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Acute, Low-Level Carbon Monoxide Poisoning:

Effects of CO on Neuropsychological Parameters:

Effects of low concentration of carbon monoxide on human physiological function

Amitai, Y., Zlotogorski, Z., Golan-Katzav, V., Wexler, A., Gross, D.


Archives of Neurology

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 CO on higher cognitive functions in young healthy volunteers and a matched non-exposed control group.

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

PARTICIPANTS: 45 student volunteers who were exposed to CO from residential kerosene stoves for 1.5 to 2.5 hours (air CO concentrations of 17-100 ppm; mean +/- SD, 61 +/- 24 ppm) served as the experimental group and 47 non-exposed 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 (COHb) levels in participants of the study group ranged from 0.01 to 0.11 (mean +/- SD, 0.04 +/- 0.03) and correlated with air CO 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 CO poisoning. Low-level exposure to CO results in impairment of higher cognitive functions. Neuropsychological testing appears to be sensitive in the detection of subtle neurologic dysfunctions resulting from CO poisoning.

Department of Pediatrics, Hadassah University, Mt. Scopus, Jerusalem, Israel

From: Amitai, Y., et al. (1998) Neuropsychological impairment from acute low-level exposure to carbon monoxide. Arch. Neurology, 55, 845-848.

...... last changed 07/22/02

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