Mechanisms of Neurosyphilis-Induced Dementia: Insights into Pathophysiology

Neurosyphilis-induced dementia represents a severe manifestation of tertiary syphilis, characterized by cognitive and neuropsychiatric impairments. This condition arises from the progression of syphilis to the central nervous system, where the spirochete causes damage through invasion, chronic infla...

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Main Authors: Aya Fadel, Hussain Hussain, Robert J. Hernandez, Amanda Marie Clichy Silva, Amir Agustin Estil-las, Mohammad Hamad, Zahraa F. Saadoon, Lamia Naseer, William C. Sultan, Carla Sultan, Taylor Schnepp, Arumugam R. Jayakumar
Format: Article
Language:English
Published: MDPI AG 2024-12-01
Series:Neurology International
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Online Access:https://www.mdpi.com/2035-8377/16/6/120
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author Aya Fadel
Hussain Hussain
Robert J. Hernandez
Amanda Marie Clichy Silva
Amir Agustin Estil-las
Mohammad Hamad
Zahraa F. Saadoon
Lamia Naseer
William C. Sultan
Carla Sultan
Taylor Schnepp
Arumugam R. Jayakumar
author_facet Aya Fadel
Hussain Hussain
Robert J. Hernandez
Amanda Marie Clichy Silva
Amir Agustin Estil-las
Mohammad Hamad
Zahraa F. Saadoon
Lamia Naseer
William C. Sultan
Carla Sultan
Taylor Schnepp
Arumugam R. Jayakumar
author_sort Aya Fadel
collection DOAJ
description Neurosyphilis-induced dementia represents a severe manifestation of tertiary syphilis, characterized by cognitive and neuropsychiatric impairments. This condition arises from the progression of syphilis to the central nervous system, where the spirochete causes damage through invasion, chronic inflammation, and neurodegeneration. The pathophysiology involves chronic inflammatory responses, direct bacterial damage, and proteinopathies. <i>Treponema pallidum</i> triggers an inflammatory cascade, resulting in neuronal injury and synaptic dysfunction. Abnormal protein accumulations, including TAR DNA-binding protein 43 (TDP-43) and tau, contribute to neuronal loss and cognitive decline. Seizures, psychiatric symptoms, and motor deficits further complicate the progression of dementia. Diagnosis includes clinical assessment, cerebrospinal fluid analysis, and neuroimaging. Diagnostic tests include CSF-VDRL, FTA-ABS, and neuroimaging techniques such as MRI and PET scans, which help detect structural changes and confirm neurosyphilis. Management of neurosyphilis-induced dementia involves antibiotic therapy and psychotropic medications to address both infectious and symptomatic components. While penicillin remains the cornerstone of treatment, psychotropic agents, including haloperidol, risperidone, quetiapine, and divalproex sodium, can manage psychiatric symptoms. However, careful monitoring is required due to potential side effects and interactions with ongoing treatment. Overall, early diagnosis and comprehensive management are crucial for mitigating the cognitive and neuropsychiatric impairments associated with neurosyphilis-induced dementia.
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spelling doaj-art-bedec0267b92443da9d634d7565bf8ae2025-08-20T02:51:07ZengMDPI AGNeurology International2035-83772024-12-011661653166510.3390/neurolint16060120Mechanisms of Neurosyphilis-Induced Dementia: Insights into PathophysiologyAya Fadel0Hussain Hussain1Robert J. Hernandez2Amanda Marie Clichy Silva3Amir Agustin Estil-las4Mohammad Hamad5Zahraa F. Saadoon6Lamia Naseer7William C. Sultan8Carla Sultan9Taylor Schnepp10Arumugam R. Jayakumar11Department of Internal Medicine at Ocean Medical Center, Hackensack Meridian Health, Hackensack, NJ 07601, USADepartment of Internal Medicine, HCA Florida Kendall Hospital, Miami, FL 33175, USADepartment of Internal Medicine, HCA Florida Kendall Hospital, Miami, FL 33175, USASchool of Medicine, St. George’s University, 3500 Great River, Islip, NY 11739, USASchool of Medicine, Ross University, Miramar, FL 33025, USASchool of Medicine, Ross University, Miramar, FL 33025, USADepartment of Internal Medicine, HCA Florida Kendall Hospital, Miami, FL 33175, USADepartment of Internal Medicine, HCA Florida Kendall Hospital, Miami, FL 33175, USADepartment of Psychiatry, Broward Health Medical Center, Fort Lauderdale, FL 33316, USADepartment of Psychiatry, Southern Winds Hospital, Hialeah, FL 33012, USASchool of Medicine, Ross University, Miramar, FL 33025, USADepartment of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, University of Miami Miller, Miami, FL 33136, USANeurosyphilis-induced dementia represents a severe manifestation of tertiary syphilis, characterized by cognitive and neuropsychiatric impairments. This condition arises from the progression of syphilis to the central nervous system, where the spirochete causes damage through invasion, chronic inflammation, and neurodegeneration. The pathophysiology involves chronic inflammatory responses, direct bacterial damage, and proteinopathies. <i>Treponema pallidum</i> triggers an inflammatory cascade, resulting in neuronal injury and synaptic dysfunction. Abnormal protein accumulations, including TAR DNA-binding protein 43 (TDP-43) and tau, contribute to neuronal loss and cognitive decline. Seizures, psychiatric symptoms, and motor deficits further complicate the progression of dementia. Diagnosis includes clinical assessment, cerebrospinal fluid analysis, and neuroimaging. Diagnostic tests include CSF-VDRL, FTA-ABS, and neuroimaging techniques such as MRI and PET scans, which help detect structural changes and confirm neurosyphilis. Management of neurosyphilis-induced dementia involves antibiotic therapy and psychotropic medications to address both infectious and symptomatic components. While penicillin remains the cornerstone of treatment, psychotropic agents, including haloperidol, risperidone, quetiapine, and divalproex sodium, can manage psychiatric symptoms. However, careful monitoring is required due to potential side effects and interactions with ongoing treatment. Overall, early diagnosis and comprehensive management are crucial for mitigating the cognitive and neuropsychiatric impairments associated with neurosyphilis-induced dementia.https://www.mdpi.com/2035-8377/16/6/120dementiaTDP-43syphilisneurosyphilispenicillin
spellingShingle Aya Fadel
Hussain Hussain
Robert J. Hernandez
Amanda Marie Clichy Silva
Amir Agustin Estil-las
Mohammad Hamad
Zahraa F. Saadoon
Lamia Naseer
William C. Sultan
Carla Sultan
Taylor Schnepp
Arumugam R. Jayakumar
Mechanisms of Neurosyphilis-Induced Dementia: Insights into Pathophysiology
Neurology International
dementia
TDP-43
syphilis
neurosyphilis
penicillin
title Mechanisms of Neurosyphilis-Induced Dementia: Insights into Pathophysiology
title_full Mechanisms of Neurosyphilis-Induced Dementia: Insights into Pathophysiology
title_fullStr Mechanisms of Neurosyphilis-Induced Dementia: Insights into Pathophysiology
title_full_unstemmed Mechanisms of Neurosyphilis-Induced Dementia: Insights into Pathophysiology
title_short Mechanisms of Neurosyphilis-Induced Dementia: Insights into Pathophysiology
title_sort mechanisms of neurosyphilis induced dementia insights into pathophysiology
topic dementia
TDP-43
syphilis
neurosyphilis
penicillin
url https://www.mdpi.com/2035-8377/16/6/120
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