title: Calcified neurocysticercosis associates with hippocampal atrophy: a population-based study.
abstract: Calcified neurocysticercosis has been associated with hippocampal atrophy in patients with refractory epilepsy, but the relevance of this association in the population at large is unknown. We assessed calcified cysticerci and its association with hippocampal atrophy in elderly persons living in Atahualpa, an Ecuadorian village endemic for neurocysticercosis. All Atahualpa residents ≥ 60 years of age were invited to undergo computed tomography/magnetic resonance imaging for neurocysticercosis detection. Twenty-eight (11%) out of 248 enrolled persons had calcified cysticerci (case-patients) and were matched 1:1 by age, sex, and years of education to individuals without neurocysticercosis on computed tomography/magnetic resonance imaging (controls). Four case-patients and none of the controls had epilepsy (P = 0.134). Cognitive performance was similar across both groups. The Scheltens' medial temporal atrophy scale was used for hippocampal rating in case-patients and matched controls without neurocysticercosis. Mean score in the Scheltens' scale was higher in case-patients than in controls (P < 0.001). Atrophic hippocampi were noticed in 19 case-patients and five controls (P = 0.003). Atrophy was bilateral in 11 case-patients and unilateral in eight. All case-patients with unilateral hippocampal atrophy had at least one ipsilateral calcification. This study shows an association between calcified cysticerci and hippocampal atrophy and raises the possibility of an inflammation-mediated hippocampal damage as the responsible mechanism for these findings.
authors.affiliation: School of Medicine, Universidad Espíritu Santo - Ecuador, Guayaquil, Ecuador; Department of Neurological Sciences, Hospital-Clínica Kennedy, Guayaquil, Ecuador; Neuroimaging Unit, National Institute of Neurology and Neurosurgery Manuel Velasco Suarez, Mexico City, Mexico; Imaging Department, Hospital-Clínica Kennedy, Guayaquil, Ecuador; Community Center of the Atahualpa Project, Atahualpa, Ecuador; Outpatient Center North, Ecuadorian Institute of Social Security, Guayaquil, Ecuador; Center for Global Health, Tumbes and the Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Lima, Perú; Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Perú oscardelbrutto@hotmail.com.
authors.forename: Oscar H
authors.initials: OH
authors.lastname: Del Brutto
authors.affiliation: School of Medicine, Universidad Espíritu Santo - Ecuador, Guayaquil, Ecuador; Department of Neurological Sciences, Hospital-Clínica Kennedy, Guayaquil, Ecuador; Neuroimaging Unit, National Institute of Neurology and Neurosurgery Manuel Velasco Suarez, Mexico City, Mexico; Imaging Department, Hospital-Clínica Kennedy, Guayaquil, Ecuador; Community Center of the Atahualpa Project, Atahualpa, Ecuador; Outpatient Center North, Ecuadorian Institute of Social Security, Guayaquil, Ecuador; Center for Global Health, Tumbes and the Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Lima, Perú; Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Perú
authors.forename: Perla
authors.initials: P
authors.lastname: Salgado
authors.affiliation: School of Medicine, Universidad Espíritu Santo - Ecuador, Guayaquil, Ecuador; Department of Neurological Sciences, Hospital-Clínica Kennedy, Guayaquil, Ecuador; Neuroimaging Unit, National Institute of Neurology and Neurosurgery Manuel Velasco Suarez, Mexico City, Mexico; Imaging Department, Hospital-Clínica Kennedy, Guayaquil, Ecuador; Community Center of the Atahualpa Project, Atahualpa, Ecuador; Outpatient Center North, Ecuadorian Institute of Social Security, Guayaquil, Ecuador; Center for Global Health, Tumbes and the Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Lima, Perú; Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Perú
authors.forename: Julio
authors.initials: J
authors.lastname: Lama
authors.affiliation: School of Medicine, Universidad Espíritu Santo - Ecuador, Guayaquil, Ecuador; Department of Neurological Sciences, Hospital-Clínica Kennedy, Guayaquil, Ecuador; Neuroimaging Unit, National Institute of Neurology and Neurosurgery Manuel Velasco Suarez, Mexico City, Mexico; Imaging Department, Hospital-Clínica Kennedy, Guayaquil, Ecuador; Community Center of the Atahualpa Project, Atahualpa, Ecuador; Outpatient Center North, Ecuadorian Institute of Social Security, Guayaquil, Ecuador; Center for Global Health, Tumbes and the Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Lima, Perú; Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Perú
authors.forename: Victor J
authors.initials: VJ
authors.lastname: Del Brutto
authors.affiliation: School of Medicine, Universidad Espíritu Santo - Ecuador, Guayaquil, Ecuador; Department of Neurological Sciences, Hospital-Clínica Kennedy, Guayaquil, Ecuador; Neuroimaging Unit, National Institute of Neurology and Neurosurgery Manuel Velasco Suarez, Mexico City, Mexico; Imaging Department, Hospital-Clínica Kennedy, Guayaquil, Ecuador; Community Center of the Atahualpa Project, Atahualpa, Ecuador; Outpatient Center North, Ecuadorian Institute of Social Security, Guayaquil, Ecuador; Center for Global Health, Tumbes and the Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Lima, Perú; Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Perú
authors.forename: Xavier
authors.initials: X
authors.lastname: Campos
authors.affiliation: School of Medicine, Universidad Espíritu Santo - Ecuador, Guayaquil, Ecuador; Department of Neurological Sciences, Hospital-Clínica Kennedy, Guayaquil, Ecuador; Neuroimaging Unit, National Institute of Neurology and Neurosurgery Manuel Velasco Suarez, Mexico City, Mexico; Imaging Department, Hospital-Clínica Kennedy, Guayaquil, Ecuador; Community Center of the Atahualpa Project, Atahualpa, Ecuador; Outpatient Center North, Ecuadorian Institute of Social Security, Guayaquil, Ecuador; Center for Global Health, Tumbes and the Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Lima, Perú; Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Perú
authors.forename: Mauricio
authors.initials: M
authors.lastname: Zambrano
authors.affiliation: School of Medicine, Universidad Espíritu Santo - Ecuador, Guayaquil, Ecuador; Department of Neurological Sciences, Hospital-Clínica Kennedy, Guayaquil, Ecuador; Neuroimaging Unit, National Institute of Neurology and Neurosurgery Manuel Velasco Suarez, Mexico City, Mexico; Imaging Department, Hospital-Clínica Kennedy, Guayaquil, Ecuador; Community Center of the Atahualpa Project, Atahualpa, Ecuador; Outpatient Center North, Ecuadorian Institute of Social Security, Guayaquil, Ecuador; Center for Global Health, Tumbes and the Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Lima, Perú; Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Perú
authors.forename: Héctor H
authors.initials: HH
authors.lastname: García
mesh_terms: D000368:Aged; D001284:Atrophy; D002114:Calcinosis; D004484:Ecuador / Q000453:epidemiology; D005260:Female; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D020019:Neurocysticercosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology*; D014057:Tomography, X-Ray Computed