Relationship of short-term verbal memory to the need for hyperbaric oxygen treatment after carbon monoxide poisoning

It has long been known that carbon monoxide (CO) poisoning has a spectrum of effects on cognitive functioning, including memory, perception, and attention. The current study reports the investigation of the effects of CO poisoning on short-term verbal memory, both rote and context aided. Impairment was measured before and after hyperbaric oxygen (HBO) treatment. Twenty-six patients who had been admitted for emergency treatment after exposure to significant CO poisoning were tested using a measure of short-term recall for word lists with no or varying degrees of internal context-aided structure. Impairment of context-aided memory (but not rote memory) has been previously reported to be associated with low relative frontal volume in psychiatric patients. Carbon monoxide poisoning was significantly associated with impairment of context-aided memory, with the degree of pretreatment impairment predicting the number HBO treatments judged to be necessary on the basis of clinical monitoring of the patient. In patients with poisoning of moderate severity, pretreatment performance in context-aided memory improved after the first HBO treatment. The implications of these findings for the effects of CO poisoning on frontal area function are discussed. The memory measure used in this study appears to have considerable potential usefulness in the clinical assessment of the severity of CO poisoning in patients treated in an emergency setting.