Brain structural changes in patients with chronic methylmercury poisoning in Minamata

Exploratory whole-brain studies in patients suffering from methylmercury (MeHg) poisoning have not been conducted. We aimed to evaluate the neuroanatomical differences between patients with chronic MeHg poisoning and healthy volunteers via magnetic resonance (MR) imaging. Patients included in this case-control study were divided into three categories based on whether MeHg exposure occurred in utero, under 15 years of age, or over 15 years of age, as fetal-, pediatric-, and adult-type patients, respectively. This study analyzed MR imaging data from 10 patients each of fetal, pediatric, and adult types of chronic MeHg poisoning in Minamata and corresponding 53, 37, and 15 age- and sex-matched healthy volunteers. Whole-brain voxel-based morphometry (VBM) analysis was used to determine the volumetric gray and white matter (GM and WM) differences in patients with chronic MeHg poisoning. Compared to healthy individuals, VBM revealed a significant reduction in GM in the cerebellar and calcarine areas in pediatric- and adult-type cases and in the thalamus of fetal-type cases. A significant reduction in WM volume was also noted in the cerebral and the cerebellar regions, especially in pediatric-type cases. Patients with chronic MeHg poisoning develop structural differences in the GM of the calcarine, the cerebellum, and the thalamus and in the WM of the cerebrum and cerebellum. These changes can appear, depending on the timing of MeHg exposure.