IN NEUROCYSTICERCOSIS, CSF CYTOKINES CORRELATE WITH CEREBRAL BLOOD FLOW VELOCITIES

Abstract

Subarachnoidal cysticercosis (SAC) is frequently associated with inflammatory CSF, clinical manifestations,1,2 and vascular involvement.3-5 Our goal was to determine cytokine production in CSF in patients with SAC and their association with cerebral blood flow velocity (CBFV) before and after cysticidal treatment. ### Methods. Thirty-one patients agreed to participate from 2001 to 2003. Patients provided informed consent and the institutional review board approved the protocol. All patients had a positive immunologic reaction to cysticerci and clinical manifestations. Patients were not included if they had received corticosteroids or cysticidal drugs in the last 6 months, liver or renal dysfunction, systemic infections, cancer or pregnancy, and >50% stenosis of the internal carotid artery by ultrasound Doppler study. CSF concentration of interleukin-6 (IL-6, R&D Systems, Minneapolis, MN), tumor necrosis factor-α (TNFα, R&D Systems), interleukin-1β, and chemokine RANTES (Biosource International, Camarillo, CA) were determined with quantitative sandwich enzyme immunoassays. The lower limits of detection for IL-6, TNFα, IL-1β, and RANTES were 0.7 pg/mL, 4.4 pg/mL, 1 pg/mL, and <3 pg/mL. Transcranial sonography (TS) was performed with color-coded duplex ultrasound (Agilent SONOS 5500) to measure flow velocity without angle correction in both middle cerebral arteries. The CBFV registered was the higher peak systolic velocity obtained. Patients were treated with steroids and …