Cognitive Severity-Specific Neuronal Degenerative Network in Charcoal Burning Suicide-Related Carbon Monoxide Intoxication

Chen, Nai-Ching; Huang, Chi‐Wei; Huang, Shu-Hua; Chang, Wen-Neng; Chang, Ya-Ting; Lui, Chun‐Chung; Lin, Pei-Chao; Lee, Chen-Chang; Chang, Yen‐Hsiang; Chang, Chiung‐Chih

doi:10.1097/md.0000000000000783

Cited by 12 publications

(8 citation statements)

References 48 publications

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“…Studies on delayed neurologic or neuropsychiatric syndrome revealed that CO intoxication from charcoal-burning resulted in the diffuse demyelination in the brain 15. One study found that the fronto-insular-caudate areas represented the target degenerative network in CO intoxication 25. The decrease in the gray matter volume in the bilateral basal ganglia, left postcentral gyrus, and left hippocampus is also correlated with the decreased perceptual organization and processing speed function in these patients 54 55.…”

Section: Discussionmentioning

confidence: 99%

“…15 Another study found that the fronto-insular-caudate areas represented the target degenerative network in the CO intoxication. 25 Therefore, we hypothesize that CO intoxication in patients with suicide attempts would also be associated with dementia, and we conducted this study to clarify whether coal-burning suicide attempts would be associated with subsequent dementia.…”

Section: Original Researchmentioning

confidence: 99%

“…Studies on delayed neurologic or neuropsychiatric syndrome revealed that carbon monoxide (CO) intoxication from charcoal-burning resulted in the diffuse demyelination in the brain 15. Another study found that the fronto-insular-caudate areas represented the target degenerative network in the CO intoxication 25. Therefore, we hypothesize that CO intoxication in patients with suicide attempts would also be associated with dementia, and we conducted this study to clarify whether coal-burning suicide attempts would be associated with subsequent dementia.…”

Section: Introductionmentioning

confidence: 99%

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Risk of Dementia after Charcoal-Burning Suicide Attempts: A Nationwide Cohort Study in Taiwan

Chang

Chien

Chung

et al. 2018

Journal of Investigative Medicine

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This study aimed to investigate the association between charcoal-burning suicide attempts and the risk of developing dementia. A nationwide, matched cohort, population-based study enrolled a total of 4103 patients with newly diagnosed charcoal-burning suicide attempts, between 2000 and 2010, which were selected from the National Health Insurance Research Database of Taiwan, along with 12,309 controls matched for sex and age. After adjusting for confounding factors, Fine and Gray's competing risk analysis was used to compare the risk of developing dementia during the 10-year follow-up period. Of the enrolled patients (n=16,412), dementia developed in 303 (1.85%), including 2.56% in the study group (105 in 4103) and 1.61% (198 in 12,309) in the control group. The Fine and Gray's survival analysis revealed that the patients with charcoal-burning suicide attempts were likely to develop dementia, with a crude HR of 5.170 (95% CI 4.022 to 6.644, p<0.001). After adjusting for age, sex, comorbidity, geographic area and urbanization level of residence, and monthly insured premium, the adjusted HR was 4.220 (95% CI 3.188 to 5.586, p<0.001). Suicide attempts were associated with an increased risk of degenerative dementia in this study. Patients with charcoal-burning suicide attempts had a fourfold risk of dementia than the control group.

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Section: Discussionmentioning

confidence: 99%

Section: Original Researchmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Risk of Dementia after Charcoal-Burning Suicide Attempts: A Nationwide Cohort Study in Taiwan

Chang

Chien

Chung

et al. 2018

Journal of Investigative Medicine

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“…The patients and controls were right handed and gave written informed consent to take part. Clinical diagnosis in both patients and controls was determined after a detailed history, neurologic examination, 1-h neuro-psychological battery (Chang et al, 2016a ), laboratory screening, and visual inspection of a 3.0-tesla brain magnetic resonance imaging (MRI; Chen et al, 2015 ). Patients diagnosed with fronto-temporal lobar degeneration met the Neary criteria (Neary et al, 1998 ).…”

Section: Methodsmentioning

confidence: 99%

Anatomical Correlates of Non-Verbal Perception in Dementia Patients

Lin

Chen

et al. 2016

Front. Aging Neurosci.

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Purpose: Patients with dementia who have dissociations in verbal and non-verbal sound processing may offer insights into the anatomic basis for highly related auditory modes.Methods: To determine the neuronal networks on non-verbal perception, 16 patients with Alzheimer’s dementia (AD), 15 with behavior variant fronto-temporal dementia (bv-FTD), 14 with semantic dementia (SD) were evaluated and compared with 15 age-matched controls. Neuropsychological and auditory perceptive tasks were included to test the ability to compare pitch changes, scale-violated melody and for naming and associating with environmental sound. The brain 3D T1 images were acquired and voxel-based morphometry (VBM) was used to compare and correlated the volumetric measures with task scores.Results: The SD group scored the lowest among 3 groups in pitch or scale-violated melody tasks. In the environmental sound test, the SD group also showed impairment in naming and also in associating sound with pictures. The AD and bv-FTD groups, compared with the controls, showed no differences in all tests. VBM with task score correlation showed that atrophy in the right supra-marginal and superior temporal gyri was strongly related to deficits in detecting violated scales, while atrophy in the bilateral anterior temporal poles and left medial temporal structures was related to deficits in environmental sound recognition.Conclusions: Auditory perception of pitch, scale-violated melody or environmental sound reflects anatomical degeneration in dementia patients and the processing of non-verbal sounds are mediated by distinct neural circuits.

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“…From neuroimaging analysis, diffuse white matter (WM) damages (Sohn et al, 2000 ; Chang et al, 2011 ) and deep gray matter (GM) injuries in the globus pallidus or basal ganglia (Klawans et al, 1982 ; Pulst et al, 1983 ; Lee et al, 2010 ) were reported. Among these seemingly unrelated areas, we recently validated that the fronto-insular-temporal brain areas represented functional network that underwent neurodegenerative processes, while the spatial extents of injury are highly predictive of the cognitive severity (Chen et al, 2015 ).…”

Section: Introductionmentioning

confidence: 98%

Metabolic Covariant Network in Relation to Nigrostriatal Degeneration in Carbon Monoxide Intoxication-Related Parkinsonism

et al. 2016

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Presence of parkinsonian features after carbon monoxide (CO) intoxication is well known and the severity was found to relate to the pre-synaptic dopaminergic deficits. There is no systemic study to analyse the functional network involved in CO-related Parkinsonism. Forty-five CO-related parkinsonism patients and 25 aged-matched controls completed the 3D T1-weighted imaging and 18F-fluoro-2-deoxyglucose positron emission tomography (FDG-PET). Voxel-based morphometry (VBM) was performed to assess the structural and functional brain differences between the patients and controls. Spatial covariant networks responsible for distinguishing patients and controls were constructed using independent component analysis. For validation, the pre-synaptic dopaminergic functional network was established by regression model using striatal TRODAT-1 SPECT as the independent variable. The clinical significance of both networks was determined by correlation with the Unified Parkinson's Disease Rating Scale (UPDRS). Compared with controls, the spatial covariant signals of FDG-PET were significantly lower in the medial and lateral frontal, caudate nucleus, dorsomedial prefrontal areas, and temporal-parietal regions while the spatial intensities correlated significantly with UPDRS total scores. The functional network that correlated with striatum pre-synaptic dopaminergic uptakes included the midbrain, thalamus, caudate, lateral frontal cortex, ventral striatum, ventral, or dorsal anterior cingulate cortex. Both networks overlapped considerably and the topographies reflected structural damage pattern. Our study provides evidence that glucose metabolism in CO-parkinsonism patients pertains to an organized covariant pattern in the cortical regions that is spatially coherent with the cortical map of pre-synaptic dopamine deficits. As the fronto-temporal, striatum, and temporal-parietal areas were involved, the unique metabolic covariant network suggests a different pathophysiology in CO-related parkinsonism.

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Cognitive Severity-Specific Neuronal Degenerative Network in Charcoal Burning Suicide-Related Carbon Monoxide Intoxication

Abstract: Supplemental Digital Content is available in the text

Cited by 12 publications

References 48 publications

Risk of Dementia after Charcoal-Burning Suicide Attempts: A Nationwide Cohort Study in Taiwan

Risk of Dementia after Charcoal-Burning Suicide Attempts: A Nationwide Cohort Study in Taiwan

Anatomical Correlates of Non-Verbal Perception in Dementia Patients

Metabolic Covariant Network in Relation to Nigrostriatal Degeneration in Carbon Monoxide Intoxication-Related Parkinsonism

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