglucose F18
  • Glucose / analysis
  • Glucose / metabolism*
  • Humans
  • Male
  • Middle Aged
  • Positron-Emission Tomography / methods
  • Predictive Value of Tests
  • Radiation Injuries / diagnostic imaging
  • Radiation Injuries / metabolism*
  • Radiation Injuries / physiopathology
  • Radiotherapy / adverse effects*
  • Sensitivity and Specificity
  • Spinal Cord / physiology*


  • Fluorodeoxyglucose F18
  • Glucose