A critical period of brain development: studies of cerebral glucose utilization with PET.

Studies with positron emission tomography indicate that the human brain undergoes a period of postnatal maturation that is much more protracted than previously suspected. In the newborn, the highest degree of glucose metabolism (representative of functional activity) is in primary sensory and motor cortex, cingulate cortex, thalamus, brain stem, cerebellar vermis, and hippocampal region. At 2 to 3 months of age, glucose utilization increases in the parietal, temporal, and primary visual cortex; basal ganglia; and cerebellar hemispheres. Between 6 and 12 months, glucose utilization increases in frontal cortex. These metabolic changes correspond to the emergence of various behaviors during the first year of life. The measurement of absolute rates of glucose utilization during development indicates that the cerebral cortex undergoes a dynamic course of metabolic maturation that persists until ages 16-18 years. Initially, there is a rise in the rates of glucose utilization from birth until about age 4 years, at which time the child's cerebral cortex uses over twice as much glucose as that of adults. From age 4 to 10 years, these very high rates of glucose consumption are maintained, and only after then is there a gradual decline of glucose metabolic rates to reach adult values by age 16-18 years. Correlations between glucose utilization rates and synaptogenesis are discussed, and the argument is made that these findings have important implications with respect to human brain plasticity following injury as well as to "critical periods" of maximal learning capacity.