Brain functional activity and connectivity alterations induced by acute carbon monoxide poisoning contribute to delayed neuropsychiatric sequelae

• Published in: Toxicology and applied pharmacology Vol. 500; p. 117384
• Main Authors: Zhang, Yanli, Wang, Tianhong, Gou, Lubin, Shi, Mei, Song, Le, Zhao, Shaofeng, Wang, Shuaiwen, Guo, Shunlin, Lei, Junqiang
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2025
• Subjects: Adult; Brain - diagnostic imaging; Brain - physiopathology; Carbon monoxide poisoning; Carbon Monoxide Poisoning - complications; Carbon Monoxide Poisoning - diagnostic imaging; Carbon Monoxide Poisoning - physiopathology; Carbon Monoxide Poisoning - psychology; Case-Control Studies; Cortical function; Delayed neurological sequelae; Directed functional connectivity; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Nerve Net - physiopathology; Prospective Studies; Undirected functional connectivity; Young Adult; Carbon monoxide poisoning; Delayed neurological sequelae; Undirected functional connectivity; Directed functional connectivity; Cortical function
• ISSN: 0041-008X; 1096-0333; 1096-0333
• DOI: 10.1016/j.taap.2025.117384

The brain functional activity and connectivity alterations induced by acute carbon monoxide (CO) poisoning may contribute to delayed neurological sequelae (DNS) and be associate with the poisoning severities, although comprehensive evidence remains limited. Seventy-four subjects were prospectively recruited for this study, comprising eighteen DNS patients, twenty-six non-DNS patients, and thirty healthy controls. The study employed analysis methods such as the amplitude of low-frequency fluctuation, regional homogeneity, weighted degree centrality, secondary seed-based functional connectivity (FC), and Granger causality analysis to assess functional activity and connectivity. Partial correlation analyses between extracted abnormal functional indices and clinical variables including duration of CO exposure and Glasgow Coma Scale scores were further explored. The results showed that DNS patients exhibited altered functional activity in specific nodes of the visual network (VN), sensorimotor network (SMN), and executive control network (ECN) (Gaussian random field [GRF]-corrected, P < 0.05). Additionally, altered FC values were detected in the nodes of the VN, default mode network (DMN), ECN, SMN, and the cerebello-cortical motor loop nodes (GRF-corrected, P < 0.05). VN hyperactivity exerted inhibitory effects on the DMN and SMN, as well as self-inhibition within DMN nodes. Conversely, DMN nodes showed hypoactivity and received excitatory influences from the anterior cerebellar and ECN nodes. Connectivity changes of above networks and loop nodes were associated with the clinical severities (Bonferroni-corrected, P < 0.05). These findings highlight significant changes in neural functional activity and connectivity across cognitive and motor-related network nodes, potentially contributing to DNS development and associating with the poisoning severities. •Cortical functional abnormalities influence on prognosis of carbon monoxide poisoning•The function disorder of brain networks contribute to delayed neurological sequelae•The poisoning severity is associated with special functional connectivity alterations