Carbon monoxide (CO) poisoning may result in focal and diffuse neuropathological changes, including basal ganglia lesions. The effect of CO poisoning on basal ganglia volumes over time is unclear. We assessed basal ganglia volumes longitudinally following CO poisoning. We prospectively enrolled 73 CO poisoned patients who underwent brain MR imaging on day 1 (baseline), 2 weeks, and 6 months post-CO poisoning. Basal ganglia volumes were obtained. One patient had bilateral globus pallidus lesions at two weeks and 6 months. Of the CO-poisoned patients 28% had volume reduction in at least one basal ganglia structure by 6 months, of which 21% had putamen, 15% had caudate, 15% had globus pallidus, and 16% had total basal ganglia volume reduction. Putamen volumes were significantly smaller from baseline to six months (p = 0.02). Verbal memory and mental processing speed correlated with smaller putamen and globus pallidus volumes. Carbon monoxide poisoning results in basal ganglia volume reduction 6 months post CO poisoning. Slow mental processing speed and impaired memory correlated with smaller putamen and globus pallidus volumes. Clinicians need to be aware of basal ganglia neuropathologic changes in the absence of observable lesions following CO poisoning.

译文

一氧化碳 (CO) 中毒可能导致局灶性和弥漫性神经病理变化,包括基底节病变。CO中毒对基底神经节体积随时间的影响尚不清楚。我们在CO中毒后纵向评估了基底神经节的体积。我们前瞻性地招募了73名CO中毒患者,他们在CO中毒后第1天 (基线),2周和6个月接受了脑MR成像。获得基底神经节体积。一名患者在两周和6个月时出现双侧苍白球病变。在共中毒的患者中,28% 在6个月前至少有一个基底神经节结构的体积减少,其中21% 有壳核,15% 有尾状核,15% 有苍白球,16% 有总基底神经节体积减少。从基线到6个月,壳核体积明显较小 (p = 0.02)。言语记忆和心理处理速度与较小的壳核和苍白球体积相关。一氧化碳中毒导致CO中毒后6个月基底神经节体积减少。缓慢的心理处理速度和记忆受损与较小的壳核和苍白球体积有关。在CO中毒后没有可观察到的病变的情况下,临床医生需要意识到基底神经节的神经病理学变化。

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