Brain glucose metabolism in neurologically normal patients with sickle cell disease. Regional alterations
G. P. Rodgers, C. M. Clark, S. M. Larson, S. I. Rapoport, A. W. Nienhuis and A. N. Schechter
Laboratory of Chemical Biology, NIDDK, Bethesda, MD 20892.
Neurologic dysfunction is a significant source of morbidity and mortality
in the sickle cell diseases, occurring with a prevalence of 6% to 34%.
Because changes in brain glucose metabolism may precede gross functional or
morphologic alterations, we recently applied the technique of positron
emission tomography with fluorodeoxyglucose F 18 in an exploratory study to
compare six patients with sickle cell disease without prior neurologic
abnormalities (and with normal cranial computed tomographic scans) with six
healthy age-matched controls, with respect to overall and regional cerebral
metabolic rates for glucose. We found no significant difference in the
global metabolic rates for the two groups. However, we observed an unusual
clustering of abnormal regional cerebral metabolic rates for glucose in the
frontal lobes of these subjects. These results support previous
observations that frontal lobe involvement may be quite prevalent in sickle
cell disease, even among individuals with normal computed tomographic
scans.
