This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (34)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Behavioral Neurology  • Cognitive Disorders  • Alert me on articles by topic  Social Bookmarking   What's this?

Yona Amitai, MD; Zoli Zlotogorski, PhD; Vered Golan-Katzav, MA; Anya Wexler, MD; Ditza Gross, PhD

Arch Neurol. 1998;55:845-848.

Objective  To investigate the effects of acute low-level exposure to carbon monoxide on higher cognitive functions in healthy humans.

Design  An empirical study of the effects of low-level exposure to carbon monoxide on higher cognitive functions in young healthy volunteers and a matched nonexposed control group.

Setting  A dormitory at the Hebrew University campus in Jerusalem, Israel.

Participants  Forty-five student volunteers who were exposed to carbon monoxide from residential kerosene stoves for 1.5 to 2.5 hours (air carbon monoxide concentrations of 17-100 ppm; mean ± SD, 61 ± 24 ppm) served as the experimental group and 47 nonexposed students served as the control group.

Main Outcome Measures  A battery of neuropsychological tests was administered to each participant including digit span, the revised Wechsler Memory Scale for verbal and figural memory, Trail-Making Test parts A and B, digit symbol, block design, and the Rey Auditory Verbal Learning Test.

Results  Venous blood carboxyhemoglobin (HbCO) levels in participants of the study group ranged from 0.01 to 0.11 (mean ± SD, 0.04 ± 0.03) and correlated with air carbon monoxide concentrations (r=0.39; P=.01). The experimental group scored significantly lower than controls on the following tests: digit span forward (P=.02), short-term (P=.008) and long-term semantic memory (P=.008), digit symbol (P=.004), block design (P=.009), recall of figural memory (P=.02), and Trail-Making part A (P=.04). No significant differences were found between the experimental and control groups in other tests.

Conclusions  The lower scores on neuropsychological tests indicate dysfunctions in memory, new learning ability, attention and concentration, tracking skills, visuomotor skills, abstract thinking, and visuospatial planing and processing. These dysfunctions correspond with previous reports of carbon monoxide neurotoxic effects in patients with moderate carbon monoxide poisoning. Low-level exposure to carbon monoxide results in impairment of higher cognitive functions. Neuropsychological testing appears to be sensitive in the detection of subtle neurologic dysfunctions resulting from carbon monoxide poisoning.

From the Department of Pediatrics, Hadassah University Mt Scopus (Drs Amitai and Wexler), the Department of Behavioral Sciences, Ben-Gurion University (Dr Zlotogorski and Mr Golan-Katzav), and the Department of Anesthesiology, Hadassah University Hospital, Ein Karem (Dr Gross), Jerusalem, Israel.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Carbon Monoxide Poisoning
Weaver
NEJM 2009;360:1217-1225.
FULL TEXT  

Neuroimaging, cognitive, and neurobehavioral outcomes following carbon monoxide poisoning.
Hopkins and Woon
Behav Cogn Neurosci Rev 2006;5:141-155.
ABSTRACT  

Myocardial Dysfunction and Potential Cardiac Hypoxia in Rats Induced by Carbon Monoxide Inhalation
Favory et al.
Am. J. Respir. Crit. Care Med. 2006;174:320-325.
ABSTRACT | FULL TEXT  

Early carbon monoxide intoxication: happy to be poisoned?
Clarke et al.
Emerg. Med. J. 2005;22:754-755.
ABSTRACT | FULL TEXT  

"Low-Level" Carbon Monoxide Administration May Carry Risk
Hampson et al.
Am. J. Respir. Crit. Care Med. 2005;172:784-784.
FULL TEXT  

Memory one month after acute carbon monoxide intoxication: a prospective study
Deschamps et al.
Occup. Environ. Med. 2003;60:212-216.
ABSTRACT | FULL TEXT  

Effects on health of prolonged exposure to low concentrations of carbon monoxide
Townsend and Maynard
Occup. Environ. Med. 2002;59:708-711.
FULL TEXT  

Chronic and occult carbon monoxide poisoning: we don't know what we're missing
Wright
Emerg. Med. J. 2002;19:386-390.
ABSTRACT | FULL TEXT  

Exposure to carbon monoxide and nitrogen dioxide in enclosed ice arenas
Pelham et al.
Occup. Environ. Med. 2002;59:224-233.
ABSTRACT | FULL TEXT  

Accidental Carbon Monoxide Poisoning With Severe Cardiorespiratory Compromise in 2 Children
Grant and Clay
Am J Crit Care 2002;11:128-131.
FULL TEXT  

Ventilation for People
Brundrett
Indoor and Built Environment 2000;9:97-101.
ABSTRACT  

The Mere Presence of Low Levels of Carboxyhemoglobin Is Not Causal Proof for Altered Neuropsychological Performance
Bleecker and Lindgren
Arch Neurol 1999;56:1299-1300.
FULL TEXT