The Association between Calcified Neurocysticercosis and Cognitive Performance: A Case–Control Study Nested to a Population-Based Cohort

Oscar H. Del Brutto School of Medicine, Universidad Espíritu Santo—Ecuador, Guayaquil, Ecuador;

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Robertino M. Mera Department of Epidemiology, Gilead Sciences, Inc., Foster City, California;

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Mauricio Zambrano Community Center, The Atahualpa Project, Atahualpa, Ecuador;

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Aldo F. Costa School of Medicine, Universidad Espíritu Santo—Ecuador, Guayaquil, Ecuador;

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Gustavo C. Román Department of Neurology, Houston Methodist Hospital, Houston, Texas

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Mechanisms implicated in the association between neurocysticercosis (NCC) and cognitive impairment remain unknown. Atahualpa residents aged ≥ 40 years with calcified NCC were identified as case patients and paired 1:1 to age- and gender-matched controls. The selection process generated 79 pairs. Cognitive performance was measured by the Montreal Cognitive Assessment (MoCA). A conditional logistic regression model revealed no differences in MoCA scores across case patients and controls, after adjusting for education, epilepsy, depression, and hippocampal atrophy. The single covariate remaining significant was hippocampal atrophy. When participants were stratified according to this covariate, linear models showed lower MoCA scores among case patients (but not controls) with hippocampal atrophy. In a fully adjusted linear regression model, age remained as the single covariate explaining cognitive impairment among NCC patients. This study demonstrates an association between hippocampal atrophy and poor cognitive performance among patients with calcified NCC, most likely attributable to the effect of age.

Author Notes

Address correspondence to Oscar H. Del Brutto, Air Center 3542, P.O. Box 522970, Miami, FL 33152-2970. E-mail: oscardelbrutto@hotmail.com

Financial support: The study was partly supported by Universidad Espíritu Santo–Ecuador, Guayaquil–Ecuador. Dr. Román Research is supported by the Jack S. Blanton Presidential Distinguished Chair, the Fondren Fund, and the Wareing Family Fund at Houston Methodist Hospital.

Authors’ addresses: Oscar H. Del Brutto and Aldo F. Costa, School of Medicine, Universidad Espíritu Santo—Ecuador, Guayaquil, Ecuador, E-mails: oscardelbrutto@hotmail.com and aldocosva_01@hotmail.com. Robertino M. Mera, Department of Epidemiology, Gilead Sciences, Inc., Foster City, CA, E-mail: rmm17189@gmail.com. Mauricio Zambrano, Community Center of the Atahualpa Project, Atahualpa, Ecuador, E-mail: zamaleon@hotmail.com. Gustavo C. Román, Department of Neurology, Houston Methodist Hospital, Houston, TX, E-mail: gcroman@houstonmethodist.org.

  • 1.

    Forlenza CV, Filho AH, Nobrega JP, dos Ramos Machado L, de Barros NG, Camargo CH, da Silva MF, 1997. Psychiatric manifestations of neurocysticercosis: a study of 38 patients from a neurology clinic in Brazil. J Neurol Neurosurg Psychiatry 62: 612616.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Levav M, Mirsky AF, Cruz ME, Cruz I, 1995. Neurocysticercosis and performance on neuropsychologic tests: a family study in Ecuador. Am J Trop Med Hyg 53: 552557.

  • 3.

    Boppré MC et al. 2001. Cognitive performance of patients with epilepsy and calcified neurocysticercotic lesions: a case-control study. Epilepsy Behav 2: 558562.

  • 4.

    Campi de Andrade D, Rodrigues CL, Abraham R, Castro LH, Livramento JA, Machado LR, Leite CC, Caramelli P, 2010. Cognitive impairment and dementia in neurocysticercosis: a cross-sectional controlled study. Neurology 74: 12881295.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Wallin MT, Pretell EJ, Bustos JA, Caballero M, Alfaro M, Kane R, Wilken J, Sullivan C, Fratto T, Garcia HH, 2012. Cognitive changes and quality of life in neurocysticercosis: a longitudinal study. PLoS Negl Trop Dis 6: e1493.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Rodrigues CL, de Andrade DC, Livramento JA, Machado LR, Abraham R, Massaroppe L, Lucato LT, Caramelli P, 2012. Spectrum of cognitive impairment in neurocysticercosis: differences according to disease phase. Neurology 78: 861866.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Srivastava S, Chadda RK, Bala K, Majumdar P, 2013. A study of neuropsychiatric manifestations in patients of neurocysticercosis. Indian J Psychiatry 55: 264267.

  • 8.

    Ramirez-Bermudez J, Higuera-Calleja J, Espinola-Nadurille M, Corona T, 2017. Neuropsychiatric disorders in patients with neurocysticercosis. Asia Pac Psychiatry 9: e12250.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Nau AL et al. 2018. Cognitive impairment and quality of life of people with epilepsy and neurocysticercosis in Zambia. Epilepsy Behav 80: 354359.

  • 10.

    Terra-Bustamante VC et al. 2005. Cognitive performance of patients with mesial temporal lobe epilepsy and incidental calcified neurocysticercosis. J Neurol Neurosurg Psychiatry 76: 10801083.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Del Brutto OH, Engel J Jr., Eliashiv DS, Garcia HH, 2016. Update on cysticercosis epileptogenesis: the role of the hippocampus. Curr Neurol Neurosci Rep 16: 1.

  • 12.

    Del Brutto OH, Issa NP, Salgado P, Del Brutto VJ, Zambrano M, Lama J, Garcia HH, 2017. The association between neurocysticercosis and hippocampal atrophy is related to age. Am J Trop Med Hyg 96: 234238.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Del Brutto OH, Arroyo G, Del Brutto VJ, Zambrano M, Garcia HH, 2017. On the relationship between calcified neurocysticercosis and epilepsy in an endemic village: a large-scale, computed tomography-based population study in rural Ecuador. Epilepsia 58: 19551961.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Del Brutto OH, O’Neal SE, Dorny P, Garcia HH, 2018. Spontaneously arrested transmission of cysticercosis in a highly endemic village with a very low migration rate. Am J Trop Med Hyg 98: 776778.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Del Brutto OH, Salgado P, Lama J, Del Brutto VJ, Campos X, Zambrano M, Garcia HH, 2015. Calcified neurocysticercosis associates with hippocampal atrophy: a population-based study. Am J Trop Med Hyg 91: 6468.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Del Brutto OH, Nash TE, White AC Jr., Rajshekhar V, Wilkins PP, Singh G, Vasquez CM, Salgado P, Gilman RH, Garcia HH, 2017. Revised diagnostic criteria for neurocysticercosis. J Neurol Sci 372: 202210.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Scheltens PH, Leys D, Barkhof F, Huglo D, Weinstein HC, Vermersch P, Kuiper M, Steinling M, Wolters EC, Walk J, 1992. Atrophy of medial temporal lobes on MRI in “probable” Alzheimer’s disease and normal ageing: diagnostic value and neuropsychological correlates. J Neurol Neurosurg Psychiatry 55: 967972.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, Cummings JL, Chertkow H, 2005. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 53: 695699.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Del Brutto OH, Mera RM, Del Brutto VJ, Sedler MJ, 2016. The bicaudate index inversely associates with performance in the Montreal Cognitive Assessment (MoCA) in older adults living in rural Ecuador. The Atahualpa project. Int J Geriatr Psychiatry 31: 944950.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Boutet C, Chupin M, Colliot O, Sarazin M, Mutlu G, Drier A, Pellot A, Dormont D, Lehércy S; Alzheimer’s Disease Neuroimaging Initiative, 2012. Is radiological evaluation as good as computer-based volumetry to assess hippocampal atrophy in Alzheimer’s disease? Neuroradiology 54: 13211330.

    • PubMed
    • Search Google Scholar
    • Export Citation
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