RT Journal Article SR Electronic T1 1H-magnetic resonance spectroscopy indicates damage to cerebral white matter in the subacute phase after CO poisoning JF Journal of Neurology, Neurosurgery & Psychiatry JO J Neurol Neurosurg Psychiatry FD BMJ Publishing Group Ltd SP 869 OP 875 DO 10.1136/jnnp.2010.222422 VO 82 IS 8 A1 Takaaki Beppu A1 Hideaki Nishimoto A1 Shunrou Fujiwara A1 Kaoru Kudo A1 Katsumi Sanjo A1 Shinsuke Narumi A1 Hirotaka Oikawa A1 Makoto Onodera A1 Kuniaki Ogasawara A1 Makoto Sasaki YR 2011 UL http://jnnp.bmj.com/content/82/8/869.abstract AB Objective The authors examined whether 1H-magnetic resonance spectroscopy (MRS) can identify damage to the centrum semiovale in the subacute phase after CO exposure.Methods Subjects comprised 29 adult patients who were treated with hyperbaric oxygenation within a range of 4–95 h (mean 18.7 h) after CO exposure. Subjects were classified into three groups according to clinical behaviours: Group A, patients with transit acute symptoms only; Group P, patients with persistent neurological symptoms; and Group D, patients with ‘delayed neuropsychiatric sequelae’ occurring after a lucid interval. MRS of bilateral centrum semiovale was performed 2 weeks after CO inhalation for all patients and 13 healthy volunteers. The mean ratios of choline-containing compounds/creatine (meanCho/Cr) and N-acetylaspartate/Cr (meanNAA/Cr) for bilateral centrum semiovale were calculated and compared between the three CO groups and controls. Myelin basic protein (MBP) concentration in cerebrospinal fluid was examined at 2 weeks to evaluate the degree of demyelination in patients.Results MBP concentration was abnormal for almost all patients in Groups P and D, but was not abnormal for any Group A patients. The meanCho/Cr ratios were significantly higher in Groups P and D than in Group A. No significant difference in meanNAA/Cr ratio was seen between the three pathological groups and controls. A significant correlation was identified between MBP and meanCho/Cr ratio.Conclusions These results suggest that the Cho/Cr ratio in the subacute phase after CO intoxication represents early demyelination in the centrum semiovale, and can predict chronic neurological symptoms.