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脑囊虫钙化与认知功能的关系:一项基于人群队列的巢式病例对照研究。

The Association between Calcified Neurocysticercosis and Cognitive Performance: A Case-Control Study Nested to a Population-Based Cohort.

机构信息

School of Medicine, Universidad Espíritu Santo-Ecuador, Guayaquil, Ecuador.

Department of Epidemiology, Gilead Sciences, Inc., Foster City, California.

出版信息

Am J Trop Med Hyg. 2019 Feb;100(2):323-326. doi: 10.4269/ajtmh.18-0611.

Abstract

Mechanisms implicated in the association between neurocysticercosis (NCC) and cognitive impairment remain unknown. Atahualpa residents aged ≥ 40 years with calcified NCC were identified as case patients and paired 1:1 to age- and gender-matched controls. The selection process generated 79 pairs. Cognitive performance was measured by the Montreal Cognitive Assessment (MoCA). A conditional logistic regression model revealed no differences in MoCA scores across case patients and controls, after adjusting for education, epilepsy, depression, and hippocampal atrophy. The single covariate remaining significant was hippocampal atrophy. When participants were stratified according to this covariate, linear models showed lower MoCA scores among case patients (but not controls) with hippocampal atrophy. In a fully adjusted linear regression model, age remained as the single covariate explaining cognitive impairment among NCC patients. This study demonstrates an association between hippocampal atrophy and poor cognitive performance among patients with calcified NCC, most likely attributable to the effect of age.

摘要

神经囊尾蚴病(NCC)与认知障碍之间关联的机制尚不清楚。在阿塔瓦尔帕,年龄≥40 岁且有钙化性 NCC 的居民被确定为病例患者,并按年龄和性别与 1:1 配对的对照组。该选择过程产生了 79 对。认知功能通过蒙特利尔认知评估(MoCA)进行测量。在调整了教育、癫痫、抑郁和海马萎缩等因素后,条件逻辑回归模型显示病例患者和对照组的 MoCA 评分没有差异。唯一显著的单一协变量是海马萎缩。当根据该协变量对参与者进行分层时,线性模型显示海马萎缩的病例患者(而非对照组)的 MoCA 评分较低。在完全调整的线性回归模型中,年龄仍然是唯一能解释 NCC 患者认知障碍的协变量。这项研究表明,在有钙化性 NCC 的患者中,海马萎缩与认知功能下降之间存在关联,这很可能归因于年龄的影响。

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