Longitudinal study of carbon monoxide intoxication by diffusion tensor imaging with neuropsychiatric correlation

Chiung Chih Chang*, Wen Neng Chang, Chun Chung Lui, Jiun Jie Wang, Chih Feng Chen, Yu Chien Lee, Shun Sheng Chen, Yu Ting Lin, Chi Wei Huang, Ching Chen

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

38 Scopus citations

Abstract

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

Original languageEnglish
Pages (from-to)115-125
Number of pages11
JournalJournal of Psychiatry and Neuroscience
Volume35
Issue number2
DOIs
StatePublished - 03 2010

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