Clinical, radiological, pathological and prognostic features of general paresis: a cohort study

作者：Rongze Wang, Shufen Chen, Chen-Jie Fei, Ya-Ru Zhang, Keliang Chen, Wei Zhang, Mengmeng Li, Yuyuan Huang, Shitong Xiang, Kaimin Wu, Wen-Han Li, Bang‐Sheng Wu, W. S. Cheng, Mei Cui, Jin-Tai Yu · 发表于：Brain · 年份：2025 · DOI：10.1093/brain/awae389 · 被引用次数：7 · 研究领域：Orthopedic Surgery and Rehabilitation、Parkinson's Disease and Spinal Disorders、Botulinum Toxin and Related Neurological Disorders

General paresis is a rare type of syphilis characterized by progressive cognitive impairment and psychiatric syndromes. It is often misdiagnosed because of its rarity and similarity to other diseases. We aimed to investigate the clinical, radiological, pathological and prognostic features of general paresis comprehensively and to compare it with other dementias. Between August 2019 and January 2024, patients were recruited from a memory clinic setting at the National Center for Neurological Disorders in China. Participants underwent clinical evaluation, laboratory testing and imaging and were followed after treatment. Comparative analysis was conducted on clinical features and neuropsychiatric assessments, and brain image features were investigated using linear regression models and SuStaIn models. Seventy-eight patients were included, with 90% being male. The median duration from symptom onset to the first diagnostic visit was 15 months. Sixty-three patients were followed for an average of 1.4 years. Cognitive impairment emerged as the most common symptom, and half of the patients co-existed with motor symptoms. Impairment across all cognitive domains accompanied by positive psychiatric symptoms raised suspicion for general paresis and distinguished it from Alzheimer's disease, frontotemporal dementia and anti-LGI1 encephalitis-related dementia. Common imaging abnormalities in general paresis included whole-brain atrophy and cortical hypointensity. Hippocampus-predominant an...