OBJECTIVES: The study focuses on the 2012 methanol outbreak in the Czech Republic. The main goal of the present study was to apply analytical and descriptive tools to selected qualitative and quantitative processes related to the 2012 methanol outbreak in the Czech Republic. The secondary goal was to study and evaluate in detail their potential for creating integrated conceptual national policies aimed at eliminating the risk of methanol poisoning in the future. METHODS: The presented qualitative analysis focused on the content of documents published by Czech public authorities - the Ministry of Health, the Ministry of the Interior, the Czech Agriculture and Food Inspection Authority, and the Regional Public Health Authorities - as well as the content of the relevant legal regulations. Moreover, statistical data concerning the number of hospitalisations and deaths due to the methanol intoxication were used to provide a background to a detailed description of the relevant facts. RESULTS: In procedural terms, most of the analysed measures focused on a strongly restrictive regulation of sales, regular information channels designed to protect consumers on the national as well as international level, and elimination of further health and economic risks stemming from the dangerous alcoholic products that had already entered distribution networks. The health, social and economic consequences of such activities are quantified at a highly aggregated level. The analysed institutional ties are evaluated also in the context of international documents: the European Action Plan to Reduce Harmful Use of Alcohol 2012-2020 and the Global Strategy to Reduce Harmful Use of Alcohol, and their current potential for steering public policies is assessed. CONCLUSION: The analysis and evaluation of procedural activities carried out after the methanol outbreak have laid the foundations for a multidimensional study that can contribute to integrated national policy concepts aimed at preventing these and similar negative health, societal and economic consequences. Six years after the methanol outbreak, national and regional health policies have reflected no findings concerning the experience of patients whose health was impaired due to methanol, and the economic cost of the event has not been calculated. The quality of life of these patients has greatly decreased due to permanent or partial incapacity and serious upheavals of their and their families' economic and social conditions. This opens the question of researching and evaluating multiple aspects of health, social and economic impacts of harmful use of alcohol and setting up processes to mitigate these impacts.

• Keywords
• methanol, poisoning, public health,
• MeSH
• Disease Outbreaks * MeSH
• Qualitative Research MeSH
• Humans MeSH
• Methanol poisoning   MeSH
• Poisoning epidemiology   MeSH
• Public Policy * MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic epidemiology   MeSH
• Names of Substances
• Methanol MeSH

OBJECTIVE: During an outbreak of mass methanol poisonings in the Czech Republic in 2012-2013, fomepizole was applied as an alternative antidote to ethanol. We present the laboratory data, clinical features, adverse reactions, and treatment outcomes in all patients treated with fomepizole. METHODS: Combined retrospective and prospective case series study in 25 patients, median age 50 (16-73) years, 18 males and 7 females. RESULTS: There were 24% fatalities, 36% survivors without health impairment, and 40% survivors with sequelae. All the patients who died were comatose on admission; the mortality was 50% among patients in a coma. The median intensive care unit length of stay was six (2-22) days. The median total dose of fomepizole was 2 (1-9) g. Complications were observed in 7/25 cases: aspiration pneumonia (4), sepsis (2), bleeding (2), malignant arrhythmia (1), delirium tremens (1), and rebound of acidosis (1). The patients who survived without impairment were less acidotic than those who died or survived with sequelae (P<0.01). No difference in serum methanol and formate was found between the three groups. CONCLUSION: There is no evidence whether fomepizole is a more efficient antidote than ethanol with regards to the hospital mortality. The possibility of delirium tremens in the patients with a history of chronic alcohol abuse has to be taken in consideration. The benefits of fomepizole were indirect: no need to monitor serum ethanol's level during the hemodialysis in severely poisoned patients and less working overload on ICU doctors treating several poisoned patients simultaneously.

• MeSH
• Antidotes therapeutic use   MeSH
• Adult MeSH
• Disease Outbreaks MeSH
• Ethanol therapeutic use   MeSH
• Fomepizole MeSH
• Middle Aged MeSH
• Humans MeSH
• Methanol poisoning   MeSH
• Adolescent MeSH
• Young Adult MeSH
• Hospital Mortality MeSH
• Prospective Studies MeSH
• Pyrazoles therapeutic use   MeSH
• Retrospective Studies MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Czech Republic MeSH
• Names of Substances
• Antidotes MeSH
• Ethanol MeSH
• Fomepizole MeSH
• Methanol MeSH
• Pyrazoles MeSH

OBJECTIVES: Methanol poisonings occur frequently globally, but reports of larger outbreaks where complete clinical and laboratory data are reported remain scarce. The objective of the present study was to report the data from the mass methanol poisoning in the Czech Republic in 2012 addressing the general epidemiology, treatment, and outcomes, and to present a protocol for the use of fomepizole ensuring that the antidote was provided to the most severely poisoned patients in the critical phase. METHODS: A combined prospective and retrospective case series study of 121 patients with confirmed methanol poisoning. RESULTS: From a total of 121 intoxicated subjects, 20 died outside the hospital and 101 were hospitalized. Among them, 60 survived without, and 20 with visual/CNS sequelae, whereas 21 patients died. The total and hospital mortality rates were 34% and 21%, respectively. Multivariate regression analysis found pH < 7.0 (OR 0.04 (0.01-0.16), p < 0.001), negative serum ethanol (OR 0.08 (0.02-0.37), p < 0.001), and coma on admission (OR 29.4 (10.2-84.6), p < 0.001) to be the only independent parameters predicting death. Continuous hemodialysis was used more often than intermittent hemodialysis, but there was no significant difference in mortality rate between the two [29% (n = 45) vs 17% (n = 30), p = 0.23]. Due to limited stockpiles of fomepizole, ethanol was administered more often; no difference in mortality rate was found between the two [16% (n = 70) vs. 24% (n = 21), p = 0.39]. The effect of folate administration both on the mortality rate and on the probability of visual sequelae was not significant (both p > 0.05). CONCLUSIONS: Severity of metabolic acidosis, state of consciousness, and serum ethanol on admission were the only significant parameters associated with mortality. The type of dialysis or antidote did not appear to affect mortality. Recommendations that were issued for hospital triage of fomepizole administration allowed conservation of valuable antidote in this massive poisoning outbreak for those patients most in need.

• Keywords
• Epidemiology, Methanol poisoning, Outcomes, Prognosis, Symptoms, Treatment,
• MeSH
• Acidosis chemically induced   epidemiology   therapy   MeSH
• Antidotes therapeutic use   MeSH
• Biomarkers blood   MeSH
• Time Factors MeSH
• Renal Dialysis MeSH
• Adult MeSH
• Disease Outbreaks * MeSH
• Ethanol blood   MeSH
• Fomepizole MeSH
• Hospitalization MeSH
• Mass Casualty Incidents * MeSH
• Middle Aged MeSH
• Humans MeSH
• Logistic Models MeSH
• Methanol blood   pharmacokinetics   poisoning   MeSH
• Adolescent MeSH
• Young Adult MeSH
• Hospital Mortality MeSH
• Multivariate Analysis MeSH
• Odds Ratio MeSH
• Vision Disorders chemically induced   epidemiology   therapy   MeSH
• Drug Overdose blood   diagnosis   epidemiology   mortality   therapy   MeSH
• Prospective Studies MeSH
• Pyrazoles therapeutic use   MeSH
• Retrospective Studies MeSH
• Risk Factors MeSH
• Aged MeSH
• Severity of Illness Index MeSH
• Consciousness MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Czech Republic epidemiology   MeSH
• Names of Substances
• Antidotes MeSH
• Biomarkers MeSH
• Ethanol MeSH
• Fomepizole MeSH
• Methanol MeSH
• Pyrazoles MeSH

PURPOSE: During an outbreak of mass methanol poisoning in the Czech Republic in 2012-2014, we compared the total hospital costs and one-year medical costs in the patients treated with different antidotes (fomepizole versus ethanol) and modalities of hemodialysis (intermittent hemodialysis, IHD, versus continuous renal replacement therapy, CRRT). METHODS: Cross-sectional study in 106 patients with confirmed diagnosis treated in 30 ICU settings. For each patient, the following data were analyzed: admission laboratory data, GCS, PSS, ICU length of stay, organ failures, treatment, outcome, and total hospital costs. Of 83 survivors, in 54 (65%) patients the follow-up examination, quality of life measurement with SF36 questionnaire two years after discharge, and one-year medical costs analysis were performed. RESULTS: The median total hospital costs were 7200 (IQR 1500-10,900) euros and the median one-year medical costs were 1447 (IQR 133-1163) euros in the study population. The total hospital costs were higher in the patients treated with fomepizole comparing to ethanol: 12,890 (IQR 6910-16,210) versus 5590 (IQR 1430-6940) euros (p<0.001). The hospital costs in the patients treated with IHD were 5400 (IQR 1520-6910) versus 12,410 (IQR 5380-16,960) euros in the patients with CRRT (p=0.317). The geometric mean ratio for increased hospital costs in the patients treated with fomepizole versus ethanol adjusted for the severity of poisoning was 3.30 (1.70-3.80 CI 95%), p<0.001, and in the patients treated with IHD versus CRRT - 0.70 (0.60-0.99 CI 95%), p=0.047. The patients with visual sequelae had higher total hospital costs than those without sequelae: 10,419 (IQR 2984-14,355) versus 4605 (IQR 1303-4505) euros (p=0.009). The patients with GCS≤13 on admission had higher one-year medical costs as well (p<0.001). No difference was found in physical and mental condition scores in the patients treated with different antidotes and modalities of hemodialysis two years after discharge (both p>0.05). CONCLUSION: The total hospital costs in the patients with acute methanol poisoning were more than three times higher in the patients treated with fomepizole than in the patients treated with ethanol after adjustment for the severity of poisoning. The dialysis modality did not affect the total hospital costs, but the trend to lower costs was present in IHD-group.

• Keywords
• Acute methanol poisoning, Cost-effectiveness, Ethanol, Fomepizole, Hemodialysis,
• MeSH
• Alcoholism MeSH
• Cost-Benefit Analysis * MeSH
• Antidotes therapeutic use   MeSH
• Renal Dialysis MeSH
• Adult MeSH
• Economics, Hospital MeSH
• Disease Outbreaks MeSH
• Ethanol therapeutic use   MeSH
• Fomepizole MeSH
• Hospitalization MeSH
• Quality of Life * MeSH
• Middle Aged MeSH
• Humans MeSH
• Methanol poisoning   MeSH
• Health Care Costs MeSH
• Hospital Costs * MeSH
• Poisoning drug therapy   economics   MeSH
• Prospective Studies MeSH
• Cross-Sectional Studies MeSH
• Pyrazoles therapeutic use   MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Observational Study MeSH
• Geographicals
• Czech Republic MeSH
• Names of Substances
• Antidotes MeSH
• Ethanol MeSH
• Fomepizole MeSH
• Methanol MeSH
• Pyrazoles MeSH

BACKGROUND: In September 2012, a series of methanol poisonings occurred in the Czech Republic as a result of an influx of illicit alcohol into (predominantly) cheap alcoholic beverages on the retail market. The public authorities decided to prevent public health risks by prohibiting sales of liquors that contained more than 20% alcohol (> 20% liquor). The "partial" prohibition lasted for almost two weeks, but the poisonings still continued. This article assesses the impact of the methanol poisoning risks and the (partial) prohibition on alcohol drinking patterns, and describes the understanding of risks and their mitigation in vulnerable groups. METHODS: The rapid assessment and response method (RAR) was used during the (partial) alcohol prohibition. Semi-structured interviews were conducted with respondents recruited for the study in alcohol-intake settings (e.g., bars and restaurants, street alcohol outlets) in six regions. In total, 107 alcohol users were interviewed, mostly with risky drinking patterns (69% scored ≥ 1 on the CAGE scale), and 53 alcohol retailers/staff members serving alcohol. RESULTS: About one third of the alcohol users in the study (35%) drank > 20% liquors during the prohibition; a higher score on the CAGE scale was associated with a lower probability of drinking > 20% liquors during the period of the prohibition, probably because of the perception of being at high risk of poisoning. There was some increase in drinking liquors with an alcohol content less than 20%. Those who continued drinking > 20% liquors typically did so in the belief that some sources of these were safe. CONCLUSIONS: Public policies aimed at reducing the risk of methanol poisonings in emergency situations should adopt broader measures than those focusing on market control. These measures include increased access to brief interventions, addressing the strategies that alcohol consumers adopt to prevent risk, and, in general, helping consumers make informed choices to prevent further fatalities.

• Keywords
• CAGE, alcohol prohibition, drinking patterns, methanol poisoning, rapid assessment and response (RAR), risk-reduction strategies,
• Publication type
• Journal Article MeSH

STUDY OBJECTIVE: Methanol poisoning outbreaks are a global public health issue, with delayed treatment causing poor outcomes. Out-of-hospital ethanol administration may improve outcome, but the difficulty of conducting research in outbreaks has meant that its effects have never been assessed. We study the effect of out-of-hospital ethanol in patients treated during a methanol outbreak in the Czech Republic between 2012 and 2014. METHODS: This was an observational case-series study of 100 hospitalized patients with confirmed methanol poisoning. Out-of-hospital ethanol as a "first aid antidote" was administered by paramedic or medical staff before the confirmation of diagnosis to 30 patients; 70 patients did not receive out-of-hospital ethanol from the staff (12 patients self-administered ethanol shortly before presentation). RESULTS: The state of consciousness at first contact with paramedic or medical staff, delay to admission, and serum methanol concentration were similar among groups. The median serum ethanol level on admission in the patients with out-of-hospital administration by paramedic or medical staff was 84.3 mg/dL (interquartile range 32.7 to 129.5 mg/dL). No patients with positive serum ethanol level on admission died compared with 21 with negative serum ethanol level (0% versus 36.2%). Patients receiving out-of-hospital ethanol survived without visual and central nervous system sequelae more often than those not receiving it (90.5% versus 19.0%). A positive association was present between out-of-hospital ethanol administration by paramedic or medical staff, serum ethanol concentration on admission, and both total survival and survival without sequelae of poisoning. CONCLUSION: We found a positive association between out-of-hospital ethanol administration and improved clinical outcome. During mass methanol outbreaks, conscious adults with suspected poisoning should be considered for administration of out-of-hospital ethanol to reduce morbidity and mortality.

• MeSH
• Adult MeSH
• Disease Outbreaks * MeSH
• Ethanol blood   therapeutic use   MeSH
• Middle Aged MeSH
• Humans MeSH
• Methanol poisoning   MeSH
• Prospective Studies MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Publication type
• Journal Article MeSH
• Observational Study MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Czech Republic epidemiology   MeSH
• Names of Substances
• Ethanol MeSH
• Methanol MeSH

CONTEXT: Mass or cluster methanol poisonings are frequently reported from around the world. The comparative effectiveness of ethanol and fomepizole as antidotes for methanol poisoning is unknown due to the difficulty of performing a randomized controlled trial. OBJECTIVE: During an outbreak of mass poisonings in the Czech Republic in 2012-2014, we compared the effects of antidotes on the frequency of health sequelae and mortality. METHODS: The study was designed as a cross-sectional case series and quasi-case-control study. Patients with a diagnosis of methanol poisoning on admission to hospitals were identified for the study. Diagnosis was established when (i) a history of recent ingestion of illicit spirits was available and serum methanol was higher than 6.2 mmol/L (20 mg/dL), or (ii) there was a history/clinical suspicion of methanol poisoning, and serum methanol was above the limit of detection with at least two of the following: pH < 7.3, serum bicarbonate < 20 mmol/L, and anion gap or AG ≥ 20 mmol/L. Fomepizole was given as a bolus dose of 15 mg/kg i.v. diluted in isotonic saline, followed by 10 mg/kg every 12 h (every 4 h during hemodialysis); ethanol was administered both intravenously as a 10% solution in 5% glucose, and per os in boluses of 20% solution. Multivariate regression was applied to determine the effect of antidote on outcome. Additionally, for a retrospective quasi-case-control study, a control group of patients treated with ethanol, matched carefully on severity of poisoning and other key parameters, was selected. RESULTS: Data were obtained from 100 hospitalized patients with confirmed poisoning: 25 patients treated with fomepizole were compared with 68 patients receiving ethanol (seven patients did not receive any antidote). More severely acidotic (p < 0.001) and late-presenting (>12 h; p = 0.028) patients received fomepizole more often than ethanol, as reflected in the higher number of fomepizole-treated patients being intubated (p = 0.009). No association was found between the type of antidote and the survival in either the case series (p = 0.205) or the quasi-control groups (p = 0.705) in which patients were very closely matched to minimize confounding by allocation. In the multivariate analysis, positive serum ethanol (odds ratio [OR], 10.8; 95% confidence interval [CI], 2.9-39.9) and arterial blood pH (OR, 3.7; 95% CI, 1.3-10.5) on admission were the only independent variables for the survival. The median intensive care unit length of stay was 6 (range, 2-22) days in the fomepizole group and 4 (range, 1-33) days in the ethanol group (p = 0.131). There were no differences in the use of elimination techniques between the two groups (neither in the full material (n = 100), nor the case-control groups (n = 50)). CONCLUSIONS: This study on antidotes for methanol poisoning did not show any evidence of different clinical effectiveness. Although ethanol is generally associated with a higher incidence of complications, this study suggests that both antidotes are similarly effective and that ethanol should not be avoided on grounds of effectiveness.

• Keywords
• Antidote administration, Clinical effectiveness, Hospital treatment, Sequelae of poisoning, Treatment outcome,
• MeSH
• Antidotes administration & dosage   adverse effects   therapeutic use   MeSH
• Time Factors MeSH
• Length of Stay MeSH
• Adult MeSH
• Disease Outbreaks * MeSH
• Ethanol administration & dosage   adverse effects   therapeutic use   MeSH
• Fomepizole MeSH
• Risk Assessment MeSH
• Hospitalization MeSH
• Administration, Intravenous MeSH
• Intensive Care Units MeSH
• Middle Aged MeSH
• Humans MeSH
• Linear Models MeSH
• Logistic Models MeSH
• Methanol poisoning   MeSH
• Adolescent MeSH
• Young Adult MeSH
• Multivariate Analysis MeSH
• Poisoning diagnosis   drug therapy   mortality   MeSH
• Cross-Sectional Studies MeSH
• Pyrazoles administration & dosage   adverse effects   therapeutic use   MeSH
• Retrospective Studies MeSH
• Risk Factors MeSH
• Chi-Square Distribution MeSH
• Drug Administration Schedule MeSH
• Aged MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Comparative Study MeSH
• Geographicals
• Czech Republic epidemiology   MeSH
• Names of Substances
• Antidotes MeSH
• Ethanol MeSH
• Fomepizole MeSH
• Methanol MeSH
• Pyrazoles MeSH

OBJECTIVES: We report the results of the visual evoked potentials (VEP) examination in patients after severe poisoning by methanol. MATERIAL AND METHODS: The group of 47 patients (38 males and 9 females) was assembled out of persons who survived an outbreak of poisoning by the methanol adulterated alcohol beverages, which happened in the Czech Republic in 2012-2013. The visual evoked potentials examination was performed using monocular checkerboard pattern-reversal stimulation. Two criteria of abnormality were chosen: missing evoked response, and wave P1 latency > 117 ms. Non-parametric statistical methods (median, range, and the median test) were used to analyze factors influencing the VEP abnormality. RESULTS: The visual evoked potential was abnormal in 20 patients (43%), 5 of them had normal visual acuity on the Snellen chart. The VEP abnormality did not correlate significantly with initial serum concentrations of methanol, formic acid or lactate; however, it showed statistically significant inverse relation to the initial serum pH: the subgroup with the abnormal VEP had significantly lower median pH in comparison with the subgroup with the normal VEP (7.16 vs. 7.34, p = 0.04). The abnormality was not related to chronic alcohol abuse. CONCLUSIONS: The visual evoked potentials examination appeared sensitive enough to detected even subclinical impairment of the optic system. Metabolic acidosis is likely to be the key factor related to the development of visual damage induced by methanol. The examination performed with a delay of 1-9 months after the poisoning documented the situation relatively early after the event. It is considered as a baseline for the planned long-term follow-up of the patients, which will make it possible to assess the dynamics of the observed changes, their reversibility, and the occurrence of potential late sequelae.

• Keywords
• Czech Republic, VEP, acidosis, methanol, poisoning, visual evoked potentials,
• MeSH
• Adult MeSH
• Formates blood   MeSH
• Hydrogen-Ion Concentration MeSH
• Lactic Acid blood   MeSH
• Middle Aged MeSH
• Humans MeSH
• Methanol blood   pharmacology   poisoning   MeSH
• Young Adult MeSH
• Aged MeSH
• Visual Acuity MeSH
• Evoked Potentials, Visual drug effects   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Names of Substances
• Formates MeSH
• formic acid MeSH Browser
• Lactic Acid MeSH
• Methanol MeSH

Methanol mass poisoning is a global problem with high fatality rates and often severe sequelae in survivors. Patients typically present late to the hospital with severe metabolic acidosis followed by a rapid deterioration in their clinical status. The hypothesis 'Circulus hypoxicus' describes the metabolic acidosis following methanol poisoning as a self-enhancing hypoxic circle responsible for methanol toxicity. We wanted to test the validity of this hypothesis by an observational study based on 35 patients from the methanol outbreaks in Norway (2004) and the Czech Republic (2012). Comprehensive laboratory values, including S(serum)-methanol, S-formate, S-lactate, arterial blood gases, anion and osmolal gaps, were used in the calculations. Laboratory values and calculated gaps were compared to each other using linear regression. S-lactate and S-formate correlated better with the increased base deficit and anion gap than did S-formate alone. Base deficit rose to about 20 mmol/L and S-formate rose to 12 mmol/L prior to a significant rise in S-lactate - most likely caused by formate inhibition of mitochondrial respiration (type B lactacidosis). The further rise in S-lactate was not linear to S-formate most likely due to the self-enhancing pathophysiology, but may also be associated with hypotension in critically ill patients and variable ethanol drinking habits. Our study suggests that the primary metabolic acidosis leads to a secondary lactic acidosis mainly due to the toxic effects of formate. The following decline in pH will further increase this toxicity. As such, a vicious and self-enhancing acidotic circle may explain the pathophysiology in methanol poisoning, namely the 'Circulus hypoxicus'.

• MeSH
• Acid-Base Equilibrium drug effects   MeSH
• Acidosis chemically induced   MeSH
• Blood Gas Analysis MeSH
• Adult MeSH
• Formates blood   MeSH
• Lactic Acid blood   MeSH
• Middle Aged MeSH
• Humans MeSH
• Methanol blood   poisoning   MeSH
• Adolescent MeSH
• Young Adult MeSH
• Acid-Base Imbalance chemically induced   MeSH
• Aged MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Observational Study MeSH
• Names of Substances
• Formates MeSH
• formic acid MeSH Browser
• Lactic Acid MeSH
• Methanol MeSH

BACKGROUND: Acute methanol poisoning leads to optic neuropathy and necrotic lesions of basal ganglia (BG) and subcortical white matter. Survivors of methanol poisoning exhibit long-term executive and memory deficits. Associations between brain volumetry parameters and cognitive sequelae of methanol poisoning are not known. The aim of our study was to identify long-term associations between the cognitive performance of survivors of methanol poisoning and the volume of the brain structures that are selectively vulnerable to methanol. METHODS: We conducted a cross-sectional follow-up study on a sample of patients (n = 33, age 50 ± 14 years, 82% males) who survived acute methanol poisoning during methanol mass poisoning outbreak from September 2012 till January 2013 in the Czech Republic. A battery of neuropsychological tests and brain magnetic resonance imaging were included in the clinical examination protocol. Specific brain structures (putamen, globus pallidus, nucleus caudatus, and frontal white matter) were selected as regions of interest, and their volumes were estimated using the MorphoBox prototype software. RESULTS: In robust multiple regression models, sustained visual attention performance (as assessed by Trail Making Test and Prague Stroop Test) was positively associated with BG structures and frontal white matter volumes (Wald = 9.03 to 85.50, p < 0.01), sensitivity to interference (as assessed by Frontal Battery Assessment) was negatively associated with frontal white matter volume (Wald = 35.44 to 42.25, p < 0.001), and motor performance (as assessed by Finger Tapping Test) was positively associated with globus pallidus and frontal white matter volumes (Wald = 9.66 to 13.29, p < 0.01). CONCLUSIONS: Our results demonstrate that smaller volumes of elements of BG-thalamocortical circuitry, namely the BG and frontal white matter, relate to attention and motor performance in methanol poisoning from a long-term perspective. Disruption of those functional circuits may underlie specific cognitive deficits observed in methanol poisoning.

• Keywords
• Basal Ganglia, Methanol Poisoning, Psychomotor Speed, Subcortical White Matter, Sustained Visual Attention,
• MeSH
• Basal Ganglia diagnostic imaging   MeSH
• White Matter diagnostic imaging   MeSH
• Adult MeSH
• Executive Function drug effects   MeSH
• Cognition drug effects   MeSH
• Middle Aged MeSH
• Humans MeSH
• Magnetic Resonance Imaging MeSH
• Methanol poisoning   MeSH
• Brain diagnostic imaging   MeSH
• Follow-Up Studies MeSH
• Nerve Net diagnostic imaging   MeSH
• Neuropsychological Tests MeSH
• Memory drug effects   MeSH
• Attention drug effects   MeSH
• Survivors MeSH
• Cross-Sectional Studies MeSH
• Psychomotor Performance drug effects   MeSH
• Aged MeSH
• Learning drug effects   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Review MeSH
• Names of Substances
• Methanol MeSH