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Hippocampal Atrophy/Sclerosis Is Associated with Old, Calcified Parenchymal Brain Neurocysticercosis, But Not with More Recent, Viable Infections

Sofía S. SánchezCenter for Global Health, Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru;

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Javier A. BustosCenter for Global Health, Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru;
Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru;

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Oscar H. Del BruttoSchool of Medicine, Universidad Espíritu Santo–Ecuador, Samborondón, Ecuador;

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Genaro HerreraCysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru;

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Antonio Carlos dos SantosCentro de Cirurgia de Epilepsia, Faculdade de Medicina, Universidade de São Paulo, Ribeirão Preto, Brazil;

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E. Javier PretellCysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru;
Department of Neurology, Hospital Alberto Sabogal, Callao, Peru

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Isidro GonzalesCysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru;

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Herbert SaavedraCysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru;

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Héctor H. GarciaCenter for Global Health, Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru;
Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru;

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for the Cysticercosis Working Group in Peru
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ABSTRACT.

Magnetic resonance images from 197 patients with calcified neurocysticercosis (NCC), 38 with viable NCC and 197 NCC-free healthy rural villagers were evaluated to compare the frequency of hippocampal atrophy/sclerosis (HAS) across these populations. Scheltens’ medial temporal atrophy scale was used for hippocampal rating. The median age of the 432 study participants was 46 years (interquartile range, 29–62 years), and 58% were women. Hippocampal atrophy/sclerosis was disclosed in 26.9% patients with calcified NCC, compared with 7.9% in patients with viable NCC and 8.1% in healthy rural villagers. After adjusting for age, gender, and history of epilepsy, hippocampal atrophy/sclerosis was more frequent in patients with calcified NCC than in those with viable cysts (RR, 3.60; 95% CI, 1.18– 0.99; P = 0.025) and healthy rural villagers (RR, 3.43; 95% CI, 1.94–6.06; P < 0.001), suggesting that hippocampal damage develops late in the course of this parasitic disease.

Author Notes

Address correspondence to Oscar H. Del Brutto, Urbanización Toscana, Apt 3H, Km 4.5 vía Puntilla-Samborondón, 092301, Samborondón, Ecuador. E-mail: oscardelbrutto@hotmail.com

Financial support: This work was supported in part by the Fogarty International Center/National Institutes of Health Training grant TW001140 and by the Universidad Espíritu Santo, Ecuador.

Authors’ addresses: Sofía S. Sánchez, Center for Global Health, Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru, E-mail: sofia.sanchez@upch.pe. Javier A. Bustos and Héctor H. Garcia, Center for Global Health, Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru, and Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru, E-mails: jbustos@jhsph.edu and hgarcia@jhsph.edu. Oscar H. Del Brutto, School of Medicine, Universidad Espíritu Santo–Ecuador, Samborondón, Ecuador, E-mail: oscardelbrutto@hotmail.com. Genaro Herrera, Isidro Gonzales, and Herbert Saavedra, Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru, E-mails: genaroherrerag@gmail.com, isidrogonzalesq@hotmail.com, and herbertsaavedrap@yahoo.com. Antonio Carlos dos Santos, Centro de Cirurgia de Epilepsia, Faculdade de Medicina, Universidade de São Paulo, Ribeirão Preto, Brazil, E-mail: acsantos@fmrp.usp.br. E. Javier Pretell, Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru, and Department of Neurology, Hospital Alberto Sabogal, Callao, Peru, E-mail: jpretell@hotmail.com.

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