Clinical and laboratory characteristics in patients suffering from general paresis in the modern era

Chen, Yu‐Yan; Zhang, Yafeng; Qiu, Xin-Hui; Zhang, Qiao; Chen, Fuyi; Liu, Long; Fan, Jin-Yi; Gao, Kun; Zhu, Xiao-Zhen; Zheng, Weihong; Zhang, Huilin; Lin, Li‐Rong; Liu, Lili; Tong, Man‐Li; Niu, Jianjun

doi:10.1016/j.jns.2015.02.021

Cited by 15 publications

(32 citation statements)

References 29 publications

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“…The variable, atypical manifestations of GP not only lead to a high rate of misdiagnosis but also result in inappropriate therapeutic decisions. We have previously reported that the misdiagnosis rate of GP is approximately 63.53% [5]. Moreover, neuroimaging of the brains of patients with NS generally does not demonstrate very specific changes and does not suggest a diagnosis of GP [13].…”

Section: Discussionmentioning

confidence: 95%

“…The diagnostic and exclusion criteria for NS were described in our previous studies [8,9]. The diagnosis of GP was based on clinical evaluations, serological tests, and cerebrospinal fluid (CSF) examinations, as in our previous study [5]. The diagnosis of dementia was based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders [10] and required evidence of cognitive deficits on the neuropsychological test battery as well as evidence of impairment in social or occupational functioning [11,12].…”

Section: Diagnostic Criteriamentioning

confidence: 99%

“…Patients with GP and non-NS dementia show no differences with regard to their CT or MRI findings [3,4]. The rate of clinical misdiagnosis of syphilitic dementia is approximately 63.53% [5]. Recognition of the differences between GP and non-NS dementia is important for clinical diagnosis and effective treatment.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Clinical and Laboratory Characteristics of General Paresis and Non-Neurosyphilis Dementia

et al. 2018

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Background: The differential diagnosis of general paresis (GP) and non-neurosyphilis (NS) dementia is not clearly defined. The present study examined the differences in clinical and laboratory features of GP and non-NS dementia. Materials and Methods: We retrospectively examined clinical and laboratory features of 85 GP patients and 196 non-NS dementia patients. Data were collected from Zhongshan Hospital between June 2005 and June 2014. Results: The GP group had a higher percentage of males (83.53%, 71/85) and younger median age ([52 [interquartile range 47.0–61.0] vs. 76 [68.3–82.0] years) than the non-NS dementia group. GP have higher Mini-Mental State Examination (MMSE; Z = –5.809; p = 0.000) than non-NS dementia. Distribution of CDR scores were significantly higher in the non-NS group than GP group (χ² = 29.153; p = 0.000). The laboratory findings showed signiﬁcantly different total cholesterol (CH), low-density lipoprotein CH and homocysteine levels between the 2 groups. Serologic testing for syphilis revealed that the GP group had higher seropositive rapid plasma reagin (RPR) and Treponema pallidum particle agglutination (TPPA) rates than the non-NS dementia group (96.47% [82/85] vs. 0.51% [1/196], Z = –2.663, p = 0.008; 100% [85/85] vs. 1.02% [2/196], Z = –2.663, p = 0.008). Interestingly, cerebrospinal fluid (CSF) biochemical indices, including pleocytosis rates, increased protein levels, and positive RPR and TPPA rates in the GP group were higher than that in the non-NS dementia group. Conclusions: Based on these preliminary data, patients with clinically evident symptoms of dementia, especially middle-aged males, should undergo blood tests for syphilis. All patients with positive serology results should undergo CSF examinations to diagnose GP dementia before further pharmaceutical and behavioral interventions.

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Section: Discussionmentioning

confidence: 95%

Section: Diagnostic Criteriamentioning

confidence: 99%

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Comparison of Clinical and Laboratory Characteristics of General Paresis and Non-Neurosyphilis Dementia

et al. 2018

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“…The GP is a clinical type of neurosyphilis (NS) resulting from invasion of the central nervous system by Treponema pallidum (Ghanem, ). The clinical manifestations of GP are characterized by various psychiatric symptoms and progressive cognitive declines (Chen et al, ; Costiniuk & MacPherson, ; Jantzen et al, ; Rao et al, ; Wang et al, ; Wang et al, ; Zheng, Webster, et al, ). After treatment with penicillin, a resolution of clinical abnormalities has been found among both NS patients and GP patients (Hahn et al, ; Moulton & Koychev, ; Wilner & Brody, ).…”

Section: Introductionmentioning

confidence: 99%

Medial temporal lobe atrophy as a predictor of poor cognitive outcomes in general paresis

Chen

Shi

Hou

et al. 2017

Early Intervention Psych

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“…Approximately 40% of these patients suffer from dementia (neurosyphilis-dementia), which is often named as general paresis of insane [2]. The most frequent clinical symptoms of patients with neurosyphilis-dementia include emotional problems, personality changes, delusions, hallucinations, and abnormal behaviors [3]. …”

Section: Introductionmentioning

confidence: 99%

Neuropsychiatric Features of Neurosyphilis: Frequency, Relationship with the Severity of Cognitive Impairment and Comparison with Alzheimer Disease

Zhong

Shi

Hou

et al. 2017

Dement Geriatr Cogn Disord

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Background: The pattern of neuropsychiatric features of patients with neurosyphilis and the impact of the severity of cognitive impairment on neuropsychiatric syndromes are unknown. Objective: We aim to assess the neuropsychiatric features of patients with neurosyphilis, and compare the impact of the severity of cognitive impairment on the neuropsychiatric syndromes between neurosyphilis and Alzheimer disease (AD). Methods: Neuropsychiatric symptoms and the degree of cognitive impairment were assessed in a case-control study of 91 neurosyphilis, 162 AD, 157 mild cognitive impairment, and 139 normal controls by the Neuropsychiatric Inventory (NPI) scale and Clinical Dementia Rating scale, respectively. Factor analysis was performed on the 12 NPI items. Results: Factor analysis showed that patients with neurosyphilis showed more severe neuropsychiatric syndromes at the dementia stage than those neurosyphilis patients at the mild cognitive impairment stage, while neuropsychiatric manifestations were equally common among the different stages of dementia (all p < 0.05). Frontal lobe syndrome was more severe in patients with neurosyphilis than in patients with AD from the early mild cognitive impairment stage to the moderate dementia stage (all p < 0.01). Conclusions: Patients with neurosyphilis show different patterns of neuropsychiatric syndromes at the mild cognitive impairment and dementia stages, and differ from patients with AD.

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Clinical and laboratory characteristics in patients suffering from general paresis in the modern era

Cited by 15 publications

References 29 publications

Comparison of Clinical and Laboratory Characteristics of General Paresis and Non-Neurosyphilis Dementia

Comparison of Clinical and Laboratory Characteristics of General Paresis and Non-Neurosyphilis Dementia

Medial temporal lobe atrophy as a predictor of poor cognitive outcomes in general paresis

Neuropsychiatric Features of Neurosyphilis: Frequency, Relationship with the Severity of Cognitive Impairment and Comparison with Alzheimer Disease

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