Comment; Characteristic changes in CIRS-WDB include bilateral increased forebrain parenchymal, cortical gray matter and pallidum volumes and decreased caudate nucleus volumes. The volumes normalize with treatment of the underlying cause.
Abstract
Exposure to the complex mixture of inflammagens and toxigenic
microbes growing in water-damaged buildings (WDB) can lead to
a chronic inflammatory response syndrome (CIRS). Many CIRS
patients exhibit a neurological component of illness that includes
structural brain changes. This study shows some of those structural
brain changes are potentially reversible when patients are removed
from the WDB environment and follow sequential steps of a
published treatment protocol. We evaluated MRIs from 91 subjects
classified into four groups: controls, untreated, partially treated
and fully treated/recovered CIRS-WDB patients using the MRI
volumetric software NeuroQuant®. The current study reinforced
previous findings of increased forebrain parenchymal, cortical
gray matter and pallidum volumes, as well as decreased caudate
nucleus volumes in untreated CIRS patients compared to controls.
All changes were found bilaterally. When an ANOVA was performed
on brain structures across all patient classes, statistically significant
decreases were seen in forebrain and cortical gray matter between
untreated and fully treated/recovered patients as these structures
trended towards control levels after sequential treatment. Both the
caudate and pallidum volumes also trended towards control values
but were not significant by ANOVA. These data are consistent
with clinical improvement of executive functioning seen in patients
as they progressed through the treatment steps, suggesting that
volumetric brain imaging is a useful tool for monitoring therapy
longitudinally.
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