Traumatic brain injury (TBI) often leads to acute cerebral metabolic crisis (ACMC), which appears to have the greatest impact on the frontal-temporal regions. A recent study demonstrated that atrophy in the frontal and temporal lobes related to acute metabolic crisis due to moderate or severe TBI was associated with poorer attention, executive functioning, and psychomotor abilities at 12 months post-injury. In addition, participants with greater frontal-temporal atrophy had T-scores on all of the standard tests that were in the deficit range indicating deficits in cognition. The purpose of the current study is to investigate the ability of direct measures of acute glucose and lactate metabolism to predict recovery of frontal-temporal cognitive integration in a sample of 26 moderate to severe traumatic brain injury participants. Cerebral metabolic rate of glucose (CMRglc) and lactate (CMRlac) were measured by the Kety-Schmidt method on days 0-7 post-injury. An index of frontal-temporal cognitive integration was calculated at 6 months (FTI-6) and 12 months (FTI-12) post-injury by averaging the T-scores of the phonemic fluency portion of the Controlled Oral Word Association Test and the long-term storage score of the 6-trial version of the Buschke Selective Reminding Test. A recovery index of frontal-temporal cognitive integration (FTI-Recovery) was derived by subtracting the 6 month FTI index (FTI-6) from the 12 month FTI index (FTI-12). Hierarchical linear regression analysis was used to test acute CMRglc and CMRlac as predictors of FTI-6, FTI-12, and FTI-Recovery after controlling for severity of injury as measured by initial score on the Glasgow Coma Scale (GCS). The current study found an association between acute cerebral metabolic rates and frontal-temporal integration recovery (FTI-Recovery) for both glucose and lactate.

LLU Discipline

Clinical Psychology




School of Behavioral Health

First Advisor

Lee, Grace J.

Second Advisor

Haerich, Paul E.

Third Advisor

Morrell, Holly E. R.

Fourth Advisor

Wright, Matthew J.

Degree Name

Doctor of Philosophy (PhD)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Brain Injuries - Metabolism; Neurobehavioral Manifestations; Neuropsychological Tests; Cognition Disorders - Metabolism

Subject - Local

Traumatic Brain Injury; Cerebral Metabolic Crisis; Frontal-temporal brain atrophy; Glucose Metabolism; Lactate Metabolism



Page Count


Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives