Background

Basal ganglia lesions are typical findings on magnetic resonance imaging (MRI) of the brain in survivors of acute methanol poisoning. However, no data are available on the association between the magnitude of damaged brain regions, serum concentrations of markers of acute methanol toxicity, oxidative stress, neuroinflammation, and the rate of retinal nerve ganglion cell loss.

Objectives

To investigate the association between MRI-based volumetry of the basal ganglia, retinal nerve fibre layer (RNFL) thickness and prognostic laboratory markers of outcomes in acute methanol poisoning.

Methods

MRI-based volumetry of putamen, nucleus caudatus and globus pallidus was performed and compared with laboratory parameters of severity of poisoning and acute serum markers of oxidative damage of lipids (8-isoprostan, MDA, HHE, HNE), nucleic acids (8−OHdG, 8−OHG, 5−OHMU), proteins (o-Thyr, NO-Thyr, Cl-Thyr) and leukotrienes (LTC4, LTD4, LTE4, LTB4), as well as with the results of RNFL measurements by optic coherence tomography (OCT) in 16 patients with acute methanol poisoning (Group I) and in 28 survivors of poisoning two years after discharge with the same markers measured within the follow-up examination (Group II). The control group consisted of 28 healthy subjects without methanol poisoning.

Results

The survivors of acute methanol poisoning had significantly lower volumes of basal ganglia than the controls. The patients with MRI signs of methanol-induced toxic brain damage had significantly lower volumes of basal ganglia than those without these signs. A positive correlation was found between the volume of putamen and arterial blood pH on admission (r = 0.45; p = 0.02 and r = 0.44; p = 0.02 for left and right putamen, correspondingly). A negative correlation was present between the volumes of putamen and acute serum lactate (r = -0.63; p < 0.001 and r = -0.59; p = 0.01), creatinine (r = -0.53; p = 0.01 and r = -0.47; p = 0.01) and glucose (r = -0.55; p < 0.001 and r = -0.50; p = 0.01) concentrations.

The volume of basal ganglia positively correlated with acute concentrations of markers of lipoperoxidation (8-isoprostan: r = 0.61; p < 0.05 and r = 0.59; p < 0.05 for left and right putamen, correspondingly) and inflammation (leukotriene LTB4: r = 0.61; p < 0.05 and r = 0.61; p < 0.05 for left and right putamen, correspondingly). The higher the volume of the basal ganglia, the higher the thickness of the RNFL, with the strongest positive association between global RNFL and the volume of putamen bilaterally (all p < 0.01). In the follow-up markers of oxidative stress and inflammation, only o-Thyr concentration negatively correlated with the volume of putamen bilaterally (r = –0.39; p < 0.05 and r = –0.37; p < 0.05 for left and right putamen, correspondingly).

Conclusion

In survivors of acute methanol poisoning with signs of toxic brain damage, the magnitude of affected areas correlated with acute parameters of severity of poisoning, markers of oxidative stress and neuroinflammation. There was a positive association between the basal ganglia volume and the thickness of RNFL, making OCT an important screening test and MRI-based volumetry the confirmative diagnostic method for the detection of CNS sequelae of methanol poisoning.

中文翻译：

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基于MRI的脑容量测定和视网膜光学相干断层扫描是急性甲醇中毒结果的生物标志物。

背景

基底神经节病变是急性甲醇中毒幸存者大脑磁共振成像（MRI）的典型发现。但是，尚无关于受损脑区的大小，急性甲醇中毒标志物的血清浓度，氧化应激，神经炎症和视网膜神经节细胞丢失率之间的相关性的数据。

目标

研究基于MRI的基底神经节容积，视网膜神经纤维层（RNFL）厚度与急性甲醇中毒预后的实验室指标之间的关系。

方法

进行基于核仁的核壳核，尾核和苍白球的MRI定量，并将其与中毒严重程度和脂质（8-异前列腺素，MDA，HHE，HNE），核酸（8-OHdG）的氧化损伤的急性血清标志物的实验室参数进行比较，8-OHG，5-OHMU），蛋白质（o-Thyr，NO-Thyr，Cl-Thyr）和白三烯（LTC4，LTD4，LTE4，LTB4），以及通过光学相干断层扫描（RNFL）测量的RNFL结果（ （OCT）在16名急性甲醇中毒患者中（I组）和出院后两年中有28名中毒幸存者，且在随访检查中用相同的标记物进行了测量（II组）。对照组由28名无甲醇中毒的健康受试者组成。

结果

急性甲醇中毒的幸存者的基底神经节体积明显少于对照组。具有甲醇诱发的毒性脑损伤的MRI征象的患者的基底神经节体积明显低于没有这些征象的患者。在入院时，核壳蛋白的体积与动脉血pH之间存在正相关（r = 0.45； p = 0.02和r = 0.44； p = 0.02，左壳和右壳壳分别对应）。壳聚糖和急性血清乳酸（r = -0.63; p <0.001和r = -0.59; p = 0.01），肌酐（r = -0.53; p = 0.01和r = -0.47; p = 0.01）和葡萄糖（r = -0.55； p <0.001和r = -0.50； p = 0.01）浓度。

基底神经节的体积与脂过氧化标志物的急性浓度（8-异前列腺素：r = 0.61； p <0.05和r = 0.59； p <0.05，分别针对左右壳核）分别呈正相关，并且与炎症（白三烯LTB4：r = 0.61; p <0.05且r = 0.61;左壳和右壳的p <0.05）。基底神经节的体积越大，RNFL的厚度就越大，全局RNFL与双侧壳核的体积之间具有最强的正相关性（所有p <0.01）。在氧化应激和炎症的后续指标中，只有o-Thyr浓度与双侧壳核的体积呈负相关（r = –0.39； p <0.05和r = –0.37； p <0.05对左右壳核来说，分别）。

结论

在具有中毒性脑损伤迹象的急性甲醇中毒幸存者中，受影响区域的大小与中毒严重程度，氧化应激和神经炎症标志物的急性参数相关。基底神经节体积与RNFL厚度之间存在正相关，使OCT成为重要的筛查试验，而基于MRI的容积法则是检测甲醇中毒CNS后遗症的确诊方法。