Cognitive dysfunction has been reported in patients with carbon monoxide (CO) poisoning. However, the underpinning mechanism remained unclear. This study examined dopamine transporter (DAT) and metabolite ratios concurrently and their relationships with cognitive dysfunction in CO poisoning. Eighteen suicide attempters with charcoal burning which results in CO poisoning and 18 age- and gender- matched normal controls were recruited. A battery of cognitive assessments including attention, memory, and executive function was administered. Each participant received one single photon emission computed tomography with ^99mTc-TRODAT for measuring striatal DAT availability and proton magnetic resonance spectroscopy to determine N-acetyl aspartate/creatine (NAA/Cr), choline-containing compounds/creatine (Cho/Cr) and myo-inositol/creatine (mI/Cr) in the left parietal white matter and mid-occipital gray matter (OGM). CO poisoning patients had significant impairments in memory and executive function. Compared to normal, CO poisoning patients had lower striatal DAT availability, lower NAA/Cr levels in both regions and higher Cho/Cr levels in both regions. In CO poisoning patients, the altered left striatal DAT availability and Cho/Cr level in OGM were significantly associated with executive dysfunction in the expected directions. Moreover, there was a significant interaction between these two imaging indices on their relationships with executive dysfunction and combination of them could adequately predict executive dysfunction in more CO poisoning cases than either alone. The current results suggested that both alterations in DAT availability and metabolite ratios might play crucial roles in executive dysfunction in CO poisoning. This research also highlights the importance of multimodal imaging approaches for studying neurotoxicity effects.

据报道，一氧化碳 (CO) 中毒患者会出现认知功能障碍。然而，其支撑机制仍不清楚。本研究同时检查了多巴胺转运蛋白 (DAT) 和代谢物的比率以及它们与 CO 中毒认知功能障碍的关系。招募了 18 名烧炭导致 CO 中毒的自杀未遂者和 18 名年龄和性别匹配的正常对照。进行了一系列认知评估，包括注意力、记忆力和执行功能。每个参与者都接受了^{99m 的}单光子发射计算机断层扫描Tc-TRODAT 用于测量纹状体 DAT 可用性和质子磁共振波谱以确定 N-乙酰天冬氨酸/肌酸 (NAA/Cr)、含胆碱化合物/肌酸 (Cho/Cr) 和肌醇/肌酸 (mI/Cr)左顶叶白质和枕中灰质 (OGM)。CO中毒患者的记忆力和执行功能明显受损。与正常人相比，一氧化碳中毒患者的纹状体 DAT 可用性较低，两个区域的 NAA/Cr 水平较低，而两个区域的 Cho/Cr 水平较高。在 CO 中毒患者中，OGM 中左侧纹状体 DAT 可用性和 Cho/Cr 水平的改变与预期方向的执行功能障碍显着相关。而且，这两个成像指标与执行功能障碍的关系之间存在显着的相互作用，并且它们的组合可以充分预测更多 CO 中毒病例中的执行功能障碍，而不是单独使用。目前的结果表明，DAT 可用性和代谢物比率的改变可能在 CO 中毒的执行功能障碍中起关键作用。这项研究还强调了多模态成像方法在研究神经毒性效应方面的重要性。