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Abstract

Objective: To determine whether cumulative lead dose in former organolead workers was associated with MRI measures of white matter lesions (WML) and global and structure-specific brain volumes.
Methods: MRIs, tibia lead, and other measures were obtained from 532 former organolead workers with a mean age of 56 years and a mean of 18 years since last occupational exposure to lead. Cumulative lead dose was measured by tibia lead, obtained by X-ray fluorescence, and expressed as μg lead per gram of bone mineral (μg Pb/g). WML were evaluated using the Cardiovascular Health Study grading scale. A total of 21 global and specific brain regions were evaluated.
Results: A total of 36% of individuals had WML grade of 1 to 7 (0 to 9 scale). Increasing peak tibia lead was associated with increasing WML grade (p = 0.004). The adjusted OR for a 1 μg Pb/g increase in tibia lead was 1.042 (95% CI = 1.021, 1.063) for a CHS grade of 5+ (≥5 vs <5). In linear regression, the coefficient for tibia lead was negative for associations with all structures. Higher tibia lead was significantly related to smaller total brain volume, frontal and total gray matter volume, and parietal white matter volume. Of nine smaller specific regions of interest, higher tibia lead was associated with smaller volumes for the cingulate gyrus and insula.
Conclusions: These data suggest that cumulative lead dose is associated with persistent brain lesions, and may explain previous findings of a progressive decline in cognitive function.

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References

1.
Stewart WF, Schwartz BS, Simon D, Bolla KI, Todd AC, Links J. The relation between neurobehavioral function and tibial and chelatable lead levels in former organolead manufacturing workers. Neurology 1999;52:1610–1617.
2.
Schwartz BS, Stewart WF, Bolla KI, et al. Past adult lead exposure is associated with longitudinal decline in cognitive function. Neurology 2000;55:1144–1150.
3.
Links JM, Schwartz BS, Simon D, Bandeen-Roche K, Stewart WF. The influence of toxicant “residence time” and bioavailability from body stores in estimation of cumulative target organ dose: application to lead-associated neurocognitive decline. Environ Health Perspect 2001;109:361–368.
4.
Gong Z, Little A, El-Fawal H, Evans HL. Trimethyl lead neurotoxicity in the rat: changes in glial fibrillary acidic protein (GFAP). Arh Hig Rada Toksikol 1995;46:381–390.
5.
Grandjean P, Nielsen T. Organolead compounds: environmental health perspectives. Residue Rev 1979;72:98–148.
6.
Gutowski M, Altmann L, Sveinsson K, Wiegand H. Synaptic plasticity in the CA1 and CA3 hippocampal region of pre- and postnatally lead-exposed rats. Toxicol Lett 1998;95:195–203.
7.
Harry GJ, Schmitt TJ, Gong Z, Brown H, Zawia N, Evans HL. Lead-induced alterations of glial fibrillary acidic protein (GFAP) in the developing rat brain. Toxicol Appl Pharmacol 1996;139:84–93.
8.
Konat G. Triethyllead and cerebral development: an overview. Neurotoxicol 1984;5:87–96.
9.
Konat G, Offner H, Clausen J. The effect of triethyl lead on total and myelin protein synthesis in rat forebrain slices. J Neurochem 1979;32:187–190.
10.
Niklowitz WJ. Neurofibrillary changes after acute experimental lead poisoning. Neurology 1975;25:927–934.
11.
Selvin-Testa A, Loidl CF, Lopez-Costa JJ, Lopez EM, Pecci-Saavedra J. Chronic lead exposure induces astrogliosis in hippocampus and cerebellum. Neurotoxicology 1994;15:389–402.
12.
Walsh TJ, McLamb RL, Bondy SC, Tilson HA, Chang LW. Triethyl and trimethyl lead: effects on behavior, CNS morphology, and concentrations of lead in blood and brain of rat. Neurotoxicol 1986;7:21–34.
13.
Schwartz BS, Bolla KI, Stewart W, Ford DP, Agnew J, Frumkin H. Decrements in neurobehavioral performance associated with mixed exposure to organic and inorganic lead. Am J Epidemiol 1993;137:1006–1021.
14.
Breteler MM, van Swieten JC, Bots ML, et al. Cerebral white matter lesions, vascular risk factors, and cognitive function in a population-based study: the Rotterdam Study. Neurology 1994;44:1246–1252.
15.
DeCarli C, Miller BL, Swan GE, et al. Predictors of brain morphology for the men of the NHLBI twin study. Stroke 1999a;30:529–536.
16.
DeCarli C, Reed T, Miller BL, Wolf PA, Swan GE, Carmelli D. Impact of apolipoprotein ε4 and vascular disease on brain morphology in men from the NHLBI Twin Study. Stroke 1999b;30:1548–1553.
17.
Longstreth WT Jr., Bernick C, Manolio TA, Bryan N, Jungreis CA, Price TR. Lacunar infarcts by magnetic resonance imaging or 3660 elderly people: the Cardiovascular Health Study. Arch Neurol 1998;55:1217–1225.
18.
Swan GE, DeCarli C, Miller BL, Reed T, Wolf PA, Carmello D. Biobehavioral characteristics of nondemented older adults with subclinical brain atrophy. Neurology 2000;54:2108–2114.
19.
Dufouil C, de Kersaint-Gilly A, Besancon V, et al. Longitudinal study of blood pressure and white matter hyperintensities: the EVA MRI Cohort. Neurology 2001;56:921–926.
20.
Glenn BS, Stewart WF, Links JM, Todd AC, Schwartz BS. The longitudinal association of lead with blood pressure. Epidemiology 2003;14:30–36.
21.
Todd AC, McNeill FE. In vivo measurements of lead in bone using a 109Cd >spot= source. In: Ellis KJ, Eastman JD, eds. Human body composition studies, 1993. New York: Plenus Press, 1993;299–302.
22.
Hu H, Rabinowitz M, Smith D. Bone lead as a biological marker in epidemiologic studies of chronic toxicity: conceptual paradigms. Environ Health Perspect 1998;106:1–8.
23.
Gerhardsson L, Attewell R, Chettle DR, et al. In vivo measurements of lead in bone in long-term exposed lead smelter workers. Arch Environ Health 1993;48:147–156.
24.
Hixson JE, Vernier DT. Restriction isotyping of human apolipoprotein-E by gene amplification and cleavage with HhaI. J Lipid Res 1990;31:541–548.
25.
Nadif R, Jedlicka A, Mintz M, Bertrand JP, Kleeberger S, Kauffmann F. Effect of TNF and LTA polymorphisms on biological markers of response to oxidative stimuli in coal miners: a model of gene-environment interaction. J Med Genet 2003;40:96–103.
26.
Schafer JH, Glass TA, Bolla KI, Mintz M, Jedlicka AE, Schwartz BS. Homocysteine and cognitive function in a population-based study of older adults. J Am Geriatr Soc 2006; in press.
27.
Fried LP, Borhani NO, Enright P, et al. The Cardiovascular Health Study: design and rationale. Ann Epidemiol 1991;1:263–276.
28.
Manolio TA, Kronmal RA, Burke GL, et al. Magnetic resonance abnormalities and cardiovascular disease in older adults. The Cardiovascular Health Study. Stroke 1994;25:318–327.
29.
Bryan RN, Manolio TA, Schertz LD, et al. A method for using MR to evaluate the effects of cardiovascular disease on the brain: the cardiovascular health study. AJNR Am J Neuroradiol 1994;15:1625–1633.
30.
Bryan RN, Wells SW, Miller TJ, et al. Infarctlike lesions in the brain: prevalence and anatomic characteristics at MR imaging of the elderly–data from the Cardiovascular Health Study. Radiology 1997;202:47–54.
31.
Yue NC, Arnold AM, Longstreth WT, Jr., et al. Sulcal, ventricular, and white matter changes at MR imaging in the aging brain: data from the Cardiovascular Health Study. Radiology 1997;202:33–39.
32.
Goldszal AF, Davatzikos C, Pham DL, Yan MXH, Bryan RN, Resnick SM. An image processing protocol for the analysis of MR images from an elderly population. J Comput Assist Tomogr 1998;22:827–837.
33.
Shen D, Davatzikos C. HAMMER. Hierarchical attribute matching mechanism for elastic registration. IEEE Trans Med Imaging 2002;21:1421–1439.
34.
McCullough P, Nelder JA. Generalized linear models. London: Chapman & Hall, 1983.
35.
Varela F, Lachaux JP, Rodriguez E, Martinerie J. The brainweb: phase synchronization and large scale integration. Nat Rev Neurosci 2001;2:229–239.
36.
Benes FM, Turtle M, Khan Y, Farol P. Myelination of a key relay zone in the hippocampal formation occurs in the human brain during childhood, adolescence, and adulthood. Arch Gen Psychiatry 1994;51:447–484.
37.
Bartzokis G. Age-related myelin breakdown: a developmental model of cognitive decline and Alzheimer’s disease. Neurobiol Aging 2004;25:5–18.
38.
Braak H, Del Tredici K. Poor and protracted myelination as a contributory factor to neurodegenerative disorders. Neurobiol Aging 2004;25:19–23.
39.
Scahill RI, Frost C, Jenkins R, Whitwell JL, Rossor MN, Fox NC. A longitudinal study of brain volume changes in normal aging using serial registered magnetic resonance imaging. Arch Neurol 2003;60:989–994.
40.
Davatzikos C, Genc A, Xu D, Resnick SM. Voxel-based morphometry using the RAVENS maps: methods and validation using simulated longitudinal atrophy. NeuroImage 2001;14:1361–1369.
41.
Glenn BS, Stewart WF, Links JM, Todd AC, Schwartz BS. The longitudinal association of lead with blood pressure. Epidemiology 2003;4:30–36.
42.
de la Torre JC. Alzheimer’s disease is a vasocognapathy: a new term to describe its nature. Neurol Res 2004;26:517–524.
43.
Kuller LH, Shemanski L, Manolio T, et al. Relationship between ApoE, MRI findings, and cognitive function in the Cardiovascular Health Study. Stroke 1998;29:3883–3898.
44.
Longstreth WT, Diehr P, Manolio TA, et al. Cluster analysis and patterns of findings on cranial magnetic resonance imaging of the elderly: the Cardiovascular Health Study. Arch Neurol 2001;58:635–640.
45.
de Leeuw FE, de Groot JC, Achten E, et al. Prevalence of cerebral white matter lesions in elderly people: a population based magnetic resonance imaging study. J Neurol Neurosurg Psychiatry 2001;70:9–14.
46.
Dufouil C, Alperovitch A, Tzourio. Influence of education on the relationship between white matter lesions and cognition. Neurology 2003;60:831–836.
47.
Coffey CE, Saxton JA, Ratcliff G, Bryan RN, Lucke JF. Relation of education to brain size in normal aging: implications for the reserve hypothesis. Neurology 1999;53:189–196.

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Published In

Neurology®
Volume 66Number 10May 2006
Pages: 1476-1484
PubMed: 16717205

Publication History

Published in print: May 2006
Published online: May 22, 2006

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Affiliations & Disclosures

W. F. Stewart, PhD, MPH
From the Center for Health Research and Rural Advocacy (W.F.S.), Geisinger Clinic, Danville, PA; Departments of Environmental Health Sciences (B.S.S., W.S.) and Epidemiology (W.F.S., B.S.S.), the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Radiology (C.D., D.S., D.L., X.W.), the University of Pennsylvania, Philadelphia; Department of Community and Preventive Medicine (A.C.T.), Mount Sinai School of Medicine, New York, NY; and Department of Psychiatry (S.B.) and The Russell H. Morgan Department of Radiology and Radiological Sciences (D.Y.), the Johns Hopkins School of Medicine, Baltimore, MD.
B. S. Schwartz, MD, MS
From the Center for Health Research and Rural Advocacy (W.F.S.), Geisinger Clinic, Danville, PA; Departments of Environmental Health Sciences (B.S.S., W.S.) and Epidemiology (W.F.S., B.S.S.), the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Radiology (C.D., D.S., D.L., X.W.), the University of Pennsylvania, Philadelphia; Department of Community and Preventive Medicine (A.C.T.), Mount Sinai School of Medicine, New York, NY; and Department of Psychiatry (S.B.) and The Russell H. Morgan Department of Radiology and Radiological Sciences (D.Y.), the Johns Hopkins School of Medicine, Baltimore, MD.
C. Davatzikos, PhD
From the Center for Health Research and Rural Advocacy (W.F.S.), Geisinger Clinic, Danville, PA; Departments of Environmental Health Sciences (B.S.S., W.S.) and Epidemiology (W.F.S., B.S.S.), the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Radiology (C.D., D.S., D.L., X.W.), the University of Pennsylvania, Philadelphia; Department of Community and Preventive Medicine (A.C.T.), Mount Sinai School of Medicine, New York, NY; and Department of Psychiatry (S.B.) and The Russell H. Morgan Department of Radiology and Radiological Sciences (D.Y.), the Johns Hopkins School of Medicine, Baltimore, MD.
D. Shen, PhD
From the Center for Health Research and Rural Advocacy (W.F.S.), Geisinger Clinic, Danville, PA; Departments of Environmental Health Sciences (B.S.S., W.S.) and Epidemiology (W.F.S., B.S.S.), the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Radiology (C.D., D.S., D.L., X.W.), the University of Pennsylvania, Philadelphia; Department of Community and Preventive Medicine (A.C.T.), Mount Sinai School of Medicine, New York, NY; and Department of Psychiatry (S.B.) and The Russell H. Morgan Department of Radiology and Radiological Sciences (D.Y.), the Johns Hopkins School of Medicine, Baltimore, MD.
D. Liu, MS
From the Center for Health Research and Rural Advocacy (W.F.S.), Geisinger Clinic, Danville, PA; Departments of Environmental Health Sciences (B.S.S., W.S.) and Epidemiology (W.F.S., B.S.S.), the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Radiology (C.D., D.S., D.L., X.W.), the University of Pennsylvania, Philadelphia; Department of Community and Preventive Medicine (A.C.T.), Mount Sinai School of Medicine, New York, NY; and Department of Psychiatry (S.B.) and The Russell H. Morgan Department of Radiology and Radiological Sciences (D.Y.), the Johns Hopkins School of Medicine, Baltimore, MD.
X. Wu, MS
From the Center for Health Research and Rural Advocacy (W.F.S.), Geisinger Clinic, Danville, PA; Departments of Environmental Health Sciences (B.S.S., W.S.) and Epidemiology (W.F.S., B.S.S.), the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Radiology (C.D., D.S., D.L., X.W.), the University of Pennsylvania, Philadelphia; Department of Community and Preventive Medicine (A.C.T.), Mount Sinai School of Medicine, New York, NY; and Department of Psychiatry (S.B.) and The Russell H. Morgan Department of Radiology and Radiological Sciences (D.Y.), the Johns Hopkins School of Medicine, Baltimore, MD.
A. C. Todd, PhD
From the Center for Health Research and Rural Advocacy (W.F.S.), Geisinger Clinic, Danville, PA; Departments of Environmental Health Sciences (B.S.S., W.S.) and Epidemiology (W.F.S., B.S.S.), the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Radiology (C.D., D.S., D.L., X.W.), the University of Pennsylvania, Philadelphia; Department of Community and Preventive Medicine (A.C.T.), Mount Sinai School of Medicine, New York, NY; and Department of Psychiatry (S.B.) and The Russell H. Morgan Department of Radiology and Radiological Sciences (D.Y.), the Johns Hopkins School of Medicine, Baltimore, MD.
W. Shi, MD, MS
From the Center for Health Research and Rural Advocacy (W.F.S.), Geisinger Clinic, Danville, PA; Departments of Environmental Health Sciences (B.S.S., W.S.) and Epidemiology (W.F.S., B.S.S.), the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Radiology (C.D., D.S., D.L., X.W.), the University of Pennsylvania, Philadelphia; Department of Community and Preventive Medicine (A.C.T.), Mount Sinai School of Medicine, New York, NY; and Department of Psychiatry (S.B.) and The Russell H. Morgan Department of Radiology and Radiological Sciences (D.Y.), the Johns Hopkins School of Medicine, Baltimore, MD.
S. Bassett, PhD
From the Center for Health Research and Rural Advocacy (W.F.S.), Geisinger Clinic, Danville, PA; Departments of Environmental Health Sciences (B.S.S., W.S.) and Epidemiology (W.F.S., B.S.S.), the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Radiology (C.D., D.S., D.L., X.W.), the University of Pennsylvania, Philadelphia; Department of Community and Preventive Medicine (A.C.T.), Mount Sinai School of Medicine, New York, NY; and Department of Psychiatry (S.B.) and The Russell H. Morgan Department of Radiology and Radiological Sciences (D.Y.), the Johns Hopkins School of Medicine, Baltimore, MD.
D. Youssem, MD, MBA
From the Center for Health Research and Rural Advocacy (W.F.S.), Geisinger Clinic, Danville, PA; Departments of Environmental Health Sciences (B.S.S., W.S.) and Epidemiology (W.F.S., B.S.S.), the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Radiology (C.D., D.S., D.L., X.W.), the University of Pennsylvania, Philadelphia; Department of Community and Preventive Medicine (A.C.T.), Mount Sinai School of Medicine, New York, NY; and Department of Psychiatry (S.B.) and The Russell H. Morgan Department of Radiology and Radiological Sciences (D.Y.), the Johns Hopkins School of Medicine, Baltimore, MD.

Notes

Address correspondence and reprint requests to Dr. Walter Stewart, Geisinger Health System, Center for Health Research and Rural Advocacy, MC 30-03,100 N. Academy Ave, Danville, PA 17822; e-mail: [email protected]

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