title: Psychological, neuropsychological, and electrocortical effects of mixed mold exposure.
abstract: The authors assessed the psychological, neuropsychological, and electrocortical effects of human exposure to mixed colonies of toxigenic molds. Patients (N = 182) with confirmed mold-exposure history completed clinical interviews, a symptom checklist (SCL-90-R), limited neuropsychological testing, quantitative electroencephalogram (QEEG) with neurometric analysis, and measures of mold exposure. Patients reported high levels of physical, cognitive, and emotional symptoms. Ratings on the SCL-90-R were "moderate" to "severe," with a factor reflecting situational depression accounting for most of the variance. Most of the patients were found to suffer from acute stress, adjustment disorder, or post-traumatic stress. Differential diagnosis confirmed an etiology of a combination of external stressors, along with organic metabolically based dysregulation of emotions and decreased cognitive functioning as a result of toxic or metabolic encephalopathy. Measures of toxic mold exposure predicted QEEG measures and neuropsychological test performance. QEEG results included narrowed frequency bands and increased power in the alpha and theta bands in the frontal areas of the cortex. These findings indicated a hypoactivation of the frontal cortex, possibly due to brainstem involvement and insufficient excitatory input from the reticular activating system. Neuropsychological testing revealed impairments similar to mild traumatic brain injury. In comparison with premorbid estimates of intelligence, findings of impaired functioning on multiple cognitive tasks predominated. A dose-response relationship between measures of mold exposure and abnormal neuropsychological test results and QEEG measures suggested that toxic mold causes significant problems in exposed individuals. Study limitations included lack of a comparison group, patient selection bias, and incomplete data sets that did not allow for comparisons among variables.
authors.affiliation: Neurobehavioral Health Services, Tucson, Arizona 85712, USA. bcbrain1@msn.com
authors.forename: B Robert
authors.initials: BR
authors.lastname: Crago
authors.forename: Michael R
authors.initials: MR
authors.lastname: Gray
authors.forename: Lonnie A
authors.initials: LA
authors.lastname: Nelson
authors.forename: Marilyn
authors.initials: M
authors.lastname: Davis
authors.forename: Linda
authors.initials: L
authors.lastname: Arnold
authors.forename: Jack D
authors.initials: JD
authors.lastname: Thrasher
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002908:Chronic Disease; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology; D003937:Diagnosis, Differential; D004569:Electroencephalography; D004781:Environmental Exposure / Q000009:adverse effects* / Q000032:analysis; D004784:Environmental Monitoring; D005260:Female; D005658:Fungi; D006801:Humans; D007361:Intelligence Tests; D007406:Interview, Psychological; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000209:etiology; D015651:Mycotoxicosis / Q000175:diagnosis / Q000209:etiology; D009483:Neuropsychological Tests; D020258:Neurotoxicity Syndromes / Q000175:diagnosis / Q000209:etiology; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D015983:Selection Bias; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000175:diagnosis / Q000209:etiology; D011795:Surveys and Questionnaires