Helicobacter Pylori Infection Is Associated with Neurodegeneration in Cognitively Normal Men

Article type: Research Article

Authors: Park, Jaehong^{a; b; 1} | Kim, Tae Jun^{c; 1} | Song, Joo Hye^c | Jang, Hyemin^{a; b} | Kim, Ji Sun^{a; b} | Kang, Sung Hoon^{a; b; d} | Kim, Hang-Rai^{a; b; e} | Hwangbo, Song^{a; b} | Shin, Hee Young^f | Na, Duk L.^{a; b; g} | Seo, Sang Won^{a; b; g; h} | Kim, Hee Jin^{a; b; g; i; 2; *} | Kim, Jae J.^{c; 2; *}

Affiliations: [a] Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea | [b] Alzheimer’s Disease Convergence Research Center, Samsung Medical Center, Seoul, Korea | [c] Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea | [d] Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea | [e] Department of Neurology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea | [f] Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea | [g] Department of Health Science and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea | [h] Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, Korea | [i] Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Korea

Correspondence: [*] Correspondence to: Jae J. Kim, MD, PhD, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea. Tel.: +822 3410 3409; Fax: +822 3410 6983; E-mail: jaej.kim@samsung.com and Hee Jin Kim, MD, PhD, Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea. Tel.: +822 3410 6147; Fax: +822 3410 0052; E-mail: evekhj@gmail.com.

Note: [1,2] These authors contributed equally to this work.

Abstract: Background:An association between Helicobacter pylori (H. pylori) infection and dementia was reported in previous studies; however, the evidence is inconsistent. Objective:In the present study, the association between H. pylori infection and brain cortical thickness as a biomarker of neurodegeneration was investigated. Methods:A cross-sectional study of 822 men who underwent a medical health check-up, including an esophagogastroduodenoscopy and 3.0 T magnetic resonance imaging, was performed. H. pylori infection status was assessed based on histology. Multiple linear regression analyses were conducted to evaluate the relationship between H. pylori infection and brain cortical thickness. Results:Men with H. pylori infection exhibited overall brain cortical thinning (p = 0.022), especially in the parietal (p = 0.008) and occipital lobes (p = 0.050) compared with non-infected men after adjusting for age, educational level, alcohol intake, smoking status, and intracranial volume. 3-dimentional topographical analysis showed that H. pylori infected men had cortical thinning in the bilateral lateral temporal, lateral frontal, and right occipital areas compared with non-infected men with the same adjustments (false discovery rate corrected, Q < 0.050). The association remained significant after further adjusting for inflammatory marker (C-reactive protein) and metabolic factors (obesity, dyslipidemia, fasting glucose, and blood pressure). Conclusion:Our results indicate H. pylori infection is associated with neurodegenerative changes in cognitive normal men. H. pylori infection may play a pathophysiologic role in the neurodegeneration and further studies are needed to validate this association.

Keywords: Cognitive impairment, dementia, H. pylori, neurodegeneration

DOI: 10.3233/JAD-210119

Journal: Journal of Alzheimer's Disease, vol. 82, no. 4, pp. 1591-1599, 2021