Verbal memory deficits associated with fornix atrophy in carbon monoxide poisoning

• Published in: Journal of the International Neuropsychological Society 2001-07, Vol.7 (5), p.640-646
• Main Authors: KESLER, SHELLI R., HOPKINS, RAMONA O., WEAVER, LINDELL K., BLATTER, DUANE D., EDGE-BOOTH, HOLLY, BIGLER, ERIN D.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Amnesia - diagnosis; Amnesia - physiopathology; Atrophy; Brain damage; Brain Damage, Chronic - diagnosis; Brain Damage, Chronic - physiopathology; BRIEF COMMUNICATION; Carbon monoxide poisoning; Carbon Monoxide Poisoning - diagnosis; Carbon Monoxide Poisoning - physiopathology; Female; Follow-Up Studies; Fornix; Fornix, Brain - pathology; Humans; Hypoxia; Magnetic Resonance Imaging; Male; Memory; Mental Recall - physiology; Middle Aged; Morphometric analysis; Neuropathology; Neuropsychological outcome; Neuropsychological Tests; Neuropsychology; Prospective Studies; Traumatic brain injury; Verbal Learning - physiology; Within-subjects design
• ISSN: 1355-6177; 1469-7661
• DOI: 10.1017/S1355617701005112

Magnetic resonance (MR) images and neuropsychological testing data of 69 carbon monoxide (CO) poisoned patients were prospectively obtained within 1 day of CO poisoning, two weeks and six months. CO patients' Day 1 cross-sectional fornix surface area measurements, corrected for head size by using a fornix-to-brain ratio (FBR), were compared to normal age and gender-matched controls. Additionally, a within-subjects analysis was performed comparing the mean areas between CO patients' Day 1, 2 weeks and 6-month FBR. The FBR was correlated with patients' neuropsychological data. There were no significant differences between CO patients' Day 1 fornix measurements compared to normal control subjects. However, significant atrophic changes in the fornix of CO poisoned patients occurred at two weeks with no progressive atrophy at 6 months. By 6 months, CO patients showed significant decline on tests of verbal memory (when practice effects were taken into account), whereas visual memory, processing speed and attention/concentration did not decline. This study indicates that CO results in brain damage and cognitive impairments in the absence of lesions and other neuroanatomic markers. (JINS, 2001, 7, 640–646.)