Cognitive Changes and Quality of Life in Neurocysticercosis: A Longitudinal Study

Abstract

BackgroundFew studies have focused on the cognitive morbidity of neurocysticercosis (NCC), one of the most common parasitic infections of the central nervous system. We longitudinally assessed the cognitive status and quality of life (QoL) of patients with incident symptomatic NCC cases and matched controls.Methodology/Principal FindingsThe setting of the study was the Sabogal Hospital and Cysticercosis Unit, Department of Transmissible Diseases, National Institute of Neurological Sciences, Lima, Peru. The design was a longitudinal study of new onset NCC cases and controls. Participants included a total of 14 patients with recently diagnosed NCC along with 14 healthy neighborhood controls and 7 recently diagnosed epilepsy controls. A standardized neuropsychological battery was performed at baseline and at 6 months on NCC cases and controls. A brain MRI was performed in patients with NCC at baseline and 6 months. Neuropsychological results were compared between NCC cases and controls at both time points. At baseline, patients with NCC had lower scores on attention tasks (p<0.04) compared with epilepsy controls but no significant differences compared to healthy controls. Six months after receiving anti-parasitic treatment, the NCC group significantly improved on tasks involving psychomotor speed (p<0.02). QoL at baseline suggested impaired mental function and social function in both the NCC and epilepsy group compared with healthy controls. QoL gains in social function (p = 0.006) were noted at 6 months in patients with NCC.Conclusions/SignificanceNewly diagnosed patients with NCC in this sample had mild cognitive deficits and more marked decreases in quality of life at baseline compared with controls. Improvements were found in both cognitive status and quality of life in patients with NCC after treatment.

Cerebral Toxocariasis: Silent Progression to Neurodegenerative Disorders?

“…Substantial studies have indicated a correlation between CNS inflammation and cognitive impairment in a number of neurological diseases, e.g., Alzheimer's disease (AD), because CNS inflammation has been confirmed to be implicated in the development of amyloid neuritic plaques, one of the hallmarks of AD (179,180). The impact of T. canis infection on cognitive development in humans is sorely lacking, with very few clinical or populationbased studies having examined the relationship between neuropsychological parameters and T. canis seropositivity (18,181).…”

“…The pathogenesis of dementia is postulated to be very similar to that of cognitive dysfunction (196), indicating that CNS inflammation is implicated in this neurodegenerative disease due to the development of amyloid neuritic plaques (179,180).…”

Epilepsy and Neurocysticercosis in Sub-Saharan Africa

“…Over time (6 month-follow up) people with NCC-based epilepsy, who were all treated with albendazole, had significant improvement in psychomotor speed and working memory, but there were no significant changes in any of the cognitive test scores above, although a general trend for better performance after treatment was visible. Both epilepsy groups were controlled for seizure frequency and antiepileptic medication was kept constant during the study period [102].…”

Cost of neurocysticercosis patients treated in two referral hospitals in Mexico City, Mexico

“…In Mexico, NCC‐associated severe chronic headaches and epilepsy were recently reported to reduce the quality of life of patients with NCC under care and incur a considerable number of disability adjusted life years (DALYs) . Reduction in the quality of life of patients with NCC has also been reported in Brazil and Peru and substantial numbers of NCC‐associated DALYs have been reported from Nepal and Cameroon .…”