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暴露于世界贸易中心污染物 （WTC）2001年9月11日的灾难造成神经性症状和神经系统损伤 WTC“幸存者”人口。我们的初步发现表明神经系统症状的流行率很高 在一般社区和急救人员的幸存者中。有许多原因 然而，神经性符号，例如糖尿病，贫血，焦虑和与非WTC相关的暴露 神经毒素。因此，需要研究神经性症状，以了解它们是否归因于WTC 暴露。该项目的第一个目的是探索WTC暴露与 神经性症状通过使用现有的纵向数据和神经学研究。我们的第二个 目的是通过更完整的问卷调查我们对神经系统符号的理解， 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；和HGBA1C，B12，暴露于神经毒性传染剂的血液测试，以及 神经特异性烯醇酶）在有和没有神经性病例的患者的病例对照研究中 症状。我们的具体目的是（1）分析纵向数据以描述异常的演变 表面人群； （2）分析EMG/NCV数据，以研究 报告了parasias; （3）检查幸存者和反应者的神经性症状是否存在 与神经纤维密度或EMG/神经传导研究的异常有关。已经- 将分析进行的EMG/NCV研究神经系统研究（n = 80），以确定其与 神经性符号并探索随着时间的推移，持久性，恶化或改善的相关性 这些符号。我们将评估神经纤维密度作为神经性符号的风险因素 病例对照研究。病例将是至少2个研究就诊时有40例持续性神经性症状的患者 来自Bellevue WTC环境卫生中心（WTC EHC）的患者。控件（n = 40） 将从同一WTC EHC人群中得出；单独与年龄，种族，性别和性别的案件相匹配 2001年9月11日之前，缺乏糖尿病，癌症和副虫或神经系统疾病的病史；但是免费 所有研究访问中的感觉异常。一个基于社区的非WTC暴露对照组（n = 20）也将是 在与WTC EHC控件相同的匹配变量上注册，频率与案例匹配，以便 确定普通人群中异常的患病率，而没有WTC暴露。病例对照 发现具有神经性符号的研究参与者将被转介到可选的EMG/NCV研究中 阐明神经性症状的基础机制。成功完成该项目将澄清 WTC毒素引起观察到的神经性符号。