Increased Prevalence of Antibodies to Hepatitis E Virus in Patients with Neurocysticercosis.

We explored the association between serological status for hepatitis E and neurocysticercosis (NCC) in neurologic patients attending a national neurological referral center in Lima, Perú, between the years 2008 and 2012. Anti-hepatitis E antibodies were evaluated in patients with and without NCC, and a control group of rural general population. Anti-hepatitis E IgG was found in 23.8% of patients with NCC, compared with 14.3% in subjects without NCC from a general rural population (P = 0.023) and 14.4% in subjects with neurological complaints without NCC (P = 0.027). Seropositive patients had a median age of 44 years compared with 30 years in seronegative patients (P <0.001). No significant differences in sex, region of residence, or liver enzyme values were found. Seropositivity to hepatitis E was frequent in this Peruvian population and higher in patients with NCC, suggesting shared common routes of infection.

Bradykinesia in Neurodegenerative Disorders: A Blinded Video Analysis of Pathology-Proven Cases.

BACKGROUND: Bradykinesia is a cardinal feature in parkinsonisms. No study has assessed the differential features of bradykinesia in patients with pathology-proven synucleinopathies and tauopathies. OBJECTIVE: We examined whether bradykinesia features (speed, amplitude, rhythm, and sequence effect) may differ between pathology-proven synucleinopathies and tauopathies. METHODS: Forty-two cases who underwent autopsy were included and divided into synucleinopathies (Parkinson's disease and dementia with Lewy bodies) and tauopathies (progressive supranuclear palsy). Two raters blinded to the diagnosis retrospectively scored the Movement Disorders Society-Unified Parkinson's Disease Rating Scale Part III and Modified Bradykinesia Rating Scale on standardized videotaped neurological examinations. Bradykinesia scores were compared using the Mann-Whitney test and logistic regression models to adjust for disease duration. RESULTS: Demographic and clinical parameters were similar between synucleinopathies and tauopathies. There were no differences between speed, amplitude, rhythm, and sequence effect in synucleinopathies and tauopathies in unadjusted comparisons and adjusted models (all P > 0.05). CONCLUSIONS: Clinical bradykinesia features do not distinguish the underlying neuropathology in neurodegenerative parkinsonisms. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Mortality in Parenchymal and Subarachnoid Neurocysticercosis.

Neurocysticercosis (NCC) is endemic in many parts of the world, carrying significant neurological morbidity that varies according to whether lesions are located inside the cerebral parenchyma or in extraparenchymal spaces. The latter, in particular subarachnoid NCC, is assumed to be more severe, but no controlled studies comparing mortality between types of NCC exist. The aim of this study was to compare all-cause mortality between patients with intraparenchymal NCC and those with subarachnoid NCC. Vital status and sociodemographic characteristics were evaluated in patients with intraparenchymal viable, intraparenchymal calcified, and subarachnoid NCC attending a neurological referral hospital in Lima, Perú. Survival analyses using Kaplan-Meier curves and Cox proportional regression models were carried out to compare mortality rates between groups. From 840 NCC patients followed by a median time of 82.3 months, 42 (5.0%) died, six (1.8%) in the intraparenchymal viable group, four (1.3%) in the calcified group, and 32 (16.6%) in the subarachnoid group (P < 0.001). Older age and lower education were significantly associated with mortality. The age-adjusted hazard ratio for death in the subarachnoid group was 13.6 (95% CI: 5.6-33.0, P < 0.001) compared with the intraparenchymal viable group and 10.7 (95% CI: 3.7-30.8, P < 0.001) when compared with the calcified group. We concluded that subarachnoid disease is associated with a much higher mortality in NCC.

Guillain-Barré Syndrome Outbreak in Peru 2019 Associated With Campylobacter jejuni Infection.

OBJECTIVE: To identify the clinical phenotypes and infectious triggers in the 2019 Peruvian Guillain-Barré syndrome (GBS) outbreak. METHODS: We prospectively collected clinical and neurophysiologic data of patients with GBS admitted to a tertiary hospital in Lima, Peru, between May and August 2019. Molecular, immunologic, and microbiological methods were used to identify causative infectious agents. Sera from 41 controls were compared with cases for antibodies to Campylobacter jejuni and gangliosides. Genomic analysis was performed on 4 C jejuni isolates. RESULTS: The 49 included patients had a median age of 44 years (interquartile range [IQR] 30-54 years), and 28 (57%) were male. Thirty-two (65%) had symptoms of a preceding infection: 24 (49%) diarrhea and 13 (27%) upper respiratory tract infection. The median time between infectious to neurologic symptoms was 3 days (IQR 2-9 days). Eighty percent had a pure motor form of GBS, 21 (43%) had the axonal electrophysiologic subtype, and 18% the demyelinating subtype. Evidence of recent C jejuni infection was found in 28/43 (65%). No evidence of recent arbovirus infection was found. Twenty-three cases vs 11 controls (OR 3.3, confidence interval [CI] 95% 1.2-9.2, p < 0.01) had IgM and/or IgA antibodies against C jejuni. Anti-GM1:phosphatidylserine and/or anti-GT1a:GM1 heteromeric complex antibodies were strongly positive in cases (92.9% sensitivity and 68.3% specificity). Genomic analysis showed that the C jejuni strains were closely related and had the Asn51 polymorphism at cstII gene. CONCLUSIONS: Our study indicates that the 2019 Peruvian GBS outbreak was associated with C jejuni infection and that the C jejuni strains linked to GBS circulate widely in different parts of the world.

Frequency and associated factors of amnestic mild cognitive impairment at four senior citizen clubs in Lima, Peru.

Amnestic mild cognitive impairment (aMCI) is a subtle alteration in cognitive function that does not affect day-to-day activities and can precede Alzheimer's dementia. An increase in the prevalence of both these conditions is expected given the growing elderly population and recognizing risk factors can help reduce the burden. OBJECTIVE: the aim of this study was to determine the frequency and associated factors of aMCI in senior citizen clubs (SCC) at four districts with different socioeconomic status in Lima, Peru. METHODS: we applied Petersen's criteria to determine the presence of the condition in an interview which included the use of the Memory Alteration Test (M@T) and the Pfeffer Functional Activity Questionnaire (PFAQ). RESULTS: sixty-three out of 352 (17.9%) participants had aMCI. Factors associated with this condition were older age, fewer years of education at marriage whereas being from the SCC La Molina (district with highest socioeconomic status and resources for activities for the elderly) were associated with not having aMCI. There was no difference for sex, body mass index or history of hypertension. CONCLUSION: this predementia stage is frequent and usually undetected in urban Lima. Tools such as the M@T could help general practitioners detect this condition before its progression to dementia.

O comprometimento cognitivo leve amnésico (aMCI) é uma alteração sutil na função cognitiva que não altera as atividades do dia-a-dia e pode preceder a demência de Alzheimer. Um aumento na prevalência de ambas as condições é esperado devido ao crescimento da população idosa e o reconhecimento de fatores de risco pode ajudar a reduzir a carga de doença. OBJETIVO: o objetivo deste estudo foi o de determinar a freqüência e fatores associados a MCI em clubes de cidadãos idosos (CCI) em quatro distritos com diferentes condições socioeconômicas em Lima, Peru. MÉTODOS: aplicamos os critérios de Petersen para determinar a presença da condição em uma entrevista que incluiu o uso do Teste de Alteração de Memória (M@T) e do Questionário de Atividades Funcionais de Pfeffer (QAFP). RESULTADOS: sessenta e três dos 352 (17,9%) participantes tinham MCI. Os fatores associados a essa condição foram idade avançada, menor tempo de estudo ao se casar enquanto ser provenientes do CCI La Molina (distrito com maior nível socioeconômico e recursos para atividades para idosos) foram associados a não possuir um MCI. Não houve diferença por sexo, índice de massa corporal e história de hipertensão. CONCLUSÃO: este estágio de pré-demência é frequente e geralmente não detectado na cidade de Lima. Ferramentas como o M@T poderiam ajudar os clínicos gerais a detectar essa condição antes da progressão para a demência.

Frequency and associated factors of amnestic mild cognitive impairment at four senior citizen clubs in Lima, Peru / Frequência e fatores associados do comprometimento cognitivo leve amnésico em quatro clubes de idosos em lima, peru

ABSTRACT Amnestic mild cognitive impairment (aMCI) is a subtle alteration in cognitive function that does not affect day-to-day activities and can precede Alzheimer's dementia. An increase in the prevalence of both these conditions is expected given the growing elderly population and recognizing risk factors can help reduce the burden. Objective: the aim of this study was to determine the frequency and associated factors of aMCI in senior citizen clubs (SCC) at four districts with different socioeconomic status in Lima, Peru. Methods: we applied Petersen's criteria to determine the presence of the condition in an interview which included the use of the Memory Alteration Test (M@T) and the Pfeffer Functional Activity Questionnaire (PFAQ). Results: sixty-three out of 352 (17.9%) participants had aMCI. Factors associated with this condition were older age, fewer years of education at marriage whereas being from the SCC La Molina (district with highest socioeconomic status and resources for activities for the elderly) were associated with not having aMCI. There was no difference for sex, body mass index or history of hypertension. Conclusion: this predementia stage is frequent and usually undetected in urban Lima. Tools such as the M@T could help general practitioners detect this condition before its progression to dementia.

RESUMO O comprometimento cognitivo leve amnésico (aMCI) é uma alteração sutil na função cognitiva que não altera as atividades do dia-a-dia e pode preceder a demência de Alzheimer. Um aumento na prevalência de ambas as condições é esperado devido ao crescimento da população idosa e o reconhecimento de fatores de risco pode ajudar a reduzir a carga de doença. Objetivo: o objetivo deste estudo foi o de determinar a freqüência e fatores associados a MCI em clubes de cidadãos idosos (CCI) em quatro distritos com diferentes condições socioeconômicas em Lima, Peru. Métodos: aplicamos os critérios de Petersen para determinar a presença da condição em uma entrevista que incluiu o uso do Teste de Alteração de Memória (M@T) e do Questionário de Atividades Funcionais de Pfeffer (QAFP). Resultados: sessenta e três dos 352 (17,9%) participantes tinham MCI. Os fatores associados a essa condição foram idade avançada, menor tempo de estudo ao se casar enquanto ser provenientes do CCI La Molina (distrito com maior nível socioeconômico e recursos para atividades para idosos) foram associados a não possuir um MCI. Não houve diferença por sexo, índice de massa corporal e história de hipertensão. Conclusão: este estágio de pré-demência é frequente e geralmente não detectado na cidade de Lima. Ferramentas como o M@T poderiam ajudar os clínicos gerais a detectar essa condição antes da progressão para a demência.