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

Chen, Ben; Shi, Haishan; Hou, Lei; Zhong, Xiaomei; Wang, Yanhua; Wu, Zhi‐Ying; Qi, Peng; Zheng, Dong; Zhang, Yuefen; Tan, Yan; Fang, Ziyan; Chen, Xinru; Luo, Xiaodong; Liu, Sha; Ning, Yuping

doi:10.1111/eip.12441

Cited by 14 publications

(10 citation statements)

References 34 publications

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“…Meanwhile, it was reported that frontal-parietal areas, including the right precuneus, right angular gyrus, left paracentral lobule, and right dorsolateral prefrontal cortex, are the underlying brains areas involved in executive function [ 41 ]. In addition to the above areas, white matter hyperintensities were also found to be associated with attention impairment [ 14 ]. Therefore, correlation analysis between cognitive evaluation and MRI of the brain would be helpful to further understand the impaired cognitive domains and corresponding lesions in the brain.…”

Section: Discussionmentioning

confidence: 99%

“…Atrophy of the anterior brain, including the frontal and temporal lobes, is a common neuroimaging finding in patients with GPI [ 9 ]. Severe medial temporal lobe atrophy was found to be a predictor of poor cognitive outcome [ 14 ]. A report on the postmortem histopathologic analysis of a GPI patient with an MMSE score of 25 points and Montreal Cognitive Assessment score of 22 points showed that the frontal lobe was severely damaged but the temporal lobe was relatively preserved [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Neuropsychological Features in Patients with General Paresis of the Insane at an Early Stage

Gao

Ding

et al. 2022

Med Sci Monit

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Background:This study aimed to explore the features of cognitive impairment in patients with neurosyphilis at the early stage of mild cognitive impairment (MCI). Material/Methods:A total of 18 patients with asymptomatic neurosyphilis (ANS), 19 patients with neurosyphilis at the MCI stage (neurosyphilis-MCI), and 15 patients with neurosyphilis at the dementia stage (neurosyphilis-dementia) were enrolled. Cognitive function was evaluated using comprehensive rating scales. Tests of syphilis in blood and cerebrospinal fluid (CSF) were conducted, and white blood cell (WBC) counts and protein levels in CSF were measured. Results:Overall cognitive function and individual cognitive domains, including memory, language, visuospatial skill, and attention/executive function, were all significantly impaired in the neurosyphilis-MCI group compared with the ANS group, and were further impaired in the neurosyphilis-dementia group. Although there was no difference in serum rapid plasma regain (RPR) titer among the 3 groups, the number of patients with serum RPR titer ³1: 32 in the neurosyphilis-MCI group was much higher than that in the ANS group. CSF RPR positive rate in the neurosyphilis-MCI group was significantly higher than that in the ANS group. The WBC count, protein level, and the rate of elevated protein level or increased WBC count in CSF did not differ among the 3 groups. Conclusions:The feature of cognitive impairment of neurosyphilis-MCI patients displayed multiple-domain amnestic MCI. Perhaps there were extensive brain areas involved at the early stage, and a continuous neuroinflammatory process was through the different stages of neurosyphilis. Early diagnosis and treatment are very important for preventing the progression of general paresis of the insane.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Neuropsychological Features in Patients with General Paresis of the Insane at an Early Stage

Gao

Ding

et al. 2022

Med Sci Monit

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“…Az előbbiek heveny vagy krónikus agyi ischaemia és ennek következ-ményei, míg az utóbbiak sejtpusztulás és atrophia révén alakulnak ki, melyek a motoros, a szenzoros és az occipitalis kérget aránylag megkímélik [9]. Sajnálatos módon nem pontosan ismert, hogy mely tényezők jelzik előre a rossz prognózist a neuropszichiátriai tünetek szempontjából, bár az irodalom felveti, hogy a kedvezőtlen prognózis a felfedezéskor észlelt mediotemporalis atrophia súlyosságával áll összefüggésben [10][11][12]. Esetünkben már a páciens első észlelésekor mediotemporalis és globális atrophiát találtunk, illetve a kezelést követően, a progresszió átmeneti megtorpanásakor is acalculia maradt fenn, ami már a követési időszak kezdetén is jelen lévő paralysis progressivára utal.…”

Section: Megbeszélésunclassified

Pszichiátriai tünetekkel jelentkező neuroszifilisz négyéves utánkövetése

Tombor

Salacz

Jankelovics³

et al. 2018

Orvosi Hetilap

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A szerzők pszichiátriai tünetekkel járó neuroszifiliszes esetet közölnek. Az idősödő férfit zavart, kritikátlan viselkedés, mániform állapot és megalomán téveszmék miatt vettük fel az első alkalommal. Felvételkor jobb centrális facialis paresis, tremor és parkinsonismus volt észlelhető. Akut képalkotó és rutin laborvizsgálatok a tudatzavart egyértelmű-en magyarázó eltérést nem igazoltak. A pszichiátriai kezelés hatására a delírium megszűnt. Ezután antipszichotikummal kezelt mániform állapot dominálta a képet, majd gyors kognitív leépülést és a motoros tünetek progresszióját észleltük. A koponya-MRI-vizsgálat corticalis és hippocampusatrophiát, fehérállományi hiperintenzitásokat talált. A liquorban pleocytosist, emelkedett összfehérjeszintet találtunk; a neuroszifilisz diagnózisát szerológiai vizsgálatok-kal támasztottuk alá. Penicillinkezelést követően a kognitív tünetek enyhültek, a pszichiátriai tünetek remisszióba kerültek. Négy évvel a diagnózist követően a kognitív hanyatlás fokozatos progressziót mutat, a pszichiátriai tünetek relapsusa miatt két további alkalommal volt szükség osztályos felvételre. Orv Hetil. 2018; 159(6): 234-238. Kulcsszavak: neuroszifilisz, paralysis progressiva, pszichózis, tudatzavar Four-year follow-up of a neurosyphilis case presenting psychiatric symptomsThe authors present a case of neurosyphilis associated with predominant psychiatric symptoms. The elderly man was admitted because of confused behavior, maniform state, lack of critical judgement and grandiose delusions. On admission, right central facial nerve paresis, hand tremor and parkinsonism were also found. Acute brain imaging and routine laboratory tests failed to identify a firm etiology of the confusional state. The psychiatric treatment resulted in complete recovery from delirium. Afterwards, maniform psychosis dominated the clinical picture for which antipsychotics were administered. Later, rapid cognitive deterioration and progression of motor symptoms were observed. MRI revealed cortical and hippocampal atrophy and white matter hyperintensities. Lumbar puncture found pleocytosis and elevated cerebrospinal fluid protein levels. Neurosyphilis had been confirmed by serologic tests. The cognitive symptoms improved and the psychiatric symptoms remitted under penicillin treatment. Four years after diagnosis, there is a gradual progression in the cognitive decline. Two additional hospitalizations were necessary due to the relapses of psychiatric symptoms. ESETISMERTETÉSRövidítések AKV = Addenbrooke-féle kognitív vizsgálat; HIV = humán immundeficientiavírus; MMS = mini mental state (mentális álla-potot felmérő teszt); RPR = rapid plazmareagin; TPPA = Treponema pallidum partikulum aggregáció; VDRL = venereal disease research laboratory (nemibetegség-kutató laboratórium)

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“…GP and Alzheimer's disease (AD) have similar pathophysiology. The atrophy of frontotemporal cortex and hydrocephalus in GP can be found by previous structural magnetic resonance imaging [2]. It has been reported that T. pallidum can cause chronic inflammation of blood vessels, occlusion of arterioles, and microglia activation [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Cerebaral Hyperperfusion in General Paralysis Patients

2020

Preprint

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Objective This study aimed to identify the cerebral blood flow (CBF) in patients with general paralysis (GP). Methods Three-dimensional pseudo-continuous arterial spin labeling (3D-pCASL) imaging was performed to measure the CBF in twenty patients with GP and twenty healthy subjects(NC). CBF was normalized to reduce variations among subjects. CBF was compared between the groups. Results Compared with the healthy subjects, the patients with GP exhibited increased CBF in the frontal lobe, temporal lobe, insular lobe, limbic lobe, and parietal lobe(all P<0.05). There was no difference in CBF of the occipital lobe between the GP group and the NC group(all P>0.05). Conclusions Our results suggest that the patients with GP may exhibit regional increased CBF, which may be one of the pathogenesis of general paralysis.

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

Cited by 14 publications

References 34 publications

Neuropsychological Features in Patients with General Paresis of the Insane at an Early Stage

Neuropsychological Features in Patients with General Paresis of the Insane at an Early Stage

Pszichiátriai tünetekkel jelentkező neuroszifilisz négyéves utánkövetése

Cerebaral Hyperperfusion in General Paralysis Patients

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