Frequency and Determinant Factors for Calcification in Neurocysticercosis
Abstract Background Neurocysticercosis is a major cause of acquired epilepsy. Larval cysts in the human brain eventually resolve and either disappear or leave a calcification that is associated with seizures. In this study, we assessed the proportion of calcification in parenchymal neurocysticercosi...
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| Veröffentlicht in: | Clinical infectious diseases 2021-11, Vol.73 (9), p.e2592-e2600 |
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| creator | Bustos, Javier A Arroyo, Gianfranco Gilman, Robert H Soto-Becerra, Percy Gonzales, Isidro Saavedra, Herbert Pretell, E Javier Nash, Theodore E O’Neal, Seth E Del Brutto, Oscar H Gonzalez, Armando E Garcia, Hector H |
| description | Abstract
Background
Neurocysticercosis is a major cause of acquired epilepsy. Larval cysts in the human brain eventually resolve and either disappear or leave a calcification that is associated with seizures. In this study, we assessed the proportion of calcification in parenchymal neurocysticercosis and risk factors associated with calcification.
Methods
Data for 220 patients with parenchymal NCC from 3 trials of antiparasitic treatment were assessed to determine what proportion of the cysts that resolved 6 months after treatment ended up in a residual calcification at 1 year. Also, we evaluated the risk factors associated with calcification.
Results
The overall proportion of calcification was 38% (188/497 cysts, from 147 patients). Predictors for calcification at the cyst level were cysts larger than 14 mm (risk ratio [RR], 1.34; 95% confidence interval [CI], 1.02–1.75) and cysts with edema at baseline (RR, 1.39; 95% CI, 1.05–1.85). At the patient level, having had more than 24 months with seizures (RR, 1.25; 95% CI, 1.08–1.46), mild antibody response (RR, 1.14; 95% CI, 1.002–1.27), increased dose albendazole regime (RR, 1.26; 95% CI, 1.14–1.39), lower doses of dexamethasone (RR, 1.36; 95% CI, 1.02–1.81), not receiving early antiparasitic retreatment (RR, 1.45; 95% CI, 1.08–1.93), or complete cure (RR, 1.48; 95% CI, 1.29–1.71) were associated with a increased risk of calcification.
Conclusions
Approximately 38% of parenchymal cysts calcify after antiparasitic treatment. Some factors associated with calcification are modifiable and may be considered to decrease or avoid calcification, potentially decreasing the risk for seizure relapses.
We demonstrated residual calcification in 38% of viable parenchymal brain neurocysticercosis cysts that resolved after antiparasitic treatment. Combined antiparasitic therapy, early retreatment, and enhanced corticosteroid doses appear to reduce the risk of calcification and potentially reduce future seizure recurrence. |
| doi_str_mv | 10.1093/cid/ciaa784 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8563199</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/cid/ciaa784</oup_id><sourcerecordid>2415287102</sourcerecordid><originalsourceid>FETCH-LOGICAL-c482t-2b75e75778816d874719e154f42762ea6293148ffc4a5b1e2f37632b47d004cd3</originalsourceid><addsrcrecordid>eNp9kM1LAzEQxYMotn6cvMueRJDVfG6yF0Gq1ULRi55DNpvVyDapSVbof2-ktejFwzAD8-PNmwfACYKXCNbkSts2l1Jc0B0wRozwsmI12s0zZKKkgogROIjxHUKEBGT7YEQwYxXm1RjMpsF8DMbpVaFcW9yaZMLCOuVSMVU6-RCLzodionptO6tVst4V1hWPZgher2Ky2gTto41HYK9TfTTHm34IXqZ3z5OHcv50P5vczEtNBU4lbjgznHEuBKpawSlHtUGMdjT7wUZVuCaIiq7TVLEGGdwRXhHcUN5CSHVLDsH1Wnc5NAvTauNSUL1cBrtQYSW9svLvxtk3-eo_pWAVQXWdBc43AsHn12OSCxu16XvljB-ixBQxLDiCOKMXa1QHH2Mw3fYMgvI7fJnDl5vwM33629mW_Uk7A2drwA_Lf5W-AFc2jrQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2415287102</pqid></control><display><type>article</type><title>Frequency and Determinant Factors for Calcification in Neurocysticercosis</title><source>Oxford University Press Journals All Titles (1996-Current)</source><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Bustos, Javier A ; Arroyo, Gianfranco ; Gilman, Robert H ; Soto-Becerra, Percy ; Gonzales, Isidro ; Saavedra, Herbert ; Pretell, E Javier ; Nash, Theodore E ; O’Neal, Seth E ; Del Brutto, Oscar H ; Gonzalez, Armando E ; Garcia, Hector H</creator><creatorcontrib>Bustos, Javier A ; Arroyo, Gianfranco ; Gilman, Robert H ; Soto-Becerra, Percy ; Gonzales, Isidro ; Saavedra, Herbert ; Pretell, E Javier ; Nash, Theodore E ; O’Neal, Seth E ; Del Brutto, Oscar H ; Gonzalez, Armando E ; Garcia, Hector H ; Cysticercosis Working Group in Peru ; The Cysticercosis Working Group in Peru</creatorcontrib><description>Abstract
Background
Neurocysticercosis is a major cause of acquired epilepsy. Larval cysts in the human brain eventually resolve and either disappear or leave a calcification that is associated with seizures. In this study, we assessed the proportion of calcification in parenchymal neurocysticercosis and risk factors associated with calcification.
Methods
Data for 220 patients with parenchymal NCC from 3 trials of antiparasitic treatment were assessed to determine what proportion of the cysts that resolved 6 months after treatment ended up in a residual calcification at 1 year. Also, we evaluated the risk factors associated with calcification.
Results
The overall proportion of calcification was 38% (188/497 cysts, from 147 patients). Predictors for calcification at the cyst level were cysts larger than 14 mm (risk ratio [RR], 1.34; 95% confidence interval [CI], 1.02–1.75) and cysts with edema at baseline (RR, 1.39; 95% CI, 1.05–1.85). At the patient level, having had more than 24 months with seizures (RR, 1.25; 95% CI, 1.08–1.46), mild antibody response (RR, 1.14; 95% CI, 1.002–1.27), increased dose albendazole regime (RR, 1.26; 95% CI, 1.14–1.39), lower doses of dexamethasone (RR, 1.36; 95% CI, 1.02–1.81), not receiving early antiparasitic retreatment (RR, 1.45; 95% CI, 1.08–1.93), or complete cure (RR, 1.48; 95% CI, 1.29–1.71) were associated with a increased risk of calcification.
Conclusions
Approximately 38% of parenchymal cysts calcify after antiparasitic treatment. Some factors associated with calcification are modifiable and may be considered to decrease or avoid calcification, potentially decreasing the risk for seizure relapses.
We demonstrated residual calcification in 38% of viable parenchymal brain neurocysticercosis cysts that resolved after antiparasitic treatment. Combined antiparasitic therapy, early retreatment, and enhanced corticosteroid doses appear to reduce the risk of calcification and potentially reduce future seizure recurrence.</description><identifier>ISSN: 1058-4838</identifier><identifier>EISSN: 1537-6591</identifier><identifier>DOI: 10.1093/cid/ciaa784</identifier><identifier>PMID: 32556276</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>Albendazole - therapeutic use ; Animals ; Antiparasitic Agents - therapeutic use ; Brain ; Humans ; Neurocysticercosis - complications ; Neurocysticercosis - drug therapy ; Neurocysticercosis - epidemiology ; Online only ; Seizures - epidemiology ; Seizures - etiology ; Taenia solium</subject><ispartof>Clinical infectious diseases, 2021-11, Vol.73 (9), p.e2592-e2600</ispartof><rights>The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com. 2020</rights><rights>The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c482t-2b75e75778816d874719e154f42762ea6293148ffc4a5b1e2f37632b47d004cd3</citedby><cites>FETCH-LOGICAL-c482t-2b75e75778816d874719e154f42762ea6293148ffc4a5b1e2f37632b47d004cd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,1578,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32556276$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bustos, Javier A</creatorcontrib><creatorcontrib>Arroyo, Gianfranco</creatorcontrib><creatorcontrib>Gilman, Robert H</creatorcontrib><creatorcontrib>Soto-Becerra, Percy</creatorcontrib><creatorcontrib>Gonzales, Isidro</creatorcontrib><creatorcontrib>Saavedra, Herbert</creatorcontrib><creatorcontrib>Pretell, E Javier</creatorcontrib><creatorcontrib>Nash, Theodore E</creatorcontrib><creatorcontrib>O’Neal, Seth E</creatorcontrib><creatorcontrib>Del Brutto, Oscar H</creatorcontrib><creatorcontrib>Gonzalez, Armando E</creatorcontrib><creatorcontrib>Garcia, Hector H</creatorcontrib><creatorcontrib>Cysticercosis Working Group in Peru</creatorcontrib><creatorcontrib>The Cysticercosis Working Group in Peru</creatorcontrib><title>Frequency and Determinant Factors for Calcification in Neurocysticercosis</title><title>Clinical infectious diseases</title><addtitle>Clin Infect Dis</addtitle><description>Abstract
Background
Neurocysticercosis is a major cause of acquired epilepsy. Larval cysts in the human brain eventually resolve and either disappear or leave a calcification that is associated with seizures. In this study, we assessed the proportion of calcification in parenchymal neurocysticercosis and risk factors associated with calcification.
Methods
Data for 220 patients with parenchymal NCC from 3 trials of antiparasitic treatment were assessed to determine what proportion of the cysts that resolved 6 months after treatment ended up in a residual calcification at 1 year. Also, we evaluated the risk factors associated with calcification.
Results
The overall proportion of calcification was 38% (188/497 cysts, from 147 patients). Predictors for calcification at the cyst level were cysts larger than 14 mm (risk ratio [RR], 1.34; 95% confidence interval [CI], 1.02–1.75) and cysts with edema at baseline (RR, 1.39; 95% CI, 1.05–1.85). At the patient level, having had more than 24 months with seizures (RR, 1.25; 95% CI, 1.08–1.46), mild antibody response (RR, 1.14; 95% CI, 1.002–1.27), increased dose albendazole regime (RR, 1.26; 95% CI, 1.14–1.39), lower doses of dexamethasone (RR, 1.36; 95% CI, 1.02–1.81), not receiving early antiparasitic retreatment (RR, 1.45; 95% CI, 1.08–1.93), or complete cure (RR, 1.48; 95% CI, 1.29–1.71) were associated with a increased risk of calcification.
Conclusions
Approximately 38% of parenchymal cysts calcify after antiparasitic treatment. Some factors associated with calcification are modifiable and may be considered to decrease or avoid calcification, potentially decreasing the risk for seizure relapses.
We demonstrated residual calcification in 38% of viable parenchymal brain neurocysticercosis cysts that resolved after antiparasitic treatment. Combined antiparasitic therapy, early retreatment, and enhanced corticosteroid doses appear to reduce the risk of calcification and potentially reduce future seizure recurrence.</description><subject>Albendazole - therapeutic use</subject><subject>Animals</subject><subject>Antiparasitic Agents - therapeutic use</subject><subject>Brain</subject><subject>Humans</subject><subject>Neurocysticercosis - complications</subject><subject>Neurocysticercosis - drug therapy</subject><subject>Neurocysticercosis - epidemiology</subject><subject>Online only</subject><subject>Seizures - epidemiology</subject><subject>Seizures - etiology</subject><subject>Taenia solium</subject><issn>1058-4838</issn><issn>1537-6591</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kM1LAzEQxYMotn6cvMueRJDVfG6yF0Gq1ULRi55DNpvVyDapSVbof2-ktejFwzAD8-PNmwfACYKXCNbkSts2l1Jc0B0wRozwsmI12s0zZKKkgogROIjxHUKEBGT7YEQwYxXm1RjMpsF8DMbpVaFcW9yaZMLCOuVSMVU6-RCLzodionptO6tVst4V1hWPZgher2Ky2gTto41HYK9TfTTHm34IXqZ3z5OHcv50P5vczEtNBU4lbjgznHEuBKpawSlHtUGMdjT7wUZVuCaIiq7TVLEGGdwRXhHcUN5CSHVLDsH1Wnc5NAvTauNSUL1cBrtQYSW9svLvxtk3-eo_pWAVQXWdBc43AsHn12OSCxu16XvljB-ixBQxLDiCOKMXa1QHH2Mw3fYMgvI7fJnDl5vwM33629mW_Uk7A2drwA_Lf5W-AFc2jrQ</recordid><startdate>20211102</startdate><enddate>20211102</enddate><creator>Bustos, Javier A</creator><creator>Arroyo, Gianfranco</creator><creator>Gilman, Robert H</creator><creator>Soto-Becerra, Percy</creator><creator>Gonzales, Isidro</creator><creator>Saavedra, Herbert</creator><creator>Pretell, E Javier</creator><creator>Nash, Theodore E</creator><creator>O’Neal, Seth E</creator><creator>Del Brutto, Oscar H</creator><creator>Gonzalez, Armando E</creator><creator>Garcia, Hector H</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20211102</creationdate><title>Frequency and Determinant Factors for Calcification in Neurocysticercosis</title><author>Bustos, Javier A ; Arroyo, Gianfranco ; Gilman, Robert H ; Soto-Becerra, Percy ; Gonzales, Isidro ; Saavedra, Herbert ; Pretell, E Javier ; Nash, Theodore E ; O’Neal, Seth E ; Del Brutto, Oscar H ; Gonzalez, Armando E ; Garcia, Hector H</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c482t-2b75e75778816d874719e154f42762ea6293148ffc4a5b1e2f37632b47d004cd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Albendazole - therapeutic use</topic><topic>Animals</topic><topic>Antiparasitic Agents - therapeutic use</topic><topic>Brain</topic><topic>Humans</topic><topic>Neurocysticercosis - complications</topic><topic>Neurocysticercosis - drug therapy</topic><topic>Neurocysticercosis - epidemiology</topic><topic>Online only</topic><topic>Seizures - epidemiology</topic><topic>Seizures - etiology</topic><topic>Taenia solium</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bustos, Javier A</creatorcontrib><creatorcontrib>Arroyo, Gianfranco</creatorcontrib><creatorcontrib>Gilman, Robert H</creatorcontrib><creatorcontrib>Soto-Becerra, Percy</creatorcontrib><creatorcontrib>Gonzales, Isidro</creatorcontrib><creatorcontrib>Saavedra, Herbert</creatorcontrib><creatorcontrib>Pretell, E Javier</creatorcontrib><creatorcontrib>Nash, Theodore E</creatorcontrib><creatorcontrib>O’Neal, Seth E</creatorcontrib><creatorcontrib>Del Brutto, Oscar H</creatorcontrib><creatorcontrib>Gonzalez, Armando E</creatorcontrib><creatorcontrib>Garcia, Hector H</creatorcontrib><creatorcontrib>Cysticercosis Working Group in Peru</creatorcontrib><creatorcontrib>The Cysticercosis Working Group in Peru</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bustos, Javier A</au><au>Arroyo, Gianfranco</au><au>Gilman, Robert H</au><au>Soto-Becerra, Percy</au><au>Gonzales, Isidro</au><au>Saavedra, Herbert</au><au>Pretell, E Javier</au><au>Nash, Theodore E</au><au>O’Neal, Seth E</au><au>Del Brutto, Oscar H</au><au>Gonzalez, Armando E</au><au>Garcia, Hector H</au><aucorp>Cysticercosis Working Group in Peru</aucorp><aucorp>The Cysticercosis Working Group in Peru</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Frequency and Determinant Factors for Calcification in Neurocysticercosis</atitle><jtitle>Clinical infectious diseases</jtitle><addtitle>Clin Infect Dis</addtitle><date>2021-11-02</date><risdate>2021</risdate><volume>73</volume><issue>9</issue><spage>e2592</spage><epage>e2600</epage><pages>e2592-e2600</pages><issn>1058-4838</issn><eissn>1537-6591</eissn><abstract>Abstract
Background
Neurocysticercosis is a major cause of acquired epilepsy. Larval cysts in the human brain eventually resolve and either disappear or leave a calcification that is associated with seizures. In this study, we assessed the proportion of calcification in parenchymal neurocysticercosis and risk factors associated with calcification.
Methods
Data for 220 patients with parenchymal NCC from 3 trials of antiparasitic treatment were assessed to determine what proportion of the cysts that resolved 6 months after treatment ended up in a residual calcification at 1 year. Also, we evaluated the risk factors associated with calcification.
Results
The overall proportion of calcification was 38% (188/497 cysts, from 147 patients). Predictors for calcification at the cyst level were cysts larger than 14 mm (risk ratio [RR], 1.34; 95% confidence interval [CI], 1.02–1.75) and cysts with edema at baseline (RR, 1.39; 95% CI, 1.05–1.85). At the patient level, having had more than 24 months with seizures (RR, 1.25; 95% CI, 1.08–1.46), mild antibody response (RR, 1.14; 95% CI, 1.002–1.27), increased dose albendazole regime (RR, 1.26; 95% CI, 1.14–1.39), lower doses of dexamethasone (RR, 1.36; 95% CI, 1.02–1.81), not receiving early antiparasitic retreatment (RR, 1.45; 95% CI, 1.08–1.93), or complete cure (RR, 1.48; 95% CI, 1.29–1.71) were associated with a increased risk of calcification.
Conclusions
Approximately 38% of parenchymal cysts calcify after antiparasitic treatment. Some factors associated with calcification are modifiable and may be considered to decrease or avoid calcification, potentially decreasing the risk for seizure relapses.
We demonstrated residual calcification in 38% of viable parenchymal brain neurocysticercosis cysts that resolved after antiparasitic treatment. Combined antiparasitic therapy, early retreatment, and enhanced corticosteroid doses appear to reduce the risk of calcification and potentially reduce future seizure recurrence.</abstract><cop>US</cop><pub>Oxford University Press</pub><pmid>32556276</pmid><doi>10.1093/cid/ciaa784</doi><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1058-4838 |
| ispartof | Clinical infectious diseases, 2021-11, Vol.73 (9), p.e2592-e2600 |
| issn | 1058-4838 1537-6591 |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Albendazole - therapeutic use Animals Antiparasitic Agents - therapeutic use Brain Humans Neurocysticercosis - complications Neurocysticercosis - drug therapy Neurocysticercosis - epidemiology Online only Seizures - epidemiology Seizures - etiology Taenia solium |
| title | Frequency and Determinant Factors for Calcification in Neurocysticercosis |
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