title: Spectrum of cognitive impairment in neurocysticercosis: differences according to disease phase.
abstract: OBJECTIVE
  Cognitive decline related to neurocysticercosis (NC) remains poorly characterized and underdiagnosed. In a cross-sectional study with a prospective phase, we evaluated cognitive decline in patients with strictly calcified form (C-NC), the epidemiologically largest subgroup of NC, and investigated whether there is a spectrum of cognitive abnormalities in the disease.
  
  
  METHODS
  Forty treatment-naive patients with C-NC aged 37.6 ± 11.3 years and fulfilling criteria for definitive C-NC were submitted to a comprehensive cognitive and functional evaluation and were compared with 40 patients with active NC (A-NC) and 40 healthy controls (HC) matched for age and education. Patients with dementia were reassessed after 24 months.
  
  
  RESULTS
  Patients with C-NC presented 9.4 ± 3.1 altered test scores out of the 30 from the cognitive battery when compared to HC. No patient with C-NC had dementia and 10 patients (25%) presented cognitive impairment-no dementia (CIND). The A-NC group had 5 patients (12.5%) with dementia and 11 patients (27.5%) with CIND. On follow-up, 3 out of 5 patients with A-NC with dementia previously still presented cystic lesions with scolex on MRI and still had dementia. One patient died and the remaining patient no longer fulfilled criteria for either dementia or CIND, presenting exclusively calcified lesions on neuroimaging.
  
  
  CONCLUSIONS
  Independently of its phase, NC leads to a spectrum of cognitive abnormalities, ranging from impairment in a single domain, to CIND and, occasionally, to dementia. These findings are more conspicuous during active vesicular phase and less prominent in calcified stages.
authors.affiliation: Departamento de Neurologia, Universidade de São Paulo, Brazil.
authors.forename: C L
authors.initials: CL
authors.lastname: Rodrigues
authors.forename: D C
authors.initials: DC
authors.lastname: de Andrade
authors.forename: J A
authors.initials: JA
authors.lastname: Livramento
authors.forename: L R
authors.initials: LR
authors.lastname: Machado
authors.forename: R
authors.initials: R
authors.lastname: Abraham
authors.forename: L
authors.initials: L
authors.lastname: Massaroppe
authors.forename: L T
authors.initials: LT
authors.lastname: Lucato
authors.forename: P
authors.initials: P
authors.lastname: Caramelli
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002114:Calcinosis / Q000209:etiology / Q000523:psychology; D003072:Cognition Disorders / Q000209:etiology* / Q000523:psychology*; D003704:Dementia / Q000150:complications / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D018450:Disease Progression; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020019:Neurocysticercosis / Q000150:complications* / Q000473:pathology / Q000523:psychology*; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D012640:Seizures / Q000150:complications; D014057:Tomography, X-Ray Computed; D055815:Young Adult