Cognitive Dysfunction and its Determinants in Patients with Neurocysticercosis.
BACKGROUND
Neurocysticercosis (NCC) is the most common parasitic infection of man. In addition to a headache, seizures, and focal deficits, this is associated with significant cognitive dysfunction. Many studies revealed that the number and location of lesions are not always responsible for cognitive dysfunction. Cholinesterase and pseudocholinesterase are found in the walls of the cysticercus which could contribute to cholinergic depletion and thus cognitive dysfunction.


METHODS
A total of 43 patients who presented with NCC were evaluated for cognitive deficits, as well as cholinesterase levels in cerebrospinal fluid (CSF) with control CSF from patients undergoing spinal anesthesia. Blood levels of interleukin-10 and tumor necrosis factor alpha were also estimated and correlated with cognitive deficits.


RESULTS
There is a mild increase in the acetylcholinesterase in CSF of patients compared to controls, but it did not correlate with cognitive deficits. There is an increase in interleukins to a significant level which correlates with vesicular stage of the organism and cognitive impairment. The number of lesions also correlated with cognitive impairment even though the location did not. The domains of cognitive deficits seen are sustained attention, category fluency, verbal working memory, planning, set shifting, verbal learning, visual memory, and construction.


CONCLUSIONS
NCC is associated with multi-domain cognitive impairment correlates with vescicular stage, proinflammatory cytokines and number of lesions but not location, vesicular stage, and proinflammatory cytokines.
Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
Vinod
V
Varghese
Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
Sadanandavalli Retnaswami
SR
Chandra
Department of Neurochemistry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
Rita
R
Christopher
Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
Jamuna
J
Rajeswaran
Department of NIIR, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
Chandrajit
C
Prasad
Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
R
R
Subasree
Department of Clinical Neurosciences, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
Thomas Gregor
TG
Issac
Cholinesterase levels; cognitive dysfunction; neurocysticercosis