Health Effects of Moldy Buildings – Neurological Issues

 

This page lists medical journal articles discussing the relationship between neurological issues and moldy buildings.

The Health Effects of Moldy Buildings page of the Paradigm Change site provides further information on this topic.

 

Ratnaseelan AM, Tsilioni I, Theoharides TC. Effects of Mycotoxins on Neuropsychiatric Symptoms and Immune Processes. Clin Ther. 2018 Jun;40(6):903-917. PMID: 29880330

PubMed was searched for relevant articles using terms such as mold, mycotoxins, fungi, immunity, inflammation, neurodevelopment, cognition, Alzheimer’s, and autism. The information reviewed indicates that exposure to mold and mycotoxins can affect the nervous system, directly or through immune cell activation, thus contributing to neurodevelopmental disorders such as autism spectrum disorder.

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MacNaughton P, Satish U, Laurent JGC, Flanigan S, Vallarino J, Coull B, Spengler JD, Allen JG. The Impact of Working in a Green Certified Building on Cognitive Function and Health. Build Environ. 2017 Mar;114:178-186. PMID: 28785124

Recent research has demonstrated an impact of the indoor environment on cognitive function. We recruited 109 participants from 10 high-performing buildings (i.e. buildings surpassing the ASHRAE Standard 62.1-2010 ventilation requirement and with low total volatile organic compound concentrations) in five U.S. cities. In each city, buildings were matched by week of assessment, tenant, type of worker and work functions. A key distinction between the matched buildings was whether they had achieved green certification. Workers were administered a cognitive function test of higher order decision-making performance twice during the same week while indoor environmental quality parameters were monitored. Workers in green certified buildings scored 26.4% (95% CI: [12.8%, 39.7%]) higher on cognitive function tests, controlling for annual earnings, job category and level of schooling, and had 30% fewer sick building symptoms than those in non-certified buildings.

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Martins IJ. Overnutrition Determines LPS Regulation of Mycotoxin Induced Neurotoxicity in Neurodegenerative Diseases. Int J Mol Sci. 2015 Dec 10;16(12):29554-73. PMID: 26690419

Chronic neurodegenerative diseases are now associated with obesity and diabetes and linked to the developing and developed world. Interests in healthy diets have escalated that may prevent neurodegenerative diseases such as Parkinson’s and Alzheimer’s disease. The global metabolic syndrome involves lipoprotein abnormalities and insulin resistance and is the major disorder for induction of neurological disease. The effects of bacterial lipopolysaccharides (LPS) on dyslipidemia and NAFLD indicate that the clearance and metabolism of fungal mycotoxins are linked to hypercholesterolemia and amyloid beta oligomers.

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Shoemaker RC, House D, Ryan JC. Structural brain abnormalities in patients with inflammatory illness acquired following exposure to water-damaged buildings: a volumetric MRI study using NeuroQuant. Neurotoxicol Teratol. 2014 Sep-Oct;45:18-26. PMID: 24946038

Executive cognitive and neurologic abnormalities are commonly seen in patients with a chronic inflammatory response syndrome (CIRS) acquired following exposure to the interior environment of water-damaged buildings (WDB). Symptoms of affected patients routinely include headache, difficulty with recent memory, concentration, word finding, numbness, tingling, metallic taste and vertigo. Findings of gliotic areas in MRI scans in over 45% of CIRS-WDB cases compared to 5% of controls, as well as elevated lactate and depressed ratios of glutamate to glutamine, are regularly seen in MR spectroscopy of cases. This study used the volumetric software program NeuroQuant (NQ) to determine specific brain structure volumes in consecutive patients (N=17) seen in a medical clinic specializing in inflammatory illness. When compared to those of a medical control group (N=18), statistically significant differences in brain structure proportions were seen for patients in both hemispheres of two of the eleven brain regions analyzed; atrophy of the caudate nucleus and enlargement of the pallidum. In addition, the left amygdala and right forebrain were also enlarged.

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Casas L, Torrent M, Zock JP, et al. Early life exposures to home dampness, pet ownership and farm animal contact and neuropsychological development in 4 year old children: a prospective birth cohort study. Int J Hyg Environ Health. 2013;216:690–697. PMID: 23357052 

A Spanish population-based birth-cohort enrolled 482 children, and 424 of them underwent psychometric testing at 4 years of age, including the McCarthy Scales of Child Abilities (MSCA) and the California Preschool Social Competence Scale (CPSCS). Persistent dampness during early life significantly decreased the general score of MSCA by 4.9 points (95% CI: -8.9; -0.8), and it decreased the CPSCS by 6.5 points (95% CI: -12.2; -0.9) in the child’s bedroom. In conclusion, damp housing in early life may have adverse effects on neuropsychological development at 4 years old.

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Jedrychowski W, Maugeri U, Perera F, Stigter L, Jankowski J, Butscher M, Mroz E, Flak E, Skarupa A, Sowa A. Cognitive function of 6-year old children exposed to mold-contaminated homes in early postnatal period. Prospective birth cohort study in Poland. Physiol Behav. 2011 Oct 24;104(5):989-95. PMID: 21763705

The results of this study are based on the six-year follow-up of 277 babies born at term to mothers participating in a prospective cohort study in Krakow, Poland. The presence of visible mold patches on indoor walls was monitored at regular time intervals over gestation and after birth up to the age of five. The adjusted IQ deficit attributed to longer exposures to indoor molds (>2 years) was significantly lower on the IQ scale and tripled the risk of low IQ scoring compared with references.

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Doi K, Uetsuka K. Mechanisms of mycotoxin-induced neurotoxicity through oxidative stress-associated pathways. Int J Mol Sci. 2011;12(8):5213-37. PMID: 21954354

Among many mycotoxins, T-2 toxin, macrocyclic trichothecenes, fumonisin B(1) (FB(1)) and ochratochin A (OTA) are known to have the potential to induce neurotoxicity in rodent models. This paper reviews the mechanisms of neurotoxicity induced by these mycotoxins especially from the viewpoint of oxidative stress-associated pathways.

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Empting LD. Neurologic and neuropsychiatric syndrome features of mold and mycotoxin exposure. Toxicol Ind Health. 2009 Oct-Nov;25(9-10):577-81. PMID: 19854819

The author delineates the signs and symptoms of a syndrome precipitated by mold and mycotoxin exposure and contrasts and separates these findings neurodiagnostically from known neurologic diseases. It is clear that mycotoxins can affect sensitive individuals, and possibly accelerate underlying neurologic/pathologic processes, but it is crucial to separate known neurologic and neuropsychiatric disorders from mycotoxin effects in order to study it properly.

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Islam Z, Amuzie CJ, Harkema JR, Pestka JJ. Neurotoxicity and inflammation in the nasal airways of mice exposed to the macrocyclic trichothecene mycotoxin roridin a: kinetics and potentiation by bacterial lipopolysaccharide coexposure. Toxicol Sci. 2007 Aug;98(2):526-41. PMID: 17483119

The purpose of this investigation was to determine (1) the kinetics of nasal inflammation and neurotoxicity after a single intranasal instillation of roridin A (RA), a representative macrocyclic trichothecene; and (2) the capacity of lipopolysaccharide (LPS) to modulate RA’s effects. Taken together, the results suggest that RA markedly induced the proapoptotic gene FAS and proinflammatory cytokine expression prior to evoking olfactory sensory neuron apoptosis and olfactory epithelium atrophy and that RA’s effects were augmented by LPS.

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Shenassa ED, Daskalakis C, Liebhaber A, Braubach M, Brown M. Dampness and mold in the home and depression: an examination of mold-related illness and perceived control of one’s home as possible depression pathways. Am J Public Health. 2007 Oct;97(10):1893-9. PMID: 17761567

Dampness or mold in the home was associated with depression. This association became attenuated when perception of control or a physical health index was included in the model.

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Anyanwu EC. The validity of the environmental neurotoxic effects of toxigenic molds and mycotoxins. The Internet Journal of Toxicology. 2007: 5(2).

=This paper reviews the relevant, most recent peer reviewed literatures that support the validity of the environmental risks and adverse neurotoxic health effects of chronic exposures to toxigenic molds and mycotoxins. The structures of typical mycotoxins are cited to show the relevance of functional groups, and how their biochemical activities may contribute to adverse health effects in relation to signs, symptoms, and mechanisms. The proven interactions between the biological system and the molecular functional groups of mycotoxins are evaluated to explain how they may lead to neurotoxic health effects in terms of carcinogenic, biochemical, immunological, neurophysiological and behavioral properties.

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Reinhard MJ, Satz P, Scaglione CA, et al. Neuropsychological exploration of alleged mold neurotoxicity. Arch Clin Neuropsychol. 2007;22: 533–543. PMID: 17521866 

A potential subgroup of cognitively impaired outliers within exposure litigants is explored. Despite CNS complaints often seen with mold exposed individuals, overall results did not uncover concomitant cognitive deficits suggested in previous studies or a significant reduction in intellectual functioning. Limitations of self-reported and objective measurements for mold exposure and exploratory statistical methodology are discussed.

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Stone DC, Boone KB, Back-Madruga C, Lesser IM. Has the rolling uterus finally gathered moss? Somatization and malingering of cognitive deficit in six cases of “toxic mold” exposure. Clin Neuropsychol. 2006;20:766–785. PMID: 16980261 

This article reports six cases of litigants claiming neuropsychiatric impairment due to toxic mold exposure. In spite of recent growth in personal injury claims due to mold, numerous reviews of the literature have failed to find an association between environmental exposure to mold and neuropsychiatric and/or neuropsychological damage. We report data on six patients claiming harm, 4 of whom revealed a long history of somatization by history and psychological testing, and 2 of whom were shown to be malingering based on multiple indicators of non-credible performance. Of the 6 patients, only the 2 somatoform patients who were also depressed showed credible evidence of neuropsychological dysfunction.

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Brown RC, Lockwood AH, Sonawane BR. Neurodegenerative diseases: an overview of environmental risk factors. Environ Health Perspect. 2005;113:1250–1256. PMID: 16140637 

This review provides an overview of the epidemiologic evidence for environmental etiologies for neurodegenerative diseases such as Alzheimer disease, Parkinson disease, parkinsonian syndromes (multiple system atrophy and progressive supranuclear palsy), and amyotrophic lateral sclerosis.

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Campbell, A.W., Thrasher, J.D., Gray, M.R., and Vojdani, A. Mold and mycotoxins: effects on the neurological and immune systems in humans. Adv Appl Microbiol. 2004; 55: 375–406. PMID: 15350803

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Pall ML, Anderson JH. The vanilloid receptor as a putative target of diverse chemicals in multiple chemical sensitivity. Arch Environ Health. 2004 Jul;59(7):363-75. PMID: 16241041

The vanilloid receptor (TRPV1 or VR1), widely distributed in the central and peripheral nervous system, is activated by a broad range of chemicals similar to those implicated in Multiple Chemical Sensitivity (MCS) Syndrome. The vanilloid receptor is reportedly hyperresponsive in MCS and can increase nitric oxide levels and stimulate N-methyl-D-aspartate (NMDA) receptor activity, both of which are important features in the previously proposed central role of nitric oxide and NMDA receptors in MCS. Activation of this receptor by certain mycotoxins may account for some cases of sick building syndrome, a frequent precursor of MCS.

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Gordon WA, Cantor JB, Johanning E, Charatz HJ, Ashman TA, Breeze JL, Haddad L, Abramowitz S. Cognitive impairment associated with toxigenic fungal exposure: A replication and extension of previous findings. Appl Neuropsychol. 2004;11(2):65-74. PMID: 15477176

In this study, neuropsychological data and symptom reports from 31 individuals exposed to toxic mold were examined. Most participants were found to have reduced cognitive functioning in multiple domains, with memory and executive functions the most commonly affected areas. Results also indicated that symptom report of the mold-exposed participants was not significantly different from that of matched groups of 65 persons with mild traumatic brain injury (TBI) and 26 individuals with moderate TBI.

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Anyanwu, E.C., Campbell, A.W., and Vojdani, A. Neurophysiological effects of chronic indoor environmental toxic mold exposure on children. Sci World J. 2003; 3: 281–290. PMID: 12806113

In this study, we reported the neurological findings in children who attended our Center because of chronic exposure to toxic molds. The results showed high levels of abnormalities in the analysis of the subjective responses derived from the questionnaires. The EEG examination was abnormal in seven out of ten of the patients compared to the controls with only one in ten with episodes of bihemispheric sharp activity. In all the patients, there was frontotemporal theta wave activity that seemed to indicate diffuse changes characteristic of metabolic encephalopathies. Also, there was highly marked 1 to 3 Hz delta activity that was asymmetrical in the right hemisphere of the brain in three out of ten patients. The waveforms of BAEP showed abnormalities in 90% of the patients with both 15′ and 31′ check sizes compared to none in the controls. There were significant delays in waveform V in a majority of the patients representing dysfunctional cognitive process and conductive hearing loss in both ears. VEP showed clear abnormalities in four in ten of the patients with P100 amplitudes and latencies decreased bilaterally. Overall, the objective neurophysiological measurements (EEG, BAEP, VEP, and SSEP) were abnormal, indicating significant neurological deficits in all the patients.

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Campbell AW, Thrasher JD, Madison RA, Vojdani A, Gray MR, Johnson A. Neural autoantibodies and neurophysiologic abnormalities in patients exposed to molds in water-damaged buildings. Arch Environ Health. 2003 Aug;58(8):464-74. PMID: 15259425

The authors investigated neurological antibodies and neurophysiological abnormalities in patients exposed to molds at home who developed symptoms of peripheral neuropathy (i.e., numbness, tingling, tremors, and muscle weakness in the extremities). The authors concluded that exposure to molds in water-damaged buildings increased the risk for development of neural autoantibodies, peripheral neuropathy, and neurophysiologic abnormalities in exposed individuals.

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Crago BR, Gray MR, Nelson LA, Davis M, Arnold L, Thrasher JD. Psychological, neuropsychological, and electrocortical effects of mixed mold exposure. Arch Environ Health. 2003 Aug;58(8):452-63. PMID: 15259424

The authors assessed the psychological, neuropsychological, and electrocortical effects of human exposure to mixed colonies of toxigenic molds. QEEG results included narrowed frequency bands and increased power in the alpha and theta bands in the frontal areas of the cortex. These findings indicated a hypoactivation of the frontal cortex, possibly due to brainstem involvement and insufficient excitatory input from the reticular activating system.

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Ebere C. Anyanwu, Andrew W. Campbell, and Aristo Vojdani. Neurophysiological Effects of Chronic Indoor Environmental Toxic Mold Exposure on Children. The Scientific World Journal. 2003; 3, 281-290.
In this study, we reported the neurological findings in children who attended our center because of chronic exposure to toxic molds. The children underwent a series of neurophysiological tests including electroencephalogram (EEG), brainstem evoked potential (BAEP), visual evoked potential (VEP), and somatosensory evoked potential (SSEP). The results showed high levels of abnormalities in the analysis of the subjective responses derived from the questionnaires. There was no abnormality in the controls.

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Baldo JV, Ahmad L, Ruff R. Neuropsychological performance of patients following mold exposure. Appl Neuropsychol. 2002;9(4):193-202. PMID: 12584073

This study investigated the effects of mold exposure (ME) on human cognition by analyzing neuropsychological data from patients who were exposed to mold in their homes or workplaces. Compared to normative data, ME patients were impaired (<10th percentile) on a number of cognitive measures, with the most consistent deficits in visuospatial learning, visuospatial memory, verbal learning, and psychomotor speed. We also examined emotional functioning and found that a number of ME patients showed evidence of both Axis I and Axis II pathology. Interestingly, there was a significant correlation among patients’ scores on the Beck Depression Inventory-Second Edition and the number of neuropsychological tests falling within the impaired range.

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Anyanwu E, Campbell AW, High W. Brainstem auditory evoked response in adolescents with acoustic mycotic neuroma due to environmental exposure to toxic molds. International journal of adolescent medicine and health. 2002;14:67–76. PMID: 12467209

The aim of this study was to report cases and measurements of acoustic mycotic neuroma in adolescents using the brainstem auditory evoked response. The prevalent subjective findings in the patients were headaches, memory loss, hearing loss, lack of concentration, fatigue, sleep disturbance, facial swelling, rashes, nosebleeds, diarrhea, abdominal pains and respiratory difficulties. Overall results showed the presence of acoustic mycotic neuroma and confirmed the sensitivity and usefulness of BAER in screening acoustic mycotic neuroma and sensorineural auditory dysfunction.

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Hopton, J.L. and Hunt, S.M. Housing conditions and mental health in a disadvantaged area in Scotland. J Epidemiol Community Health. 1996; 50: 56–61. PMID: 8762355

This was a post hoc analysis of data from a household interview survey in public sector housing on the outskirts of Glasgow. Reporting a problem with dampness was significantly and independently associated with scores of > or = 5 on the general health questionnaire (GHQ30) after controlling for possible confounding variables. The researchers concluded that initiatives to tackle housing dampness may be important in developing a strategy to improve mental health for the study area.

 

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