Longitudinal study of carbon monoxide intoxication by diffusion tensor imaging with neuropsychiatric correlation.
BACKGROUND
White matter damage is common after carbon monoxide (CO) intoxication, but in vivo follow-up studies about the mechanism of white matter damage are not possible in pathology series. Diffusion tensor imaging (DTI) and voxel-based morphometry (VBM) can quantify diffusion parameters and volumetric changes in white matter that can be correlated with neuropsychological performances in longitudinal studies.


METHODS
We examined 9 patients with CO intoxication using DTI, VBM and neuropsychologic tests at an average of 3 and 10 months after CO exposure. We used data from 18 age- and sex-matched controls for comparison.


RESULTS
We found that cognitive recovery at 10 months after CO intoxication was not significant, although it was after 3 months. The neuropsychologic tests correlated better for the fibre tract of the semicentrum ovale and not the periventricular fibres. Diffusion measures suggest increases in fractional anisotropy, mean diffusivity and axial eigenvalues over time, while increases in radial eigenvalue were evident at 3 months compared with controls. Periventricular white matter atrophy was observed 10 months after CO intoxication.


CONCLUSIONS
Our study included few cases, and the interpretation of the putative changes on neuroimaging findings cannot be confirmed by histology.


CONCLUSIONS
Our study showed that the evolution of white matter injury in CO encephalopathy occurred over time. Cognitive recovery was not evident in the follow-up period because of white matter injuries.
Chang
Chiung-Chih
CC
Department of Neurology, Chang Gung Memorial Hospital, Kaohsiung Medical Center and Chang Gung University College of Medicine, Kaohsiung, Taiwan. neur099@adm.cgmh.org.tw
Chang
Wen-Neng
WN
Lui
Chun-Chung
CC
Wang
Jiun-Jie
JJ
Chen
Chih-Feng
CF
Lee
Yu-Chang
YC
Chen
Shun-Sheng
SS
Lin
Yu-Ting
YT
Huang
Chi-Wei
CW
Chen
Ching
C
D000328:Adult; D016880:Anisotropy; D001921:Brain / Q000473:pathology*; D002249:Carbon Monoxide Poisoning / Q000150:complications / Q000473:pathology*; D003071:Cognition; D003072:Cognition Disorders / Q000209:etiology / Q000473:pathology*; D056324:Diffusion Tensor Imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology; D009483:Neuropsychological Tests; D013997:Time Factors; D055815:Young Adult