- Title
- Subacute and chronic neuropsychological sequalae of acute organophosphate pesticide self-poisoning: a prospective cohort study from Sri Lanka
- Creator
- Dassanayake, Tharaka L.; Weerasinghe, Vajira S.; Gawarammana, Indika; Buckley, Nicholas A.
- Relation
- Clinical Toxicology Vol. 59, Issue 2, p. 118-130
- Publisher Link
- http://dx.doi.org/10.1080/15563650.2020.1778719
- Publisher
- Taylor & Francis
- Resource Type
- journal article
- Date
- 2021
- Description
- Context: Some epidemiological evidence implicates acute organophosphate (OP) pesticide poisoning in long-term neurocognitive deficits. However, no study has prospectively followed up poisoned patients long-term from the time of intoxication. We aimed to determine whether clinically significant acute OP self-poisoning leads to subacute and chronic neurocognitive deficits, in a prospective follow up study. Methods: Employing Mini Mental State Examination, Digit Span and Cambridge Neuropsychological Test Automated Battery (CANTAB), we compared multiple cognitive functions in 222 patients hospitalized with acute OP pesticide self-poisoning with a control group of 52 patients hospitalized with paracetamol overdose, at three time points: on discharge following clinical recovery, 6 weeks and 6 months post-ingestion. Intergroup comparisons at each time point were done in multiple regression models, adjusting for sex, age, education and psychiatric comorbidities. OP within-group analysis was done to determine a dose-response relationship. Results: After adjusting for covariates, the OP poisoned group had significantly poorer working memory (Digit Span) and episodic memory (CANTAB Paired Associates Learning); impaired spatial planning (CANTAB Stocking of Cambridge); and slower response speed in the sustained attention task (CANTAB Rapid Visual Information Processing), in the post-discharge assessment. Only working memory and episodic memory measures were impaired in the OP group at 6 weeks, whereas no significant intergroup differences were observed at 6 months. The OP subgroup who had complete red cell acetylcholinesterase inhibition on admission had poorer episodic memory when tested post-discharge than those who had partial inhibition, but no significant subgroup differences were observed at 6 weeks or 6 months. Discussion: Acute OP pesticide poisoning may cause neuropsychological impairment that outlasts the cholinergic phase on a subacute time scale; but does not cause measurable chronic neuropsychological deficits.
- Subject
- organophosphate; pesticide; poisoning; cognition; memory; neurophsychological effects; self-harm; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1462147
- Identifier
- uon:46394
- Identifier
- ISSN:1556-3650
- Rights
- This is an Accepted Manuscript of an article published by Taylor & Francis in Clinical Toxicology on 22/06/2020, available online: https://www.tandfonline.com/doi/full/10.1080/15563650.2020.1778719.
- Language
- eng
- Full Text
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