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Association Between Preoperative Anxiety in Spinal Stenosis Patients and Abnormal Cerebral Glucose Metabolism: Voxel-Based Statistical Analysis of F-18 FDG Brain PET

Received March 13, 2008; revised September 1, 2008; accepted September 11, 2008. Drs. S-J Kim and I-J Kim are affiliated with the Department of Nuclear Medicine at Medical Research Institute, Pusan National University School of Medicine, Pusan, Korea; Drs. Suh, Cho, and Lee are affiliated with the Department of Orthopedic Surgery at Medical Research Institute, Pusan National University School of Medicine. Address correspondence to Jung Sub Lee, M.D., Ph.D., Department of Orthopedic Surgery, Medical Research Institute, Pusan National University School of Medicine, 1-10 Ami-Dong, Seo-Gu, Pusan 602-739, Korea; jungsublee{at}pusan.ac.kr (e-mail).

Although a possible association between preoperative anxiety and abnormal cerebral glucose metabolism may exist, the authors are not aware of any report describing preoperative anxiety and cerebral metabolism in patients with spinal stenosis in detail. Fluorine-18 fluorodeoxyglucose positron emission tomography with statistical parametric mapping analysis was used to compare regional brain glucose metabolism between 34 spinal stenosis patients and 34 healthy comparison subjects. Spinal stenosis patients with preoperative anxiety showed several voxel clusters of significantly decreased cerebral metabolism. The largest clusters were areas of left insula and left prefrontal cortex (Brodmann’s areas 9 and 11). The second largest cluster area was left prefrontal cortex (Brodmann’s area 10). The other clusters were right insula (Brodmann’s area 13), right superior temporal gyrus (Brodmann’s area 22), and right middle frontal gyrus (Brodmann’s area 8).

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