Intrahemispheric symmetry of brain perfusion. Part 2. Clinical investigations

N. A. Nikolov; T. G. Novikova; Serhii Makeiev; Vsevolod Stebliuk; V. O. Tsikalo

doi:10.3103/S0735272722050028

Authors

N. A. Nikolov National Technical University of Ukraine “Igor Sikorsky Kyiv Polytechnic Institute”; Kundiiev Institute of Occupational Health of the National Academy of Medical Sciences of Ukraine, Ukraine https://orcid.org/0000-0001-8716-6254
T. G. Novikova Romodanov Neurosurgery Institute National Academy of Medical Sciences of Ukraine, Ukraine http://orcid.org/0000-0001-8916-3233
Serhii Makeiev Romodanov Neurosurgery Institute National Academy of Medical Sciences of Ukraine, Ukraine http://orcid.org/0000-0001-9068-508X
Vsevolod Stebliuk Ukrainian Military Medical Academy, Kyiv, Ukraine http://orcid.org/0000-0001-9575-8030
V. O. Tsikalo National Technical University of Ukraine “Igor Sikorsky Kyiv Polytechnic Institute”, Ukraine http://orcid.org/0000-0002-0434-3217

DOI:

https://doi.org/10.3103/S0735272722050028

Abstract

This study presents the assessment of the clinical significance of the quantitative criterion of intrahemispheric symmetry (IHS) of cerebral perfusion according to the data of single-photon emission computed tomography (SPECT) with perfusion radiopharmaceutical in patients with mild cerebral injury due to combat trauma. The results of examination of 44 patients were analyzed. The main materials for comparison included SPECT images of brain with 99mTc-HMPAO and data of the neuropsychological testing (NPT), such as assessment of vegetative disorders according to Wayne, the assessment of psychoemotional sphere, the assessment of the symptom severity of traumatic brain injury based on the Cicerone questionnaire, and the assessment of the severity of post trauma stress disorder (PTSD) based on the PCL-military tests.

The results of the analysis of scatterograms in brain segments for various quantitative NPT criteria and the IHS criterion showed the data clustering and nonlinear relationship. In some cases, this relationship is characterized by threshold effects (catastrophes and bifurcations). Hence, the assessment of psychoemotional and cognitive impairments based on SPECT and IHS data could be expediently carried out on the basis of piecewise polynomial, linear or parabolic functions.

For the first time, the clinical informativeness of the IHS criterion for brain perfusion according to SPECT data has been shown that allows us to assess quantitatively the psychoemotional and cognitive impairments in patients with moderate cerebral injury due to combat contusion accompanied by the development of post trauma stress disorder (PTSD).

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