2- 18 F-fluoro-2-deoxyglucose positron emission tomography in delirium
Open accessAbstract
Delirium is a common, serious, yet poorly understood syndrome. Growing evidence suggests cerebral metabolism is fundamentally disturbed; however, it has not been investigated using 2- 18 F-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) in delirium. This prospective study thus explored FDG PET patterns of cerebral glucose metabolism in older inpatients with delirium. A particular emphasis was on the posterior cingulate cortex (PCC), a key region for attention, which is a central feature of delirium. Delirium scans were compared with post-delirium scans using visual analysis and semi-quantitative analysis with NeuroQ; 13 participants (8 female, median 84 y) were scanned during delirium, and 6 scanned again after resolution. On visual analysis, cortical hypometabolism was evident in all participants during delirium (13/13), and improved with delirium resolution (6/6). Using NeuroQ, glucose metabolism was higher post-delirium in the whole brain and bilateral PCC compared to during delirium ( p < 0.05). Greater metabolism in both PCCs correlated with better performance on a neuropsychological test of attention, the WAIS-IV Digit Span Test forwards, and with shorter delirium duration. This research found widespread, reversible cortical hypometabolism during delirium and PCC hypometabolism was associated with inattention during delirium.
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The frontal hypo-metabolism pattern on FDG-PET in COVID-19 acute encephalopathy differs from usual findings in delirium.
“that differs from usual findings in delirium [149].”
From Cognitive decline following acute viral infections: literature review and projections for post-COVID-19 (2022) · cites this paper as [149]
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- Authors
- Haggstrom, L. R., Nelson, J. A., Wegner, E. A., & Caplan, G. A.
- Affiliations
- UNSW Sydney (AU)
- Prince of Wales Hospital (AU)
- Corresponding author
- Caplan, Gideon A
- Venue
- Journal of Cerebral Blood Flow & Metabolism
- Publisher
- SAGE Publications
- Published
- 2017-03-28
- Volume
- 37
- Issue
- 11
- Pages
- 3556-3567
- ISSN
- 0271-678X (ISSN-L)
- 1559-7016
- PMC
- PMC5669345
- OpenAlex
- W2599859498
- Cited by
- 78
- References
- 63
- Citations by year
- 2026: 8 · 2025: 9 · 2024: 9 · 2023: 8 · 2022: 8 · 2021: 13 · 2020: 15 · 2019: 4 · 2018: 3 · 2017: 1
- FWCI
- 5.91
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Journal of Cerebral Blood Flow & Metabolism (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- UNSWorks (UNSW Sydney) (submittedVersion, cc-by-nc-nd)
- UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
- Topics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Neurology › Alcoholism and Thiamine Deficiency
- Keywords
- delirium, FDG-PET, brain glucose metabolism, posterior cingulate cortex, cortical hypometabolism, inattention, attention, hospitalized older adults, delirium resolution, delirium duration, digit span
- MeSH terms
- Aged, Aged, 80 and over, Attention, Delirium, Female, Glucose, Gyrus Cinguli, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Neuropsychological Tests, Prospective Studies, Radiopharmaceuticals, Fluorodeoxyglucose F18, Positron-Emission Tomography
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