title: Validity of a PCR assay in CSF for the diagnosis of neurocysticercosis.
abstract: OBJECTIVE
  To prospectively evaluate the validity of a PCR assay in CSF for the diagnosis of neurocysticercosis (NC).
  
  
  METHODS
  We conducted a multicenter, prospective case-control study, recruiting participants from 5 hospitals in Cuenca, Ecuador, from January 2015 to February 2016. Cases fulfilled validated diagnostic criteria for NC. For each case, a neurosurgical patient who did not fulfill the diagnostic criteria for NC was selected as a control. CT and MRI, as well as a CSF sample, were collected from both cases and controls. The diagnostic criteria to identify cases were used as a reference standard.
  
  
  RESULTS
  Overall, 36 case and 36 control participants were enrolled. PCR had a sensitivity of 72.2% (95% confidence interval [CI] 54.8%-85.8%) and a specificity of 100.0% (95% CI 90.3%-100.0%). For parenchymal NC, PCR had a sensitivity of 42.9% (95% CI 17.7%-71.1%), and for extraparenchymal NC, PCR had a sensitivity of 90.9% (95% CI 70.8%-98.9%).
  
  
  CONCLUSIONS
  This study demonstrated the usefulness of this PCR assay in CSF for the diagnosis of NC. PCR may be particularly helpful for diagnosing extraparenchymal NC when neuroimaging techniques have failed.
  
  
  METHODS
  This study provides Class III evidence that CSF PCR can accurately identify patients with extraparenchymal NC.
authors.affiliation: Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador.
authors.forename: Arturo
authors.initials: A
authors.lastname: Carpio
authors.affiliation: Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Campoverde
authors.affiliation: Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador.
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Romo
authors.affiliation: Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador.
authors.forename: Lorena
authors.initials: L
authors.lastname: García
authors.affiliation: Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador.
authors.forename: Luis M
authors.initials: LM
authors.lastname: Piedra
authors.affiliation: Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador.
authors.forename: Mónica
authors.initials: M
authors.lastname: Pacurucu
authors.affiliation: Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador.
authors.forename: Nelson
authors.initials: N
authors.lastname: López
authors.affiliation: Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador.
authors.forename: Jenner
authors.initials: J
authors.lastname: Aguilar
authors.affiliation: Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador.
authors.forename: Sebastian
authors.initials: S
authors.lastname: López
authors.affiliation: Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador.
authors.forename: Luis C
authors.initials: LC
authors.lastname: Vintimilla
authors.affiliation: Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador.
authors.forename: Ana M
authors.initials: AM
authors.lastname: Toral
authors.affiliation: Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador.
authors.forename: Pablo
authors.initials: P
authors.lastname: Peña-Tapia