Platelet hyperactivity, neurobehavioral symptoms and depression among Indian women chronically exposed to low level of arsenic

The prevalence of neurobehavioral symptoms (NBS) and depression has been investigated in premenopausal rural women of West Bengal, India enrolled from arsenic (As) endemic (groundwater As 11-50 μg/L; n = 342) and control areas (As level ≤ 10 μg/L; n = 312). The subjective symptoms questionnaire and Beck's 21-point depression inventory-II were used for the detection of NBS and depression, respectively. Platelet P-selectin expression was measured by flow cytometry, plasma neurotransmitter activity with high performance liquid chromatography and groundwater As level by atomic absorption spectroscopy. The As level in groundwater was 2.72 ± 1.18 μg/L in control and 28.3 ± 13.51 μg/L in endemic areas (p < 0.0001). Women residing in endemic areas demonstrated a higher prevalence of depressive symptoms (39.8 vs. 19.9%, p < 0.001) and anxiety (43.3 vs. 18.0% in control, p < 0.001), fatigue (68.4 vs. 23.4%, p < 0.0001), reduced sense of taste (15.8 vs. 4.5%, p < 0.0001) and smell (14.9 vs. 5.8%, p < 0.001); burning sensation (36.8 vs. 5.4%, p < 0.0001) and tingling or numbness in the extremities (25.1 vs. 5.1%, p < 0.0001); and transient loss of memory (69.9 vs. 28.2%, p < 0.001). As-exposed women had 1.6-times more plasma epinephrine and norepinephrine (p < 0.05), 1.8-times higher level plasma serotonin with 28.9% lower intraplatelet serotonin (p < 0.05 for both), but their plasma dopamine level was not significantly different (p > 0.05) from that of controls. Moreover, women from endemic areas had 2.3-times more P-selectin-expressing platelets in their circulation (p < 0.001). After controlling the potential confounders, chronic low level As (11-50 μg/L) exposure showed a positive association with the prevalence of neurobehavioral symptoms and depression among Indian women in their child-bearing age.