Objective: World Trade Center (WTC) responders are susceptible to both cognitive and neuropsychiatric impairments, particularly chronic posttraumatic stress disorder. The present study examined self-reported behavioral impairments in a sample of 732 WTC responders, 199 of whom were determined to have high risk of WTC-related cortical atrophy by an artificial neural network. Results: We found that responders at increased risk of cortical atrophy showed behavioral impairment across five domains: motivation, mood, disinhibition, empathy, and psychosis (14.6% vs 3.9% in the low-risk group; P = 3.90 × 10-7). Factor analysis models revealed that responders at high risk of cortical atrophy tended to have deficits generalized across all aspects of behavioral impairment with focal dysfunction in sensory psychosis. We additionally describe how relationships are modulated by exposure severity and pharmacological treatments. Discussion: Our findings suggest a potential link between sensory deficits and the development of cortical atrophy in WTC responders and may indicate symptoms consistent with a clinical portrait of parietal dominant Alzheimer's disease or a related dementia (ADRD). Results underscore the importance of investigating neuropsychiatric symptomatology in clinical evaluations of possible ADRD.

中文翻译：

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世贸中心响应者的行为障碍和皮质萎缩风险增加的风险评分。

目的：世界贸易中心 (WTC) 的响应者容易受到认知和神经精神障碍的影响，特别是慢性创伤后应激障碍。本研究检查了 732 名 WTC 响应者样本中自我报告的行为障碍，人工神经网络确定其中 199 人具有与 WTC 相关的皮质萎缩的高风险。结果：我们发现，皮质萎缩风险增加的反应者在五个领域表现出行为障碍：动机、情绪、去抑制、同理心和精神病（低风险组为 14.6% vs 3.9%；P = 3.90 × 10-7） 。因子分析模型显示，皮质萎缩高风险的反应者往往在行为障碍的各个方面都有缺陷，并伴有感觉精神病的局灶性功能障碍。我们还描述了如何通过暴露严重程度和药物治疗来调节关系。讨论：我们的研究结果表明，WTC 应答者的感觉缺陷与皮质萎缩的发生之间存在潜在联系，并且可能表明与顶叶显性阿尔茨海默病或相关痴呆 (ADRD) 的临床特征一致的症状。结果强调了研究神经精神症状学在可能的 ADRD 临床评估中的重要性。