沙林和梭曼低水平暴露以及海湾战争病对大脑结构和功能的影响：4T 研究。
Effects of low-level sarin and cyclosarin exposure and Gulf War Illness on brain structure and function: a study at 4T.
机构信息
Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA.
出版信息
Neurotoxicology. 2011 Dec;32(6):814-22. doi: 10.1016/j.neuro.2011.06.006. Epub 2011 Jun 29.
BACKGROUND
More than 100,000 US troops were potentially exposed to chemical warfare agents sarin (GB) and cyclosarin (GF) when an ammunition dump at Khamisiyah, Iraq was destroyed during the 1991 Persian Gulf War (GW). We previously found reduced total gray matter (GM) volume in 40 GW veterans with suspected GB/GF exposure relative to 40 matched, unexposed GW veterans on a 1.5T MR scanner. In this study, we reexamine the relationship between GB/GF exposure and volumetric measurements of gross neuroanatomical structures in a different cohort of GW veterans on a 4T MR scanner.
METHODS
Neuropsychological and magnetic resonance imaging (MRI) data from a cross sectional study on Gulf War Illness performed between 2005 and 2010 were used in this study. 4T MRI data were analyzed using automated image processing techniques that produced volumetric measurements of gray matter (GM), white matter (WM) and cerebrospinal fluid (CSF).
RESULTS
Binary comparisons of 64 GB/GF exposed veterans and 64 'matched', unexposed veterans revealed reduced GM (p=0.03) and WM (p=0.03) volumes in the exposed veterans. Behaviorally, exposed veterans committed more errors of omission (p=0.02) and tended to have slower responses (p=0.05) than unexposed veterans on the Continuous Performance Test (CPT), a measure sustained and selective attention. Regression analyses confirmed that GB/GF exposure status predicted GM (β=-0.11, p=0.02) and WM (β=-0.14, p=0.03) volumes, and number of CPT omission errors (β=0.22, p=0.02) over and above potentially confounding demographic, clinical, and psychosocial variables. There was no dose-response relationship between estimated levels of GB/GF exposure and brain volume. However, we did find an effect of Gulf War Illness/Chronic Multisymptom Illness on both GM and WM volume in the GB/GF exposed veterans.
CONCLUSIONS
These findings confirm previous reports by our group and others of central nervous system pathology in GW veterans with suspected exposure to low levels of GB/GF two decades after the exposure.
背景
在 1991 年的波斯湾战争（GW）期间，伊拉克的哈米什亚弹药库被摧毁，超过 100,000 名美国士兵可能接触到沙林（GB）和环沙林（GF）等化学战剂。我们之前在 1.5T 磁共振扫描仪上发现，40 名有疑似 GB/GF 暴露史的 GW 退伍军人的总灰质（GM）体积减少，而 40 名匹配的未暴露 GW 退伍军人则没有。在这项研究中，我们在另一组 GW 退伍军人的 4T 磁共振扫描仪上重新检查了 GB/GF 暴露与大体神经解剖结构体积测量之间的关系。
方法
这项研究使用了 2005 年至 2010 年进行的海湾战争疾病横断面研究的神经心理学和磁共振成像（MRI）数据。使用自动图像处理技术对 4T MRI 数据进行了分析，该技术产生了灰质（GM）、白质（WM）和脑脊液（CSF）的体积测量值。
结果
对 64 名 GB/GF 暴露的退伍军人和 64 名“匹配”的未暴露退伍军人进行了二进制比较，发现暴露的退伍军人 GM（p=0.03）和 WM（p=0.03）体积减少。在连续动作测试（CPT）中，暴露组的退伍军人犯的遗漏错误更多（p=0.02），反应速度也较慢（p=0.05），CPT 是一种持续和选择性注意力的测量方法。回归分析证实，GB/GF 暴露状况预测了 GM（β=-0.11，p=0.02）和 WM（β=-0.14，p=0.03）体积，以及 CPT 遗漏错误的数量（β=0.22，p=0.02），超过了潜在的混杂人口统计学、临床和社会心理变量。GB/GF 暴露水平与大脑体积之间没有剂量反应关系。然而，我们确实发现海湾战争疾病/慢性多症状疾病对暴露于低水平 GB/GF 的 GW 退伍军人的 GM 和 WM 体积都有影响。
结论
这些发现证实了我们小组和其他小组以前的报告，即在暴露 20 年后，有疑似接触低水平 GB/GF 的 GW 退伍军人的中枢神经系统病理学。
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