World Trade Center Exposures, Neuropathic Symptoms and Nervous System Injury

世贸中心暴露、神经症状和神经系统损伤

• 批准号: 9341210
• 负责人: MICHAEL MARMOR
• 金额: $ 34.91万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-01 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9341210
• 关键词: World; Trade; Center; Exposures; Neuropathic

ABSTRACT The long-term goal of our research is to determine if exposure to contaminants from the World Trade Center (WTC) disaster of September 11, 2001 caused neuropathic symptoms, and nervous system injuries in the WTC “Survivor” population. Our preliminary findings demonstrate a high prevalence of neurologic symptoms among both Survivors from the general community and first responders. There are numerous causes of neuropathic symptoms, however, such as diabetes, anemia, anxiety, and exposure to non-WTC-related neurotoxins. Neuropathic symptoms thus need to be investigated to understand whether they are due to WTC exposures. The first objective of this project is to explore the connection between WTC exposure and neuropathic symptoms through use of existing longitudinal data and neurological studies. Our second objective is to refine our understanding of neurologic symptoms with more complete questionnaires, neurological examination and objective testing (electromyography/nerve conduction velocity [EMG/NCV]; histopathologic evaluations; and blood tests for HgbA1c, B12, exposure to neurotoxic infectious agents, and neuron-specific enolase) in the context of a case-control study of patients with and without neuropathic symptoms. Our specific aims are (1) to analyze longitudinal data to describe the evolution of paresthesias in the survivor population; and (2) to analyze EMG/NCV data in order to investigate the pathophysiology of the reported paresthesias; and (3) to examine whether neuropathic symptoms among Survivors and Responders are associated with abnormalities in nerve fiber densities or EMG/nerve conduction studies. Already- performed EMG/NCV studies neurologic studies (n=80) will be analyzed to determine their relationship to neuropathic symptoms and to explore correlates of persistence, deterioration or improvement over time in these symptoms. We will evaluate nerve fiber densities as risk factors for neuropathic symptoms as part of the case-control study. Cases will be 40 patients with persistent neuropathic symptoms on at least 2 study visits drawn from patients enrolled in the Bellevue WTC Environmental Health Center (WTC EHC). Controls (n=40) will be drawn from the same WTC EHC population; individually matched to cases on age, race, gender and absence of histories of diabetes, cancer and paresthesias or neurologic disorders prior to 9/11/2001; but free of paresthesias on all study visits. A community-based, non-WTC-exposed control group (n=20) also will be enrolled, frequency-matched to cases on the same matching variables as the WTC EHC controls, in order to determine the prevalence of abnormalities in the general population without WTC-exposure. Case-control study participants found to have neuropathic symptoms will be referred for optional EMG/NCV studies to elucidate mechanisms underlying neuropathic symptoms. Successful completion of this project will clarify whether exposure to WTC toxins caused the observed neuropathic symptoms.

抽象的 我们研究的长期目标是确定是否接触世贸中心的污染物 (WTC) 2001 年 9 月 11 日的灾难导致了神经病症状和神经系统损伤 我们的初步研究结果表明，WTC“幸存者”人群中神经系统症状的患病率很高。 对于普通社区的幸存者和急救人员来说，造成这种情况的原因有很多。 然而，神经性症状，例如糖尿病、贫血、焦虑以及接触与世贸中心无关的环境 因此，需要对神经性症状进行调查，以了解它们是否是由 WTC 引起的。 该项目的首要目标是探索世贸中心暴露与风险之间的联系。 我们的第二个研究是通过使用现有的纵向数据和神经学研究来确定神经病理性症状。 目标是通过更完整的问卷来加深我们对神经系统症状的理解， 神经系统检查和客观测试（肌电图/神经传导速度[EMG/NCV]）； 组织病理学评估；以及 HgbA1c、B12 的血液检查、神经毒性感染剂的暴露情况以及 神经元特异性烯醇化酶）在对患有和不患有神经病的患者进行病例对照研究的背景下 我们的具体目标是（1）分析纵向数据以描述感觉异常的演变。 幸存者群体；(2) 分析 EMG/NCV 数据，以研究其病理生理学 报告的感觉异常；以及（3）检查幸存者和应答者是否有神经性症状 与神经纤维密度或肌电图/神经传导研究的异常有关。 将分析进行的 EMG/NCV 研究 神经学研究 (n=80) 以确定它们与 神经病理性症状，并探索随时间推移持续、恶化或改善的相关性 作为神经病理性症状的一部分，我们将评估神经纤维密度。 病例对照研究，病例为 40 名在至少 2 次研究访视中出现持续性神经病症状的患者。 选自贝尔维尤世贸中心环境健康中心 (WTC EHC) 的患者 (n=40)。 将从相同的 WTC EHC 人群中抽取；与年龄、种族、性别和年龄进行单独匹配 2001 年 9 月 11 日之前没有糖尿病、癌症和感觉异常或神经系统疾病病史，但无症状； 所有研究访视中的感觉异常情况也将由非 WTC 暴露的社区对照组 (n=20) 进行。 登记，与 WTC EHC 对​​照相同匹配变量的病例进行频率匹配，以便 确定未接触 WTC 的一般人群中异常的发生率。 发现有神经性症状的研究参与者将被转介进行可选的 EMG/NCV 研究 阐明神经病理性症状的机制。该项目的成功完成将澄清这一问题。 接触世贸中心毒素是否导致观察到的神经性症状。