Asymptomatic sequelae to acute sarin poisoning in the central and autonomic nervous system 6 months after the Tokyo subway attack |
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Authors: | K Murata Shunichi Araki Kazuhito Yokoyama Tetsu Okumura Shinichi Ishimatsu Nobukatsu Takasu Roberta F White |
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Institution: | (1) Department of Public Health, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113, Japan, JP;(2) Emergency Department, St. Luke’s International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo 104, Japan, JP;(3) Department of Neurology, Boston University School of Medicine, 80 East Concord Street, Boston, MA 02118, USA, US |
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Abstract: | Six to eight months after the Tokyo subway attack in March 1995, the neurophysiological effects of acute sarin poisoning
were investigated in 18 passengers exposed to sarin (sarin cases) in the subways to ascertain the focal or functional brain
deficits induced by sarin. The event-related and visual evoked potentials (P300 and VEP), brainstem auditory evoked potential,
and electrocardiographic R-R interval variability (CVRR), together with the score on the posttraumatic stress disorder (PTSD) checklist, were measured in the sarin cases and the
same number of control subjects matched for sex and age. None of the sarin cases had any obvious clinical abnormalities at
the time of testing. The P300 and VEP (P100) latencies in the sarin cases were significantly prolonged compared with the matched
controls. In the sarin cases, the CVRR was significantly related to serum cholinesterase (ChE) levels determined immediately after exposure; the PTSD score was
not significantly associated with any neurophysiological data despite the high PTSD score in the sarin cases. These findings
suggest that asymptomatic sequelae to sarin exposure, rather than PTSD, persist in the higher and visual nervous systems beyond
the turnover period of ChE; sarin may have neurotoxic actions in addition to the inhibitory action on brain ChE.
Received: 2 April 1997 Received in revised from: 15 July 1997 Accepted: 1 August 1997 |
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Keywords: | Sarin poisoning Asymptomatic sequelae Neurotoxicity Neurophysiological methods Posttraumatic stress disorder |
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