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

Abstract

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.

Inflammation may be correlated with Symptomatic Neurosyphilis

“…In our study, there were more males in the symptomatic NS group (54/69, 78.26%) than in the ANS group (14/35, 40%). The result was consistent with previous studies [16].…”

Clinical Manifestations, Fluid Changes and Neuroimaging Alterations in Patients with General Paresis of the Insane

“…It mostly occurred in the middle-aged population, no matter in the pre-antibiotic era 14 or in the modern era. 7 It was reported that the gender ratio of male to female in all types of neurosyphilis was about 1.53~5.1:1 4,5 and this ratio was even higher in GPI, 6,15,16 which was the same as our results. In contrast, Tong et al discovered that compared with non-neurosyphilis dementia, GPI had a higher percentage of males and younger age.…”

“…In contrast, Tong et al discovered that compared with non-neurosyphilis dementia, GPI had a higher percentage of males and younger age. 15 We suspected the reason was that syphilis patients increased most among men who had sex with men (MSM) 17 and the females might have more opportunities (such as pregnancy and abortion) to screen syphilis-related variables detected than the males, thus, they were less likely to develop symptomatic neurosyphilis due to the early diagnosis and treatment. A previous study summarized the GPI patients from 1924-1954 and discovered the low education level of the total patients (95% completed elementary school only).…”

Clinical and Laboratory Characteristics of Symptomatic and Asymptomatic Neurosyphilis in HIV-Negative Patients: A Retrospective Study of 264 Cases

“…There were more males in the SNS group (88/110, 80.0%) than in the ANS group (72/154, 46.8%). Other studies also found that the overall incidence of SNS was higher in males than in females [12, 16, 17]. We speculated the reason for gender-related differences could be that the unhealthy sexual behavior was more common among men.…”