TY - JOUR
T1 - Cognitive impairment and World Trade Centre-related exposures
AU - Clouston, Sean A.P.
AU - Hall, Charles B.
AU - Kritikos, Minos
AU - Bennett, David A.
AU - DeKosky, Steven
AU - Edwards, Jerri
AU - Finch, Caleb
AU - Kreisl, William C.
AU - Mielke, Michelle
AU - Peskind, Elaine R.
AU - Raskind, Murray
AU - Richards, Marcus
AU - Sloan, Richard P.
AU - Spiro, Avron
AU - Vasdev, Neil
AU - Brackbill, Robert
AU - Farfel, Mark
AU - Horton, Megan
AU - Lowe, Sandra
AU - Lucchini, Roberto G.
AU - Prezant, David
AU - Reibman, Joan
AU - Rosen, Rebecca
AU - Seil, Kacie
AU - Zeig-Owens, Rachel
AU - Deri, Yael
AU - Diminich, Erica D.
AU - Fausto, Bernadette A.
AU - Gandy, Sam
AU - Sano, Mary
AU - Bromet, Evelyn J.
AU - Luft, Benjamin J.
N1 - Publisher Copyright:
© 2021, Springer Nature Limited.
PY - 2022/2
Y1 - 2022/2
N2 - On 11 September 2001 the World Trade Center (WTC) in New York was attacked by terrorists, causing the collapse of multiple buildings including the iconic 110-story ‘Twin Towers’. Thousands of people died that day from the collapse of the buildings, fires, falling from the buildings, falling debris, or other related accidents. Survivors of the attacks, those who worked in search and rescue during and after the buildings collapsed, and those working in recovery and clean-up operations were exposed to severe psychological stressors. Concurrently, these ‘WTC-affected’ individuals breathed and ingested a mixture of organic and particulate neurotoxins and pro-inflammogens generated as a result of the attack and building collapse. Twenty years later, researchers have documented neurocognitive and motor dysfunctions that resemble the typical features of neurodegenerative disease in some WTC responders at midlife. Cortical atrophy, which usually manifests later in life, has also been observed in this population. Evidence indicates that neurocognitive symptoms and corresponding brain atrophy are associated with both physical exposures at the WTC and chronic post-traumatic stress disorder, including regularly re-experiencing traumatic memories of the events while awake or during sleep. Despite these findings, little is understood about the long-term effects of these physical and mental exposures on the brain health of WTC-affected individuals, and the potential for neurocognitive disorders. Here, we review the existing evidence concerning neurological outcomes in WTC-affected individuals, with the aim of contextualizing this research for policymakers, researchers and clinicians and educating WTC-affected individuals and their friends and families. We conclude by providing a rationale and recommendations for monitoring the neurological health of WTC-affected individuals.
AB - On 11 September 2001 the World Trade Center (WTC) in New York was attacked by terrorists, causing the collapse of multiple buildings including the iconic 110-story ‘Twin Towers’. Thousands of people died that day from the collapse of the buildings, fires, falling from the buildings, falling debris, or other related accidents. Survivors of the attacks, those who worked in search and rescue during and after the buildings collapsed, and those working in recovery and clean-up operations were exposed to severe psychological stressors. Concurrently, these ‘WTC-affected’ individuals breathed and ingested a mixture of organic and particulate neurotoxins and pro-inflammogens generated as a result of the attack and building collapse. Twenty years later, researchers have documented neurocognitive and motor dysfunctions that resemble the typical features of neurodegenerative disease in some WTC responders at midlife. Cortical atrophy, which usually manifests later in life, has also been observed in this population. Evidence indicates that neurocognitive symptoms and corresponding brain atrophy are associated with both physical exposures at the WTC and chronic post-traumatic stress disorder, including regularly re-experiencing traumatic memories of the events while awake or during sleep. Despite these findings, little is understood about the long-term effects of these physical and mental exposures on the brain health of WTC-affected individuals, and the potential for neurocognitive disorders. Here, we review the existing evidence concerning neurological outcomes in WTC-affected individuals, with the aim of contextualizing this research for policymakers, researchers and clinicians and educating WTC-affected individuals and their friends and families. We conclude by providing a rationale and recommendations for monitoring the neurological health of WTC-affected individuals.
UR - http://www.scopus.com/inward/record.url?scp=85119498240&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85119498240&partnerID=8YFLogxK
U2 - 10.1038/s41582-021-00576-8
DO - 10.1038/s41582-021-00576-8
M3 - Review article
C2 - 34795448
AN - SCOPUS:85119498240
SN - 1759-4758
VL - 18
SP - 103
EP - 116
JO - Nature Reviews Neurology
JF - Nature Reviews Neurology
IS - 2
ER -