Cyclosporin neuro effects shown to be CUMULATIVE

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Cyclosporins occur in stachybotrys. Transplant recipients receive

cyclosporin A to prevent their bodies from rejecting the alien tissue.

However, they pay a huge price in that cyclosporin causes systemic

side effects, including permanent neurological issues, similar to what

chemo brain does. These changes appear to be directly proportional to

the total CUMULATIVE dose of the mycotoxin cyclosporin they have

received.

Cyclopsorin also causes kidney damage, hypertension, hardening of the

arteries and sexual dysfunction. As well as many other health issues.

As it is a drug, study of these issues has been well funded.

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(Circulation. 1996;94:1339-1345.)

Cyclosporine May Affect Improvement of Cognitive Brain Function After

Successful Cardiac Transplantation

Grimm, MD; Wafa Yeganehfar, MD; Gunther Laufer, MD, PhD;

Christian Madl, MD; Ludwig Kramer, MD; Edith Eisenhuber, MD;

Simon, MD; Natascha Kupilik, MD; Wolfgang Schreiner, PhD;

Pacher, MD; Brigitta Bunzel, PhD; Ernst Wolner, MD, PhD; Georg Grimm,

MD, PhD

the Department of Cardiothoracic Surgery (M.G., W.Y., G.L., P.S.,

N.K., B.B., E.W.); the Fourth Department of Internal Medicine (C.M.,

L.K., E.E., G.G.); the Department of Medical Computer Science (W.S.);

and the Second Department of Internal Medicine (R.P.), University of

Vienna, Austria.

Correspondence to Georg Grimm, MD, PhD, Second Department of Internal

Medicine, General Hospital Klagenfurt, St Veiterstr 47, A-9020

Klagenfurt, Austria.

Background The effects of cardiac transplantation on cognitive brain

function are uncertain.

Methods and Results We measured cognitive brain function and quality

of life in out-of-hospital cardiac transplant candidates (n=55;

ejection fraction, 19.9%; age, 54.8 years [means]). After

transplantation, the patients were serially reevaluated at 4 months

(n=25) and at 12 months (n=19). Brain function was measured

objectively by cognitive P300 evoked potentials. Additionally,

standard psychometric tests (Trail Making Test A, Mini-Mental State

Examination, and Profile of Mood State test) were performed. Cognitive

P300 evoked potentials were impaired in cardiac transplant candidates

(359 ms, recorded at vertex) compared with 55 age- and sex-matched

healthy subjects (345 ms, P<.01). Trail Making Test A was also

abnormal (45 versus 31 seconds in 55 healthy subjects, P<.01). After

transplantation, P300 measures were normalized at 4 months (345 ms,

P<.05 versus before transplantation) but declined again at 12 months

(352 ms, P=NS versus before transplantation). Stepwise multiple

regression analysis revealed that cumulative cyclosporine dosage was

the only predictor of individual cognitive brain function 4 months

(753 mg/kg body wt, P<.05) and 12 months (2006 mg/kg body wt, P<.01)

after transplantation, respectively.

Conclusions Objective cognitive P300 auditory evoked potential

measurements indicate that cognitive brain function is significantly

impaired in patients suffering from stable end-stage heart failure.

Successful cardiac transplantation is effective to fully normalize

impaired brain function. Subsequent relative long-term decline of

cognitive brain function after successful cardiac transplantation is

strongly suggested to be related to cumulative cyclosporine

neurotoxicity.

Key Words: transplantation • cyclosporine • brain