Cognitive impairment associated with toxigenic fungal exposure: a replication and extension of previous findings

Gordon WA, Cantor JB, Johanning E +5 more2004Applied NeuropsychologyJournal Article

CardiovascularEndocrine (ADH/ACTH/MSH)Immune/InnateNeurologicalRespiratory/Sinus

Indoor Mold (Stachybotrys, Aspergillus, etc.)MycotoxinsWater-Damaged Buildings (WDB)

Abstract

In this study, neuropsychological data and symptom reports from 31 individuals exposed to toxic mold were examined. Most participants were found to have reduced cognitive functioning in multiple domains, with memory and executive functions the most commonly affected areas. Rates of dysfunction were significantly greater than chance on more than half of the tests. Number of cognitive impairments was found to be related to depression, although few neuropsychological test scores were correlated with depression. Results also indicated that symptom report of the mold-exposed participants was not significantly different from that of matched groups of 65 persons with mild traumatic brain injury (TBI) and 26 individuals with moderate TBI. The mold-exposed participants reported significantly more symptoms than 47 people with no disability. This study adds to a growing body of literature (e.g., Baldo, Ahmad, & Ruff, 2002; Gordon, Johanning, & Haddad, 1999) relating exposure to mycotoxins to cognitive dysfunction.

Key Biomarkers

Abnormal nerve conduction studiesAbnormal quantitative EEG (narrowed frequency bands, increased alpha/theta in frontal cortex)Altered T cell phenotypes (CD20+, CD5+CD25+, CD3+CD26+, CD8+HLR-DR+, CD8+CD38+)Antinuclear autoantibodies (ANA)Autoantibodies against CNS and PNS myelinAutoantibodies against smooth muscle (ASM)Decreased NK cells (CD3-CD16+CD56+)Elevated autoantibodies to neural antigens (IgA, IgM, IgG)Trichothecene toxin in urine and serum

Symptom Clusters

Autonomic nervous system dysfunctionBalance and motor coordination dysfunctionCognitive impairment (memory, executive function, concentration, digit-symbol substitution, trail making)DizzinessMood disturbance and depressionNeuropsychological deficits (visuospatial learning, verbal learning, psychomotor speed)Peripheral neuropathy (numbness, tingling, tremors, muscle weakness)Reduced grip strengthRespiratory symptoms (rhinorrhea, sinus tenderness, wheezing, airway obstruction)Visual dysfunction (color discrimination, visual fields)

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