Abstract
On March 20, 1995, about 5500 people were affected by the sarin released from the plastic bag placed in the subway car in Tokyo, 12 of whom have died (Tokyo subway sarin gas attack) . Sarin is a kind of organic phosphoric acid compounds, which are potent acetylcholine (Ach) esterase inhibitors. Through the effect on the cholinergic receptors it inhibits the neurotransmission in the autonomic nervous system. The chronic brain disorder and its related sustained changes of the brain function were suggested in victims of sarin gas attack. In this paper, I overviewed the previous reports of the long- term impact of the sarin on the nervous systems in victims of this gas attack. The review of the previous works suggested the possibility that the sudden and excessive load of the sarin on the Ach-nervous system contribute the chronic damage of the neuronal, mental and behavioral damages even years after the accident. Further, in addition to the overview of the functional and anatomical investigation by neuropsychological tests and MRI, I discussed the usefulness of the long- term investigation of the in- vivo cerebral molecular changes by PET/SPECT imaging.
