Sarin poisoning in Tokyo subway

Suzuki, Tsuneo; Morita, Hiroyuki; Ono, Katsushige; Maekawa, Kazuyuki; Nagai, Ryozo; Yazaki, Yoshio; Nozaki, Hiroyuki; Aikawa, Naoki; Shinozawa, Yotaro; Hori, Satoshi; Fujishima, Seitaro; Takuma, Kiyotsugu; Sagoh, Masachika

doi:10.1016/s0140-6736(95)90726-2

Cited by 299 publications

(91 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The Tokyo subway sarin attack was caused by terrorists belonging to a cult named Aum Shinrikyo in Japan on March 20, 1995. Approximately 5,500 victims were exposed to sarin, a poisonous gas, and 12 of the victims died (22). We recruited those victims, with or without PTSD, who had never received psychiatric treatment for PTSD caused by the attack.…”

mentioning

confidence: 99%

Voxel-based analysis of MRI reveals anterior cingulate gray-matter volume reduction in posttraumatic stress disorder due to terrorism

Yamasue

Kasai

Iwanami

et al. 2003

Proc. Natl. Acad. Sci. U.S.A.

344

198

View full text Add to dashboard Cite

MRI studies using the manual tracing method have shown a smaller-than-normal hippocampal volume in patients with posttraumatic stress disorder (PTSD). However, these studies have yielded inconsistent results, and brain structures other than the hippocampus have not been well investigated. A recently developed, fully automated method called voxel-based morphometry enables an exploration of structural changes throughout the brain by applying statistical parametric mapping to high-resolution MRI. Here we first used this technology in patients with PTSD. Participants were 9 victims of the Tokyo subway sarin attack with PTSD and 16 matched victims of the same traumatic event without PTSD. The voxel-based morphometry showed a significant gray-matter volume reduction in the left anterior cingulate cortex (ACC) in trauma survivors with PTSD compared with those without PTSD. The severity of the disorder was negatively correlated with the gray-matter volume of the left ACC in PTSD subjects. There were no significant differences in other gray-matter regions or any of the white-matter regions between two groups. The present study demonstrates evidence for structural abnormalities of ACC in patients with PTSD. Together with previous functional neuroimaging studies showing a dysfunction of this region, the present findings provide further support for the important role of ACC, which is pivotally involved in attention, emotional regulation, and conditioned fear, in the pathology of PTSD.F indings from neuroimaging studies of patients with posttraumatic stress disorder (PTSD) have suggested that some brain pathology plays an important role in the disorder (1, 2). Six structural MRI studies have shown that combat-related or childhood physically and͞or sexually abused subjects with PTSD have a smaller-than-normal hippocampal volume (3-8). However, almost the same number of studies failed to show reduced hippocampal volume in chronically maltreated children (9-11), survivors of acute traumatic events (12), nonalcoholic combat veterans (13), and alcoholic patients (14) with PTSD. In contrast, brain structures other than the hippocampus have received less attention, although a few studies have reported whole-brain volume reduction (9), reduced total white-matter volume (7), smaller corpus callosum (9), larger superior temporal gyrus gray-matter volume (15), and attenuation of frontal lobe asymmetry (11). Therefore, it is unclear whether structural abnormality in brain structures other than the hippocampus exists in patients with PTSD.In contrast to the emphasis on the hippocampus in previous structural MRI studies, symptom-provocation and cognitiveactivation studies using functional neuroimaging have revealed greater activation of the amygdala, anterior paralimbic structures, Broca's region, and other neocortical regions and a failure of activation of anterior cingulate cortex (ACC) in response to trauma-related stimuli in individuals with PTSD (1, 2, 16). Furthermore, one study (17) showed a reduced N-acetylaspartate͞creatine ratio...

show abstract

mentioning

confidence: 99%

Voxel-based analysis of MRI reveals anterior cingulate gray-matter volume reduction in posttraumatic stress disorder due to terrorism

Yamasue

Kasai

Iwanami

et al. 2003

Proc. Natl. Acad. Sci. U.S.A.

344

198

View full text Add to dashboard Cite

show abstract

“…Cardiovascular effects initially are due to nicotinic stimulation, leading to tachycardia and hypertension [103], but hypotension and cardiac conduction abnormalities are seen as well.…”

Section: Nerve Agentsmentioning

confidence: 99%

Treatment of Neuroterrorism

Busl

Bleck

2012

Neurotherapeutics

View full text Add to dashboard Cite

Bioterrorism is defined as the intentional use of biological, chemical, nuclear, or radiological agents to cause disease, death, or environmental damage. Early recognition of a bioterrorist attack is of utmost importance to minimize casualties and initiate appropriate therapy. The range of agents that could potentially be used as weapons is wide, however, only a few of these agents have all the characteristics making them ideal for that purpose. Many of the chemical and biological weapons can cause neurological symptoms and damage the nervous system in varying degrees. Therefore, preparedness among neurologists is important. The main challenge is to be cognizant of the clinical syndromes and to be able to differentiate diseases caused by bioterrorism from naturally occurring disorders. This review provides an overview of the biological and chemical warfare agents, with a focus on neurological manifestation and an approach to treatment from a perspective of neurological critical care.

show abstract

“…In 1995, two terrorist attacks in Japan with sarin caused several deaths and thousands of injuries (Suzuki et al, 1995). Sarin is metabolized by PON1, and homozygotes for the PON1 Q192 allele hydrolyze sarin better than individuals homozygous for the PON1 R192 allele (Davies et al, 1996).…”

Section: Pon1 Status and Op Toxicity: Evidence In Humansmentioning

confidence: 99%