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Early gray matter atrophy and neurological deficits in patients with carbon monoxide poisoning

  • Diagnostic Neuroradiology
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Abstract

Purpose

To investigate early neurological deficits-related change patterns in gray matter (GM) volume in patients with carbon monoxide poisoning (COP) and GM volume differences between patients with and without delayed neurological sequelae (DNS) and those with and without T2 hyperintense lesions after COP.

Methods

Forty-one COP patients (24 patients with DNS) and 36 sex- and age-matched healthy controls (HC) were enrolled in this study. The neurological assessments were administered within 24 h after MRI scans. Voxel-based morphometry analysis was used to detect regional GM volume change.

Results

The COP group had statistically significant GM atrophy in the bilateral prefrontal and temporal lobes, anterior cingulate (ACC), thalamus, posterior cerebellum, and right hippocampus compared to the HC group. Atrophy in the left medial orbital superior frontal gyrus (SFG), bilateral ACC, and bilateral thalamus were related to lower Mini-Mental State Examination (MMSE) scores and higher Unified Parkinson’s Disease Rating Scale subsection III and neuro-psychiatric inventory scores. Atrophy in the hippocampus and posterior cerebellum were also related to decrease MMSE scores. The DNS subgroup had greater GM atrophy in the limbic system than the non-DNS subgroup. Compared to the subgroup without T2 hyperintense lesions, greater GM atrophy in the limbic system, motor and visual cortex, and default network was observed in the subgroup with T2 hyperintense lesions.

Conclusion

GM atrophy in the medial orbital SFG, ACC, thalamus, hippocampus, and posterior cerebellum is associated with early neurological deficits in patients with COP. Greater atrophy occurred in patients with DNS and those with T2 hyperintense lesions.

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Acknowledgements

The authors wish to thank the patients and their caregivers for their time and commitment to this research. We are also grateful that the study was supported by research grants from the Natural Science Foundation of China (NO. 82160930) and the technology plan project of Lanzhou city (NO. 2020-ZD-71).

Funding

The research leading to these results received funding from the National Natural Science Foundation of China under Grant Agreement NO [82160930] and technology plan project of Lanzhou under Grant Agreement NO [2020-ZD-71]. Author Yanli Zhang has received research support from the two institutions.

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Authors and Affiliations

  1. Deparment of Radiology, The Intelligent Imaging Medical Engineering Research Center of Gansu Province, Accurate Image Collaborative Innovation International Science and Technology Cooperation Base of Gansu Province, Radiological Clinical Medicine Research Center of Gansu Province, The First Hospital of Lanzhou University, Gansu, China

    Yanli Zhang, Shuaiwen Wang, Yuling Gao, Shunlin Guo & Junqiang Lei

  2. Department of Neurology, The First Hospital of Lanzhou University, Gansu, China

    Tianhong Wang

  3. MR Scientific Marketing, Siemens Healthineers, Xi’an, China

    Shaoyu Wang

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  1. Yanli Zhang
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Correspondence to Junqiang Lei.

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This study was performed in line with the principles of the The Ethics Committee of The First Hospital of Lanzhou University (2018, LDYYLL2018-114).

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Zhang, Y., Wang, T., Wang, S. et al. Early gray matter atrophy and neurological deficits in patients with carbon monoxide poisoning. Neuroradiology 65, 245–256 (2023). https://doi.org/10.1007/s00234-022-03041-5

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