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Neuroradiology

, Volume 52, Issue 8, pp 735–743 | Cite as

Assessment of damage to cerebral white matter fiber in the subacute phase after carbon monoxide poisoning using fractional anisotropy in diffusion tensor imaging

  • Takaaki BeppuEmail author
  • Hideaki Nishimoto
  • Daiya Ishigaki
  • Shunrou Fujiwara
  • Tomoyuki Yoshida
  • Hirotaka Oikawa
  • Katsura Kamada
  • Makoto Sasaki
  • Kuniaki Ogasawara
Diagnostic Neuroradiology

Abstract

Introduction

Chronic neuropsychiatric symptoms after carbon monoxide (CO) poisoning are caused by demyelination of cerebral white matter fibers. We examined whether diffusion tensor imaging can sensitively represent damage to fibers of the centrum semiovale in the subacute phase after CO intoxication.

Methods

Subjects comprised 13 adult patients with CO poisoning, classified into three groups according to clinical behaviors: 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. Median fractional anisotropy (FA) and apparent diffusion coefficient (ADC) of the centrum semiovale bilaterally at 2 weeks were compared between these groups and a control group of ten healthy volunteers. 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 or detectable for all group P and group D patients but was undetectable for all patients assigned to group A. Low FA values in groups P and D displaying chronic neurological symptoms clearly differed from those in controls and group A without chronic neurological symptoms, but ADC showed no significant differences between patient groups.

Conclusions

MBP concentration at 2 weeks after CO inhalation confirmed a certain extent of demyelination in the central nervous system of patients who would develop chronic neurological symptoms. In these patients, FA sensitively represented damage to white matter fibers in the centrum semiovale in the subacute phase after CO intoxication.

Keywords

Carbon monoxide poisoning Delayed neuropathy Diffusion tensor imaging Fractional anisotropy Myelin basic protein 

Abbreviations

CNS

Central nervous system

CSF

Cerebrospinal fluid

CO

Carbon monoxide

COHb

Carboxyhemoglobin

DNS

Delayed neuropsychiatric sequelae

DTI

Diffusion tensor imaging

FA

Fractional anisotropy

ADC

Apparent diffusion coefficient

GCS

Glasgow coma scale

MBP

Myelin basic protein

MRI

Magnetic resonance imaging

ROI

Region of interest

T2WI

T2-weighted magnetic resonance imaging

Notes

Acknowledgment

This study was supported in part by a Grant-in-Aid for Strategic Medical Science Research Center for Advanced Medical Science Research from the Ministry of Science, Education, Sports and Culture, Japan.

Conflict of interest statement

We declare that we have no conflict of interest.

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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Takaaki Beppu
    • 1
    • 2
    Email author
  • Hideaki Nishimoto
    • 1
    • 3
  • Daiya Ishigaki
    • 1
    • 3
  • Shunrou Fujiwara
    • 3
  • Tomoyuki Yoshida
    • 4
  • Hirotaka Oikawa
    • 5
  • Katsura Kamada
    • 2
  • Makoto Sasaki
    • 3
  • Kuniaki Ogasawara
    • 1
  1. 1.Departments of NeurosurgeryIwate Medical UniversityMoriokaJapan
  2. 2.Department of Hyperbaric MedicineIwate Medical UniversityMoriokaJapan
  3. 3.Advanced Medical Research CenterIwate Medical UniversityMoriokaJapan
  4. 4.Department of PsychiatryIwate Medical UniversityMoriokaJapan
  5. 5.Iwate Prefectural Advanced Critical Care and EmergencyMoriokaJapan

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