1H-magnetic resonance spectroscopy indicates damage to cerebral white matter in the subacute phase after CO poisoning. Issue 8 (17th January 2011)

• Record Type: Journal Article
• Authors: Beppu, Takaaki; Nishimoto, Hideaki; Fujiwara, Shunrou; Kudo, Kaoru; Sanjo, Katsumi; Narumi, Shinsuke; Oikawa, Hirotaka; Onodera, Makoto; Ogasawara, Kuniaki; Sasaki, Makoto
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 82:Issue 8(2011)
• Page Start: 869
• Page End: 875
• Publication Date: 2011-01-17
• Subjects: Carbon monoxide poisoning -- delayed neuropathy -- demyelination -- 1H-magnetic resonance spectroscopy -- myelin basic protein -- cerebral metabolism -- image analysis -- MRS -- neurotoxicology; Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp.2010.222422
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Objective: The authors examined whether 1 H-magnetic resonance spectroscopy (MRS) can identify damage to the centrum semiovale in the subacute phase after CO exposure. Methods: Subjects comprised 29 adult patients who were treated with hyperbaric oxygenation within a range of 4–95 h (mean 18.7 h) after CO exposure. Subjects were classified into three groups according to clinical behaviours: Group A, patients with transit acute symptoms only; Group P, patients with persistent neurological symptoms; and Group D, patients with 'delayed neuropsychiatric sequelae' occurring after a lucid interval. MRS of bilateral centrum semiovale was performed 2 weeks after CO inhalation for all patients and 13 healthy volunteers. The mean ratios of choline-containing compounds/creatine (mean Cho/Cr) and N-acetylaspartate/Cr (mean NAA/Cr) for bilateral centrum semiovale were calculated and compared between the three CO groups and controls. Myelin basic protein (MBP) concentration in cerebrospinal fluid was examined at 2 weeks to evaluate the degree of demyelination in patients. Results: MBP concentration was abnormal for almost all patients in Groups P and D, but was not abnormal for any Group A patients. The mean Cho/Cr ratios were significantly higher in Groups P and D than in Group A. No significant difference in mean NAA/Cr ratio was seen between the three pathological groups and controls. A significant correlation was identified between MBP and mean Cho/Cr ratio. Conclusions: These results suggest that the Cho/Cr ratio in the subacute phase after CO intoxication represents early demyelination in the centrum semiovale, and can predict chronic neurological symptoms.