Del Brutto Oscar H, Issa Naoum P, Salgado Perla, Del Brutto Victor J, Zambrano Mauricio, Lama Julio, García Héctor H
School of Medicine, Universidad Espíritu Santo-Ecuador, Guayaquil, Ecuador.
Department of Neurological Sciences, Hospital-Clínica Kennedy, Guayaquil, Ecuador.
Am J Trop Med Hyg. 2017 Jan 11;96(1):243-248. doi: 10.4269/ajtmh.16-0689. Epub 2016 Nov 14.
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.
神经囊尾蚴病（NCC）与海马萎缩有关，但其在这种关系中的患病率及致病机制尚不清楚。采用基于人群的病例对照研究设计，将一个乡村（阿塔瓦尔帕）年龄≥40岁且有钙化NCC的居民确定为病例，并与按年龄、性别和教育水平匹配的无NCC个体（对照对象）配对。病例和对照对象均接受磁共振成像检查，根据内侧颞叶萎缩的谢尔滕斯量表对海马进行评分，并接受访谈以确定患有临床癫痫障碍的患者。通过使用麦克尼马尔相关比例检验比较病例和对照对象中海马萎缩的患病率。分析纳入了75例有钙化NCC的个体及其匹配的对照对象。26例（34.7%）病例和9例（12%）对照对象存在海马萎缩（优势比：4.4；95%置信区间：1.6 - 14.9，P < 0.0021）。根据年龄三分位数对配对进行分层显示，这种关联存在与年龄相关的趋势，仅在年龄≥68岁的人群中具有显著性（P = 0.027）。只有5例病例和1例对照有癫痫复发（P = 0.221）；这5例病例中有3例存在海马萎缩，而唯一的对照对象海马正常。本研究证实了NCC与海马萎缩之间的关联，并表明这种关联在老年人群中更强。这表明NCC相关的海马萎缩需要很长时间才能发展形成。
