title: The Association Between Neurocysticercosis and Hippocampal Atrophy is Related to Age.
abstract: Neurocysticercosis (NCC) has been associated with hippocampal atrophy, but the prevalence and pathogenic mechanisms implicated in this relationship are unknown. Using a population-based, case-control study design, residents in a rural village (Atahualpa) aged ≥ 40 years with calcified NCC were identified as cases and paired to NCC-free individuals (control subjects) matched by age, sex, and level of education. Cases and control subjects underwent magnetic resonance imaging for hippocampal rating according to the Scheltens' scale for medial temporal atrophy and were interviewed to identify those with a clinical seizure disorder. The prevalence of hippocampal atrophy was compared between cases and control subjects by the use of the McNemar's test for correlated proportions. Seventy-five individuals with calcified NCC and their matched control subjects were included in the analysis. Hippocampal atrophy was noted in 26 (34.7%) cases and nine (12%) control subjects (odds ratio: 4.4; 95% confidence interval: 1.6-14.9, P < 0.0021). Stratification of pairs according to tertiles of age revealed an age-related trend in this association, which became significant only in those aged ≥ 68 years (P = 0.027). Only five cases and one control had recurrent seizures (P = 0.221); three of these five cases had hippocampal atrophy, and the single control subject had normal hippocampi. This study confirms an association between NCC and hippocampal atrophy, and shows that this association is stronger in older age groups. This suggests that NCC-related hippocampal atrophy takes a long time to develop.
authors.affiliation: School of Medicine, Universidad Espíritu Santo-Ecuador, Guayaquil, Ecuador. oscardelbrutto@hotmail.com.|Department of Neurological Sciences, Hospital-Clínica Kennedy, Guayaquil, Ecuador.
authors.forename: Oscar H
authors.initials: OH
authors.lastname: Del Brutto
authors.affiliation: Department of Neurology, University of Chicago, Chicago, Illinois.
authors.forename: Naoum P
authors.initials: NP
authors.lastname: Issa
authors.affiliation: Neuroimaging Unit, National Institute of Neurology and Neurosurgery Manuel Velasco Suarez, Mexico City, Mexico.
authors.forename: Perla
authors.initials: P
authors.lastname: Salgado
authors.affiliation: Department of Neurology, University of Chicago, Chicago, Illinois.
authors.forename: Victor J
authors.initials: VJ
authors.lastname: Del Brutto
authors.affiliation: Atahualpa Project, Community Center, Atahualpa, Ecuador.
authors.forename: Mauricio
authors.initials: M
authors.lastname: Zambrano
authors.affiliation: Imaging Department, Hospital-Clínica Kennedy, Guayaquil, Ecuador.
authors.forename: Julio
authors.initials: J
authors.lastname: Lama
authors.affiliation: Center for Global Health, Tumbes, Perú.|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: D000328:Adult; D000368:Aged; D000375:Aging; D001284:Atrophy / Q000469:parasitology* / Q000473:pathology; D016022:Case-Control Studies; D005260:Female; D006624:Hippocampus / Q000469:parasitology* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020019:Neurocysticercosis / Q000469:parasitology* / Q000473:pathology; D016017:Odds Ratio; D012307:Risk Factors; D012424:Rural Population