Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Social Psychiatry and Psychiatric Epidemiology
Published in: Social Psychiatry and Psychiatric Epidemiology 6/2014

01-06-2014 | Original Paper

The association of Toxoplasma gondii infection with neurocognitive deficits in a population-based analysis

Authors: Brad D. Pearce, Deanna Kruszon-Moran, Jeffrey L. Jones

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 6/2014

Login to get access

Abstract

Purpose

To examine the relationship between infection with Toxoplasma gondii (toxo) and cognition.

Methods

Multivariate logistic regression was used to test the association of toxo seropositivity with indices of cognitive function among over 4,200 adults in the third National Health and Nutrition Examination Survey.

Results

Toxo-seropositive participants were more likely than seronegative participants to score in the worst quartile of the simple reaction time test (OR 1.3, 95 % CI 1.0, 1.6), symbol-digit substitution test (SDST, OR 1.5, 95 % CI 1.2, 1.9) and the serial-digit learning test (trials to criterion) (SDLTNT, OR 1.4, 95 % CI 1.1, 1.8) in models adjusted for age, race/ethnicity, gender and foreign birth. After further adjustment for all cofactors, the association between toxo seropositivity and these outcomes was no longer significant. However, seropositivity was associated with worse scores on the SDST (OR 2.9, 95 % CI 1.8, 4.8) among those in the lowest income category and the SDLTNT (OR 1.5, 95 % CI 1.1, 2.5) among those foreign born.

Conclusions

Toxo seropositivity may be associated with poor cognitive test scores in certain subgroups; however, causation cannot be established in this cross-sectional study.
Literature
1.
2.
Dubey JP, Jones JL (2008) Toxoplasma gondii infection in humans and animals in the United States. Int J Parasitol 38(11):1257–1278PubMedCrossRef
3.
4.
Hrdá Š, Votýpka J, Kodym P, Flegr J (2000) Transient nature of Toxoplasma gondii-induced behavioral changes in mice. J Parasitol 86:657–663PubMedCrossRef
5.
Vyas A, Kim SK, Giacomini N, Boothroyd JC, Sapolsky RM (2007) Behavioral changes induced by Toxoplasma infection of rodents are highly specific to aversion of cat odors. Proc Natl Acad Sci USA 104(15):6442–6447PubMedCentralPubMedCrossRef
6.
Prandovszky E, Gaskell E, Martin H, Dubey J, Webster JP, McConkey GA (2011) The neurotropic parasite Toxoplasma gondii increases dopamine metabolism. PLoS One 6(9):e23866PubMedCentralPubMedCrossRef
7.
8.
Havlicek J, Gašová Z, Smith AP, Zvára K, Flegr J (2001) Decrease of psychomotor performance in subjects with latent ‘asymptomatic’ toxoplasmosis. Parasitology 122(05):515–520PubMedCrossRef
9.
Flegr J, Preiss M, Klose J, Havlicek J, Vitakova M, Kodym P (2003) Decreased level of psychobiological factor novelty seeking and lower intelligence in men latently infected with the protozoan parasite Toxoplasma gondii Dopamine, a missing link between schizophrenia and toxoplasmosis? Biol Psychol 63(3):253–268 (pii:S0301051103000759)PubMed
10.
11.
Hamdani N, Daban-Huard C, Lajnef M, Richard J-R, Delavest M, Godin O, Guen EL, Vederine F-E, Lépine J-P, Jamain S (2013) Relationship between Toxoplasma gondii infection and bipolar disorder in a French sample. J Affect Disord 148:444–448PubMedCrossRef
12.
13.
Kocazeybek B, Oner YA, Turksoy R, Babur C, Cakan H, Sahip N, Unal A, Ozaslan A, Kılıc S, Saribas S (2009) Higher prevalence of toxoplasmosis in victims of traffic accidents suggest increased risk of traffic accident in Toxoplasma-infected inhabitants of Istanbul and its suburbs. Forensic Sci Int 187(1):103–108PubMed
14.
Flegr J, Havlícek J, Kodym P, Malý M, Smahel Z (2002) Increased risk of traffic accidents in subjects with latent toxoplasmosis: a retrospective case-control study. BMC Infect Dis 2(1):11PubMedCentralPubMedCrossRef
15.
Alvarado-Esquivel C, Torres-Castorena A, Liesenfeld O, Estrada-Martínez S, Urbina-Álvarez JD (2012) High seroprevalence of Toxoplasma gondii infection in a subset of Mexican patients with work accidents and low socioeconomic status. Parasit Vectors 5:13PubMedCentralPubMedCrossRef
16.
Yereli K, Balcioğlu IC, Özbilgin A (2006) Is Toxoplasma gondii a potential risk for traffic accidents in Turkey? Forensic Sci Int 163(1):34–37PubMed
17.
Yolken R, Dickerson F, Fuller Torrey E (2009) Toxoplasma and schizophrenia. Parasite Immunol 31(11):706–715PubMedCrossRef
18.
Novotná M, Havlíček J, Smith A, Kolbeková P, Skallová A, Klose J, Gašová Z, Písačka M, Sechovská M, Flegr J (2008) Toxoplasma and reaction time: role of toxoplasmosis in the origin, preservation and geographical distribution of Rh blood group polymorphism. Parasitology 135(11):1253–1261PubMedCrossRef
19.
Holub D, Flegr J, Dragomirecká E, Rodriguez M, Preiss M, Novák T, Čermák J, Horáček J, Kodym P, Libiger J (2013) Differences in onset of disease and severity of psychopathology between toxoplasmosis-related and toxoplasmosis-unrelated schizophrenia. Acta Psychiatr Scand 127:227–238PubMedCrossRef
20.
NCHS (1992) Sample design: Third National Health and Nutrition Examination Survey, 1988–1994. DHHS publication no. (PHS) 92-1387. Vital and health statistics, vol series 2, no. 113. US GPO, Washington, DC
21.
22.
Krieg EF Jr, Chrislip DW, Letz RE, Otto DA, Crespo CJ, Stephen Brightwell W, Ehrenberg RL (2001) Neurobehavioral test performance in the third National Health and Nutrition Examination Survey. Neurotoxicol Teratol 23(6):569–589PubMedCrossRef
23.
Tolppanen AM, Williams DM, Lawlor DA (2011) The association of serum ionized calcium and vitamin D with adult cognitive performance. Epidemiology 22(1):113PubMedCentralPubMed
24.
Hailpern SM, Melamed ML, Cohen HW, Hostetter TH (2007) Moderate chronic kidney disease and cognitive function in adults 20 to 59 years of age: third National Health and Nutrition Examination Survey (NHANES III). J Am Soc Nephrol 18(7):2205–2213PubMedCrossRef
25.
Jones JL, Kruszon-Moran D, Wilson M, McQuillan G, Navin T, McAuley JB (2001) Toxoplasma gondii infection in the United States: seroprevalence and risk factors. Am J Epidemiol 154(4):357–365PubMedCrossRef
26.
27.
Mohadjer L, Waksberg J (1996) National Health and Nutrition Examination Survey III: weighting and estimation methodology. National Center for Health Statistics, Hyattsville
28.
Ezzati T, Khare M (1993) Nonresponse adjustment in a national health survey. 1992 proceedings of the section on survey research methods. American Statistical Association, Alexandria, pp 339–344
29.
Korn EL, Graubard BI (1998) Confidence intervals for proportions with small expected number of positive counts estimated from survey data. Surv Methodol 24:193–201
30.
Ferreira ÉC, Marchioro AA, Guedes TA, Mota DC, Guilherme AL, de Araújo SM (2013) Association between seropositivity for Toxoplasma gondii, scholastic development of children and risk factors for T. gondii infection. Trans R Soc Trop Med Hyg 107(6):390–396PubMedCrossRef
31.
Dickerson F, Stallings C, Origoni A, Vaughan C, Khushalani S, Yolken R (2012) Additive effects of elevated C-reactive protein and exposure to herpes simplex virus type 1 on cognitive impairment in individuals with schizophrenia. Schizophr Res 134:83–88PubMedCrossRef
32.
Hilmas C, Pereira EFR, Alkondon M, Rassoulpour A, Schwarcz R, Albuquerque EX (2001) The brain metabolite kynurenic acid inhibits α7 nicotinic receptor activity and increases non-α7 nicotinic receptor expression: physiopathological implications. J Neurosci 21(19):7463–7473PubMed
33.
34.
Kobrosly RW, Seplaki CL, Jones CM, van Wijngaarden E (2012) Physiologic dysfunction scores and cognitive function test performance in US adults. Psychosom Med 74(1):81–88PubMedCentralPubMedCrossRef
35.
Caiaffa WT, Chiari CA, Figueiredo AR, Orefice F, Antunes CM (1993) Toxoplasmosis and mental retardation: report of a case-control study. Mem Inst Oswaldo Cruz 88(2):253–261PubMedCrossRef
36.
Krieg EF Jr, Butler MA (2009) Blood lead, serum homocysteine, and neurobehavioral test performance in the third National Health and Nutrition Examination Survey. Neurotoxicology 30(2):281–289PubMedCrossRef
37.
Zhang J, Muldoon MF, McKeown RE (2004) Serum cholesterol concentrations are associated with visuomotor speed in men: findings from the third National Health and Nutrition Examination Survey, 1988–1994. Am J Clin Nutr 80(2):291–298PubMed
38.
Beydoun MA, Beydoun HA, Shroff MR, Kitner-Triolo MH, Zonderman AB (2013) Helicobacter pylori seropositivity and cognitive performance among US adults: evidence from a large national survey. Psychosom Med 75(5):486–496PubMedCrossRef
39.
Pavlik VN, Hyman DJ, Doody R (2004) Cardiovascular risk factors and cognitive function in adults 30–59 years of age (NHANES III). Neuroepidemiology 24(1–2):42–50PubMed
Metadata
Title
The association of Toxoplasma gondii infection with neurocognitive deficits in a population-based analysis
Authors
Brad D. Pearce
Deanna Kruszon-Moran
Jeffrey L. Jones
Publication date
01-06-2014
Publisher
Springer Berlin Heidelberg
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 6/2014
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-014-0820-5

Other articles of this Issue 6/2014

Social Psychiatry and Psychiatric Epidemiology 6/2014 Go to the issue

Original Paper

“The psychological skeleton in the closet”: mortality after a sibling’s suicide

Original Paper

Depressive symptoms among adolescents and older adults in Mexico City

Original Paper

Another time point, a different story: one year effects of a social media intervention on the attitudes of young people towards mental health issues

Original Paper

How do neighborhoods affect depression outcomes? A realist review and a call for the examination of causal pathways

Original Paper

The efficacy of religious service attendance in reducing depressive symptoms

Original Paper

Translating multilevel theory into multilevel research: challenges and opportunities for understanding the social determinants of psychiatric disorders