Cognitive impairment and dementia in neurocysticercosis A cross-sectional controlled study
Cognitive impairment and dementia in neurocysticercosis A cross-sectional controlled study
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DOI：
10.1212/wnl.0b013e3181d9eda6
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发表时间：
2010-04-20
期刊：
影响因子：
9.9
通讯作者：
Caramelli, P.
中科院分区：
文献类型：
--
作者：
de Andrade, D. Ciampi;Rodrigues, C. L.;Caramelli, P.
目的：神经囊尾蚴病 (NCYST) 是全世界最常见的中枢神经系统寄生虫病，影响超过 5000 万人。然而，其一些临床发现，例如认知障碍和痴呆，仍不清楚，迄今为止尚未进行对照研究。我们调查了 NCYST 患者样本中认知障碍和痴呆的频率和临床特征，并与认知健康对照 (HC) 和隐源性癫痫 (CE) 患者进行比较。方法：40 名未接受过治疗的 NCYST 患者，年龄 39.25 +/- 10.50 岁，满足 MRI 确定的活动性 NCYST 的绝对标准，接受全面的认知和功能评估，并与 49 名 HC 和 28 名 CE 患者进行比较结果：与 HC 相比，NCYST 患者在执行功能、言语和非言语记忆、建设性实践和言语流畅性方面表现出显着损害（p < 0.05）。根据 DSM-IV 标准，12.5% 的 NCYST 患者被诊断为痴呆。与 CE 患者相比，NCYST 患者表现出工作和情景言语记忆、执行功能、命名、言语流畅性、建设性实践和视觉空间定向的改变。认知评分与 MRI 上 NCYST 病变的数量、定位或类型之间没有相关性。结论：认知障碍在活动性神经囊尾蚴病 (NCYST) 患者样本中普遍存在。抗癫痫药物的使用和癫痫发作频率不能解释这些特征。很大一部分患者患有痴呆症。这些数据拓宽了我们对 NCYST 临床表现及其对世界公共卫生影响的了解。神经病学（R）2010；74：1288-1295
Objectives: Neurocysticercosis (NCYST) is the most frequent CNS parasitic disease worldwide, affecting more than 50 million people. However, some of its clinical findings, such as cognitive impairment and dementia, remain poorly characterized, with no controlled studies conducted so far. We investigated the frequency and the clinical profile of cognitive impairment and dementia in a sample of patients with NCYST in comparison with cognitively healthy controls (HC) and patients with cryptogenic epilepsy (CE).Methods: Forty treatment-naive patients with NCYST, aged 39.25 +/- 10.50 years and fulfilling absolute criteria for definitive active NCYST on MRI, were submitted to a comprehensive cognitive and functional evaluation and were compared with 49 HC and 28 patients with CE of similar age, educational level, and seizure frequency.Results: Patients with NCYST displayed significant impairment in executive functions, verbal and nonverbal memory, constructive praxis, and verbal fluency when compared with HC (p < 0.05). Dementia was diagnosed in 12.5% patients with NCYST according to DSM-IV criteria. When compared with patients with CE, patients with NCYST presented altered working and episodic verbal memory, executive functions, naming, verbal fluency, constructive praxis, and visual-spatial orientation. No correlation emerged between cognitive scores and number, localization, or type of NCYST lesions on MRI.Conclusions: Cognitive impairment was ubiquitous in this sample of patients with active neurocysticercosis (NCYST). Antiepileptic drug use and seizure frequency could not account for these features. Dementia was present in a significant proportion of patients. These data broaden our knowledge on the clinical presentations of NCYST and its impact in world public health. Neurology (R) 2010;74:1288-1295