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甲醇暴露后的认知变化:纵向观察。

Cognitive changes after methanol exposure: Longitudinal perspective.

机构信息

Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.

Toxicological Information Centre, Department of Occupational Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.

出版信息

Toxicol Lett. 2021 Oct 1;349:101-108. doi: 10.1016/j.toxlet.2021.06.008. Epub 2021 Jun 17.

Abstract

BACKGROUND

From 2012 to 2013, there was a mass methanol poisoning outbreak in the Czech Republic. Methanol metabolites can cause specific lesions in the basal ganglia, subcortical white matter, and optic nerve. However, long-term sequelae of methanol poisoning on cognitive functioning have not yet been explored. The current study aimed to delineate the cognitive changes observed in methanol poisoning survivors in the seven years since 2012.

METHODS

We conducted longitudinal research with repeated measurements in 2013, 2015, 2017 and 2019 to evaluate the development of cognitive changes after acute methanol poisoning. A complex neuropsychological battery consisted of tests of global cognitive performance, auditory and visual attention, executive functioning, learning and memory, working memory and language. Motor performance measures and depression scale were also included.

RESULTS

Repeated measures ANOVA of four measurements with post-hoc tests showed a significant decline in the Mini-Mental State Examination (p = 0.007); however, other parameters were not significantly decreasing. In comparison to normative values, the z-scores for each test measure, in the memory domain, in particular, ranged from 43 to 60 % of participants below 1.5 SD. Mild to severe depression levels from the onset of poisoning improved during the seven years, returning to normal in up to 27 % of participants.

CONCLUSION

In the longitudinal perspective, methanol poisoning survivors manifest progressive global cognitive decline and overall persistent below-average cognitive performance with some improvements in the frequency of depressive symptoms.

摘要

背景

2012 年至 2013 年,捷克共和国发生了一起大规模甲醇中毒事件。甲醇代谢物可导致基底节、皮质下白质和视神经出现特定损伤。然而,甲醇中毒对认知功能的长期影响尚未得到探索。本研究旨在描绘 2012 年以来 7 年间甲醇中毒幸存者的认知变化。

方法

我们于 2013 年、2015 年、2017 年和 2019 年进行了纵向研究,重复测量,以评估急性甲醇中毒后认知变化的发展。一个复杂的神经心理学测试包包括对整体认知表现、听觉和视觉注意力、执行功能、学习和记忆、工作记忆和语言的测试。还包括运动表现测量和抑郁量表。

结果

四项测量的重复测量方差分析和事后检验显示,简易精神状态检查(p=0.007)显著下降;然而,其他参数并没有明显下降。与正常值相比,记忆域中每个测试指标的 z 分数范围为 43%至 60%的参与者低于 1.5 SD。从中毒开始,轻度至重度抑郁水平在七年内有所改善,多达 27%的参与者恢复正常。

结论

从纵向角度来看,甲醇中毒幸存者表现出进行性的整体认知衰退和总体持续低于平均水平的认知表现,抑郁症状的频率有所改善。

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