Neurological Impacts of Chronic Methylmercury Exposure in Munduruku Indigenous Adults: Somatosensory, Motor, and Cognitive Abnormalities
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Field Work
2.2. Evaluated Population
Fish Consumption Estimates
2.3. Neurological Examination
2.3.1. Static Balance and Walking Evaluation
2.3.2. Cranial Nerve Examination
2.3.3. Sensory Testing
- (a)
- Sharp nickel-plated pin (Bacchi® number 29): mechanical nociceptive perception.
- (b)
- Sorri Bauru esthesiometer/Von Frey 10g monofilament: tactile sensitivity.
- (c)
- Dry cotton wad: dynamic tactile sensitivity.
- (d)
- 128 Hz diapason: tactile vibration sensitivity and thermic sensitivity to cold [50].
2.3.4. Motor Function
2.3.5. Cognitive Evaluation
Brief Cognitive Screening Battery (BCSB)
Verbal Fluency Test in the Animal Category
Stick Design Test
2.4. MeHg Exposure Biomarker
2.5. Statistical Analysis
3. Results
3.1. Overall Data by Village
3.2. Neurological Abnormalities According to MeHg Exposure Levels
3.2.1. Somatic Sensitivity (Somatosensory)
3.2.2. Motor Function
3.2.3. Cognitive Alterations
3.2.4. Main Findings Considering the Neurological Abnormalities, According to MeHg Exposure Levels
3.2.5. Poisson’s Regression Model Findings, Considering Cognition Abilities of the Participants
4. Discussion
4.1. Somatosensory Abnormalities
4.2. Motor Functions Abnormalities
4.3. Cognitive Abnormalities
4.4. Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Villages | |||||||||
---|---|---|---|---|---|---|---|---|---|
Sociodemographic Variables | Sawré Muybu | Poxo Muybu | Sawré Aboy | Total | p-Value | ||||
Sex | n | % | n | % | n | % | n | % | |
Female | 25 | 50.0 | 17 | 45.9 | 10 | 43.5 | 52 | 47.3 | 0.857 |
Male | 25 | 50.0 | 20 | 54.1 | 13 | 56.5 | 58 | 52.7 | |
Total | 50 | 37 | 23 | 110 | |||||
Age range (years) | |||||||||
12 to 19 | 9 | 18.0 | 16 | 43.2 | 11 | 47.8 | 36 | 32.7 | 0.032 |
20 to 24 | 11 | 22.0 | 6 | 16.2 | 3 | 13.0 | 20 | 18.2 | |
25 to 29 | 13 | 26.0 | 2 | 5.4 | 2 | 8.7 | 17 | 15.5 | |
≥30 | 17 | 34.0 | 13 | 35.1 | 7 | 30.4 | 37 | 33.6 | |
Total | 50 | 37 | 23 | 110 | |||||
Hair-methylmercury levels | |||||||||
≥10 µg/g | 11 | 22.4 | 4 | 10.8 | 18 | 78.3 | 33 | 30.3 | 0.001 |
<10 µg/g | 38 | 77.6 | 33 | 89.2 | 5 | 21.7 | 76 | 69.7 | |
Total | 49 | 37 | 23 | 109 | |||||
Somatosensory signs | |||||||||
Distal pinprick perception | |||||||||
Normal | 40 | 80.0 | 37 | 100.0 | 18 | 78.3 | 95 | 86.4 | 0.012 |
Abnormal | 10 | 20.0 | 0 | 0.0 | 5 | 21.7 | 15 | 13.6 | |
Total | 50 | 37 | 23 | 110 | |||||
Distal Thermal Sensitivity | |||||||||
Normal | 38 | 76.0 | 37 | 100.0 | 17 | 73.0 | 92 | 83.6 | 0.004 |
Abnormal | 12 | 24.0 | 0 | 0.0 | 6 | 26.1 | 18 | 16.4 | |
Total | 50 | 37 | 23 | 110 | |||||
Hallux or Thumb Vibration Sensitivity | |||||||||
Normal | 46 | 92.0 | 36 | 97.3 | 18 | 78.3 | 100 | 90.9 | 0.042 |
Abnormal | 4 | 8.0 | 1 | 2.7 | 5 | 21.7 | 10 | 9.1 | |
Total | 50 | 37 | 23 | 110 | |||||
Feet mechanical detection threshold | |||||||||
Normal | 33 | 66.0 | 37 | 100.0 | 15 | 65.2 | 85 | 77.3 | 0.001 |
Abnormal | 17 | 34.0 | 0 | 0.0 | 8 | 34.8 | 25 | 22.7 | |
Total | 50 | 37 | 23 | 110 | |||||
Clinical signs of polyneuropathy (Neuropathy burden) | |||||||||
No | 29 | 58.0 | 33 | 89.2 | 13 | 56.4 | 75 | 68.2 | 0.003 |
Yes | 21 | 42.0 | 4 | 10.8 | 10 | 43.5 | 35 | 31.8 | |
Total | 50 | 37 | 23 | 110 | |||||
Motor functions | |||||||||
Toe amyotrophy | |||||||||
Absent | 48 | 96.0 | 34 | 91.9 | 23 | 100.0 | 105 | 95.5 | 0.331 |
Present | 2 | 4.0 | 3 | 8.1 | 0 | 0.0 | 5 | 4.5 | |
Total | 50 | 37 | 23 | 110 | |||||
Ankle jerk reflex | |||||||||
Normal | 40 | 80.0 | 36 | 97.3 | 17 | 73.9 | 92 | 83.6 | 0.025 |
Abnormal | 10 | 20.0 | 1 | 2.7 | 6 | 26.1 | 17 | 16.4 | |
Total | 50 | 37 | 23 | 110 | |||||
Bradykinesia | |||||||||
Absent | 49 | 98.0 | 37 | 100.0 | 21 | 91.3 | 107 | 97.3 | 0.121 |
Present | 1 | 2.0 | 0 | 0.0 | 2 | 8.7 | 3 | 2.7 | |
Total | 50 | 37 | 23 | 110 | |||||
Cerebellar Ataxia | |||||||||
Absent | 49 | 98.0 | 37 | 100.0 | 21 | 95.5 | 108 | 98.2 | 0.468 |
Present | 1 | 2.0 | 0 | 0.0 | 1 | 4.5 | 2 | 1.8 | |
Total | 50 | 37 | 22 | 110 | |||||
Cognition | |||||||||
Brief Cognitive Screening Battery (BCSB) | |||||||||
Normal | 42 | 82.4 | 29 | 78.4 | 14 | 60.9 | 85 | 76.6 | 0.124 |
Abnormal | 9 | 17.6 | 8 | 21.6 | 9 | 39.1 | 26 | 23.4 | |
Total | 51 | 37 | 23 | 111 | |||||
Stick design test | |||||||||
Normal | 50 | 98.0 | 37 | 100.0 | 22 | 95.7 | 109 | 98.2 | 0.466 |
Abnormal | 1 | 2.0 | 0 | 0.0 | 1 | 4.3 | 2 | 1.8 | |
Total | 51 | 37 | 23 | 111 | |||||
Verbal Fluency test | |||||||||
Normal | 47 | 94.0 | 33 | 89.2 | 17 | 73.9 | 97 | 88.2 | 0.046 |
Abnormal | 3 | 6.0 | 4 | 10.8 | 6 | 26.1 | 13 | 11.8 | |
Total | 50 | 37 | 23 | 110 |
Hair-MeHg Levels | |||||||
---|---|---|---|---|---|---|---|
Sociodemographic Variables | <10.0 µg/g | ≥10.0 µg/g | Total | ||||
Sex | n | % | n | % | n | % | p-value |
Female | 36 | 47.4 | 16 | 48.5 | 52 | 47.7 | 0.915 |
Male | 40 | 52.6 | 17 | 51.5 | 57 | 52.3 | |
Total | 76 | 33 | 109 | ||||
Age range (years) | |||||||
12 to 19 | 26 | 34.2 | 10 | 30.3 | 36 | 33.0 | 0.774 |
20 to 24 | 12 | 15.8 | 8 | 24.2 | 20 | 18.3 | |
25 to 29 | 12 | 15.8 | 5 | 15.2 | 17 | 15.6 | |
≥30 | 26 | 34.2 | 10 | 30.3 | 36 | 33.0 | |
Total | 76 | 33 | 109 | ||||
Somatosensory signs | |||||||
Distal pinprick perception | |||||||
Normal | 65 | 85.5 | 29 | 87.9 | 94 | 86.2 | 0.743 |
Abnormal | 11 | 14.5 | 4 | 12.1 | 15 | 13.8 | |
Total | 76 | 33 | 109 | ||||
Distal Thermal Sensitivity | |||||||
Normal | 65 | 85.5 | 26 | 78.8 | 91 | 83.5 | 0.384 |
Abnormal | 11 | 14.5 | 7 | 21.2 | 18 | 16.5 | |
Total | 76 | 33 | 109 | ||||
Hallux or Thumb Vibration Sensitivity | |||||||
Normal | 71 | 93.4 | 28 | 84.8 | 99 | 90.8 | 0.154 |
Abnormal | 5 | 6.6 | 5 | 15.2 | 10 | 9.2 | |
Total | 76 | 33 | 109 | ||||
Feet mechanical detection threshold | |||||||
Normal | 62 | 81.6 | 22 | 66.7 | 84 | 77.1 | 0.089 |
Abnormal | 14 | 18.4 | 11 | 33.3 | 25 | 22.9 | |
Total | 76 | 33 | 109 | ||||
Clinical signs of polyneuropathy (neuropathy burden) | |||||||
No | 53 | 69.7 | 21 | 63.6 | 74 | 67.9 | 0.531 |
Yes | 23 | 30.3 | 12 | 36.4 | 35 | 32.1 | |
Total | 76 | 33 | 109 | ||||
Motor function | |||||||
Toe amyotrophy | |||||||
Absent | 71 | 93.4 | 33 | 100.0 | 104 | 95.4 | 0.131 |
Present | 5 | 6.6 | 0 | 0.0 | 5 | 4.6 | |
Total | 76 | 33 | 109 | ||||
Ankle jerk reflex | |||||||
Normal | 66 | 86.8 | 26 | 78.8 | 92 | 84.4 | 0.287 |
Abnormal | 10 | 13.2 | 7 | 21.2 | 17 | 15.6 | |
Total | 76 | 33 | 109 | ||||
Bradykinesia | |||||||
Absent | 75 | 98.7 | 31 | 93.9 | 106 | 97.2 | 0.164 |
Present | 1 | 1.3 | 2 | 6.1 | 3 | 2.8 | |
Total | 76 | 33 | 109 | ||||
Cerebellar incoordination (ataxia) | |||||||
Absent | 76 | 100.0 | 31 | 93.9 | 107 | 98.2 | 0.030 |
Present | 0 | 0.0 | 2 | 6.1 | 2 | 1.8 | |
Total | 76 | 33 | 109 | ||||
Cognition | |||||||
Brief Cognitive Screening Battery (BCSB) | |||||||
Normal | 63 | 82.9 | 21 | 63.6 | 84 | 77.1 | 0.028 |
Abnormal | 13 | 17.1 | 12 | 36.4 | 25 | 22.9 | |
Total | 76 | 33 | 109 | ||||
Stick design test | |||||||
Normal | 75 | 98.7 | 32 | 97.0 | 107 | 98.2 | 0.540 |
Abnormal | 1 | 1.3 | 1 | 3.0 | 2 | 1.8 | |
Total | 76 | 33 | 109 | ||||
Verbal Fluency test | |||||||
Normal | 70 | 92.1 | 26 | 78.8 | 96 | 88.1 | 0.049 |
Abnormal | 6 | 7.9 | 7 | 21.2 | 13 | 11.9 | |
Total | 76 | 33 | 109 |
Hair-MeHg Levels | |||||||
---|---|---|---|---|---|---|---|
Clinical Variables | <10.0 µg/g | ≥10.0 µg/g | Total | ||||
Somatosensory Signs | N | % | n | % | n | % | p-Value |
Feet mechanical detection threshold | |||||||
Normal | 62 | 81.6 | 22 | 66.7 | 84 | 77.1 | 0.089 |
Abnormal | 14 | 18.4 | 11 | 33.3 | 25 | 22.9 | |
Total | 76 | 33 | 109 | ||||
Motor function | |||||||
Cerebellar incoordination (ataxia) | |||||||
Absent | 76 | 100.0 | 31 | 93.9 | 107 | 98.2 | 0.030 |
Present | 0 | 0.0 | 2 | 6.1 | 2 | 1.8 | |
Total | 76 | 33 | 109 | ||||
Cognition | |||||||
Brief Cognitive Screening Battery (BCSB) | |||||||
Normal | 63 | 82.9 | 21 | 63.6 | 84 | 77.1 | 0.028 |
Abnormal | 13 | 17.1 | 12 | 36.4 | 25 | 22.9 | |
Total | 76 | 33 | 109 | ||||
Verbal Fluency test | |||||||
Normal | 70 | 92.1 | 26 | 78.8 | 96 | 88.1 | 0.049 |
Abnormal | 6 | 7.9 | 7 | 21.2 | 13 | 11.9 | |
Total | 76 | 33 | 109 |
Cognitive Screening Brief Battery | ||||
---|---|---|---|---|
Variables | PR Crude (CI 95%) | p-Value | PR Adjusted (CI 95%) | p-Value |
Hair-MeHg level | ||||
<10 µg/g | 1.0 | 1.0 | ||
≥10 µg/g | 2.1 (1.08–4.15) | 0.027 | 2.2 (1.13–4.26) | 0.028 |
Age range (years) | ||||
20 to 24 | 1.0 | 1.0 | ||
12 to 19 | 1.3 (0.38–4.47) | 0.681 | 1.5 (0.44–4.80) | 0.424 |
25 to 29 | 1.7 (0.51–5.46) | 0.399 | 1.9 (0.60–6.05) | 0.280 |
≥30 | 2.2 (0.65–7.61) | 0.204 | 2.4 (0.74–7.82) | 0.144 |
Sex | ||||
Female | 1.0 | 1.0 | ||
Male | 1.1 (0.57–2.29) | 0.71 | 1.2 (0.61–2.32) | 0.492 |
Verbal Fluency Test | ||||
Variables | PR Crude (CI 95%) | p-Value | PR Adjusted (CI 95%) | p-Value |
Hair-MeHg level | ||||
<10 µg/g | 1.0 | 1.0 | ||
≥10 µg/g | 1.9 (1.07–3.38) | 0.03 | 2.0 (1.18–3.35) | 0.010 |
Age range (years) | ||||
20 to 24 | 1.0 | 1.0 | ||
12 to 19 | 3.0 (0.98–8.95) | 0.054 | 3.2 (1.06–9.42) | 0.039 |
25 to 29 | 0.8 (0.15–4.16) | 0.775 | 0.9 (0.16–4.64) | 0.871 |
≥30 | 1.8 (0.56–5.81) | 0.324 | 2.0 (0.63–6.46) | 0.239 |
Sex | ||||
Female | 1.0 | 1.0 | ||
Male | 0.6 (0.31–1.05) | 0.071 | 0.6 (0.34–1.11) | 0.109 |
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Oliveira, R.A.A.d.; Pinto, B.D.; Rebouças, B.H.; Ciampi de Andrade, D.; Vasconcellos, A.C.S.d.; Basta, P.C. Neurological Impacts of Chronic Methylmercury Exposure in Munduruku Indigenous Adults: Somatosensory, Motor, and Cognitive Abnormalities. Int. J. Environ. Res. Public Health 2021, 18, 10270. https://doi.org/10.3390/ijerph181910270
Oliveira RAAd, Pinto BD, Rebouças BH, Ciampi de Andrade D, Vasconcellos ACSd, Basta PC. Neurological Impacts of Chronic Methylmercury Exposure in Munduruku Indigenous Adults: Somatosensory, Motor, and Cognitive Abnormalities. International Journal of Environmental Research and Public Health. 2021; 18(19):10270. https://doi.org/10.3390/ijerph181910270
Chicago/Turabian StyleOliveira, Rogério Adas Ayres de, Bruna Duarte Pinto, Bruno Hojo Rebouças, Daniel Ciampi de Andrade, Ana Claudia Santiago de Vasconcellos, and Paulo Cesar Basta. 2021. "Neurological Impacts of Chronic Methylmercury Exposure in Munduruku Indigenous Adults: Somatosensory, Motor, and Cognitive Abnormalities" International Journal of Environmental Research and Public Health 18, no. 19: 10270. https://doi.org/10.3390/ijerph181910270