Quantitative magnetic resonance brain imaging in US army veterans of the 1991 Gulf War potentially exposed to sarin and cyclosarin
Quantitative magnetic resonance brain imaging in US army veterans of the 1991 Gulf War potentially exposed to sarin and cyclosarin
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DOI：
10.1016/j.neuro.2007.03.006
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发表时间：
2007-07-01
期刊：
影响因子：
3.4
通讯作者：
White, Roberta F.
中科院分区：
文献类型：
--
作者：
Heaton, Kristin J.;Palumbo, Carole L.;White, Roberta F.
背景资料：1991年3月，伊拉克哈米斯耶的一个弹药储存中心被摧毁，可能使10万多名美军暴露在低水平的有机磷酸盐神经毒剂沙林和环沙林中。关于低剂量接触沙林/环沙林对人类的神经生理影响，人们知之甚少，尽管一些研究表明，接触沙林/环沙林的个体在不足以产生明显临床症状的水平上会发生微妙但持久的神经行为和神经化学变化。然而，这些变化的神经解剖学相关性尚不清楚。目前的研究探讨模型估计沙林/环沙林暴露水平和体积测量的总神经解剖结构在1991年海湾战争退伍军人不同程度的可能的低水平沙林/环沙林exposure.Methods：26 GW部署的退伍军人招募的德文斯队列研究参加。采集脑部磁共振图像，并使用形态测量技术进行分析，测量白色物质、灰质、左右侧脑室和脑脊液的体积。体积数据进行了分析，使用1991年Khamisiyah假定暴露hazards.Results的风险估计从细化模型获得：沙林/环沙林'暴露'（N = 13）和'未暴露'（N = 13）退伍军人的二元比较显示离散脑组织的体积测量没有差异。然而，线性趋势分析显示，估计沙林/环沙林暴露水平较高与白色物质减少之间存在显著关联（调整后的参数估计值=-4.64，p < 0.0001）和右侧脑室增加（调整后的参数估计值= 0.11，p = 0.0288）和左侧脑室（调整参数估计值= 0.13，p < 0.0001）体积。这些发现表明，海湾战争退伍军人可能暴露于低水平沙林/环沙林的微妙但持久的中枢神经系统病理学，并主张进一步研究低剂量沙林/环沙林的长期影响。人体暴露于环沙林(c)2007年爱思唯尔公司All rights reserved.
Background: In March 1991, a munitions storage complex at Khamisiyah, Iraq was destroyed, potentially exposing more than 100,000 US troops to low levels of the organophosphate nerve agents sarin and cyclosarin. Little is known about the neurophysiological effects of low-dose exposure to sarin/cyclosarin in humans, although some research has indicated subtle but persistent neurobehavioral and neurochemical changes in individuals exposed to sarin/cyclosarin at levels insufficient to produce obvious clinical symptoms. However, the neuroanatomical correlates of these changes are unclear. The current study examined the association between modeled estimates of sarin/cyclosarin exposure levels and volumetric measurements of gross neuroanatomical structures in 1991 Gulf War veterans with varying degrees of possible low-level sarin/cyclosarin exposure.Methods: Twenty-six GW-deployed veterans recruited from the Devens Cohort Study participated. Magnetic resonance images of the brain were acquired and analyzed using morphometric techniques, producing volumetric measurements of white matter, gray matter, right and left lateral ventricles, and cerebrospinal fluid. Volumetric data were analyzed using exposure estimates obtained from refined models of the 1991 Khamisiyah presumed exposure hazard area.Results: Binary comparisons of sarin/cyclosarin 'exposed' (N = 13) and 'unexposed' (N = 13) veterans revealed no differences in volumetric measurements of discrete brain tissues. However, linear trend analyses showed a significant association between higher levels of estimated sarin/cyclosarin exposure and both reduced white matter (adjusted parameter estimate = -4.64, p < 0.0001) and increased right lateral ventricle (adjusted parameter estimate = .11, p = 0.0288) and left lateral ventricle (adjusted parameter estimate =.13, p < 0.0001) volumes.Conclusions: These findings suggest subtle but persistent central nervous system pathology in Gulf War veterans potentially exposed to low levels of sarin/cyclosarin and argue for further investigation of the long-term effects of low-dose sarin/cyclosarin exposures in humans. (c) 2007 Elsevier Inc. All rights reserved.