Generic placeholder image

Infectious Disorders - Drug Targets


ISSN (Print): 1871-5265
ISSN (Online): 2212-3989


Association between Toxoplasma gondii Infection and Headache: A Systematic Review and Meta-Analysis

Author(s): Tooran Nayeri, Shahabeddin Sarvi, Mahmood Moosazadeh, Zahra Hosseininejad, Afsaneh Amouei and Ahmad Daryani*

Volume 21, Issue 4, 2021

Published on: 17 June, 2020

Page: [643 - 650] Pages: 8

DOI: 10.2174/1871526520666200617135851

Price: $65


Background: The impact of infectious agents, such as Toxoplasma gondii (T. gondii), on human behavior and mental disorders, has recently attracted the attention of researchers. T. gondii has emerged as a suitable candidate for such disorders due to its neutral nature. Therefore, the current study aimed at investigating the possible relationship between T. gondii infection and headache.

Methods: Five databases were thoroughly searched (up to October 4, 2019) for articles on the prevalence of T. gondii in headache sufferers. In this study, the odds ratio (OR) and corresponding 95% confidence interval (CI) were estimated using a random effect model and forest plot to gauge effect size and effect of each study.

Results: A total number of four articles, including one cross-sectional and three case-control studies 2517 participants, entered the meta-analysis, out of whom, 1205 subjects were afflicted with headache or migraine (17.67% positive for toxoplasmosis) and 1312 participants were not (18.29% for toxoplasmosis). The results of the meta-analysis indicated a common OR of 1.59 (95% CI: 1.03-2.47) by the random effect model.

Conclusion: The obtained results of several studies have linked toxoplasmosis and headache. Therefore, more quality studies with larger sample sizes are needed to determine the detailed association between headache and T. gondii infection for the prevention and control of toxoplasmosis among headache sufferers.

Keywords: Toxoplasma gondii, toxoplasmosis, headache, migraine, systematic review, meta-analysis.

Graphical Abstract
Denkers, E.Y.; Gazzinelli, R.T. Regulation and function of T-cell-mediated immunity duringToxoplasma gondii infection. Clin. Microbiol. Rev., 1998, 11(4), 569-588.
[PMID: 9767056]
Tenter, A.M.; Heckeroth, A.R.; Weiss, L.M. Toxoplasma gondii: from animals to humans. Int. J. Parasitol., 2000, 30(12-13), 1217-1258.
[PMID: 11113252]
Hill, D.; Dubey, J.P. Toxoplasma gondii: transmission, diagnosis and prevention. Clin. Microbiol. Infect., 2002, 8(10), 634-640.
[PMID: 12390281]
Koseoglu, E.; Yazar, S.; Koc, I. Is Toxoplasma gondii a causal agent in migraine? Am. J. Med. Sci., 2009, 338(2), 120-122.
[PMID: 19564786]
Mathew, M.J.; Chandy, M.J. Central nervous system toxoplasmosis in acquired immunodeficiency syndrome: An emerging disease in India. Neurol. India, 1999, 47(3), 182-187.
[PMID: 10514576]
Fung, H.B.; Kirschenbaum, H.L. Treatment regimens for patients with toxoplasmic encephalitis. Clin. Ther., 1996, 18(6), 1037-1056.
[PMID: 9001822]
Nissapatorn, V.; Lee, C.; Quek, K.F.; Leong, C.L.; Mahmud, R.; Abdullah, K.A. Toxoplasmosis in HIV/AIDS patients: a current situation. Jpn. J. Infect. Dis., 2004, 57(4), 160-165.
[PMID: 15329448]
Haj, S.M. Severe unexplained headache and toxoplasmosis in the normal “imunocompetent patients”. J US China Med Sci, 2011, 8(6), 359-365.
Olesen, J.; Pain, F. The international classification of headache disorders. Headache, 2008, 48(5), 691-693.
[PMID: 18471112]
Solomon, S. Diagnosis of primary headache disorders: validity of the international headache society criteria in clinical practice. Neurol. Clin., 1997, 15(1), 15-26.
[PMID: 9058394]
Mathers, CD; Stein, C; Ma Fat, D. Global burden of disease 2000: version 2 methods and results 2002.
Piane, M.; Lulli, P.; Farinelli, I.; Simeoni, S.; De Filippis, S.; Patacchioli, F.R.; Martelletti, P. Genetics of migraine and pharmacogenomics: some considerations. J. Headache Pain, 2007, 8(6), 334-339.
[PMID: 18058067]
Köseoglu, E.; Naçar, M.; Talaslioglu, A.; Cetinkaya, F. Epidemiological and clinical characteristics of migraine and tension type headache in 1146 females in Kayseri, Turkey. Cephalalgia, 2003, 23(5), 381-388.
[PMID: 12780769]
Moher, D.; Liberati, A.; Tetzlaff, J.; Altman, D.G. PRISMA Group. Reprint--preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Phys. Ther., 2009, 89(9), 873-880.
[PMID: 19723669]
Wells, G.; Shea, B.; O’connell, D. The Newcastle Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analysesOttawa Hospital Research Institute oxford; , 2015.
Higgins, J.P.; Thompson, S.G. Quantifying heterogeneity in a meta-analysis. Stat. Med., 2002, 21(11), 1539-1558.
[PMID: 12111919]
Egger, M.; Davey Smith, G.; Schneider, M.; Minder, C. Bias in meta-analysis detected by a simple, graphical test. BMJ, 1997, 315(7109), 629-634.
[PMID: 9310563]
Prandota, J. Recurrent headache as the main symptom of acquired cerebral toxoplasmosis in nonhuman immunodeficiency virus-infected subjects with no lymphadenopathy: the parasite may be responsible for the neurogenic inflammation postulated as a cause of different types of headaches. Am. J. Ther., 2007, 14(1), 63-105.
[PMID: 17303977]
Silva, C.S.; Neves, Ede.S.; Benchimol, E.I.; Moraes, D.R. Postnatal acquired toxoplasmosis patients in an infectious diseases reference center. Braz. J. Infect. Dis., 2008, 12(5), 438-441.
[PMID: 19219285]
Wong, W.K.; Upton, A.; Thomas, M.G. Neuropsychiatric symptoms are common in immunocompetent adult patients with Toxoplasma gondii acute lymphadenitis. Scand. J. Infect. Dis., 2013, 45(5), 357-361.
[PMID: 23210638]
Santoni, J.R.; Santoni-Williams, C.J. Headache and painful lymphadenopathy in extracranial or systemic infection: etiology of new daily persistent headaches. Intern. Med., 1993, 32(7), 530-532.
[PMID: 8286828]
Ramezani, M.; Shojaii, M.; Asadollahi, M. Seroprevalence of Toxoplasma gondii in Iranian patients with idiopathic Parkinson’s disease. Clin. Exp. Neuroimmunol., 2016, 7(4), 361-365.
Alvarado-Esquivel, C.; Rico-Almochantaf, Y.D.R.; Sanchez-Anguiano, L.F.; Quinones-Canales, G.; Hernandez-Tinoco, J.; Torres-Gonzalez, J.; Gonzalez-Silva, M.F.; Ramirez-Valles, E.G. Toxoplasma gondii infection and headache: a matched case-control study in a public hospital in Durango City, Mexico. J. Clin. Med. Res., 2018, 10(1), 27-31.
[] [PMID: 29238431]
Flegr, J.; Escudero, D.Q. Impaired health status and increased incidence of diseases in Toxoplasma-seropositive subjects - an explorative cross-sectional study. Parasitology, 2016, 143(14), 1974-1989.
[PMID: 27719690]
Prandota, J.; Gryglas, A.; Fuglewicz, A.; Zesławska-Faleńczyk, A.; Ujma-Czapska, B.; Szenborn, L.; Mierzwa, J. Recurrent headaches may be caused by cerebral toxoplasmosis. World J. Clin. Pediatr., 2014, 3(3), 59-68.
[PMID: 25254186]
Feigin, V.L.; Abajobir, A.A.; Abate, K.H. GBD 2015 Neurological Disorders Collaborator Group. Global, regional, and national burden of neurological disorders during 1990-2015: a systematic analysis for the global burden of disease study 2015. Lancet Neurol., 2017, 16(11), 877-897.
[PMID: 28931491]
Dardé, M.L. Toxoplasma gondii, “new” genotypes and virulence. Parasite, 2008, 15(3), 366-371.
[PMID: 18814708]
Sutterland, A.L.; Fond, G.; Kuin, A.; Koeter, M.W.; Lutter, R.; van Gool, T.; Yolken, R.; Szoke, A.; Leboyer, M.; de Haan, L. Beyond the association. Toxoplasma gondii in schizophrenia, bipolar disorder, and addiction: systematic review and meta-analysis. Acta Psychiatr. Scand., 2015, 132(3), 161-179.
[PMID: 25877655]
Nayeri Chegeni, T.; Sarvi, S.; Amouei, A.; Moosazadeh, M.; Hosseininejad, Z.; A Aghayan, S.; Daryani, A. Relationship between toxoplasmosis and obsessive compulsive disorder: A systematic review and meta-analysis. PLoS Negl. Trop. Dis., 2019, 13(4)e0007306
[PMID: 30969961]
Ngoungou, E.B.; Bhalla, D.; Nzoghe, A.; Dardé, M.L.; Preux, P.M. Toxoplasmosis and epilepsy--systematic review and meta analysis. PLoS Negl. Trop. Dis., 2015, 9(2)e0003525
[PMID: 25695802]
Nayeri Chegeni, T.; Sarvi, S.; Moosazadeh, M.; Sharif, M.; Aghayan, S.A.; Amouei, A.; Hosseininejad, Z.; Daryani, A. Is Toxoplasma gondii a potential risk factor for Alzheimer’s disease? A systematic review and meta-analysis. Microb. Pathog., 2019, 137103751
[PMID: 31536800]
Nayeri Chegeni, T.; Sharif, M.; Sarvi, S.; Moosazadeh, M.; Montazeri, M.; Aghayan, S.A.; Balalami, N.J.; Gholami, S.; Hosseininejad, Z.; Saberi, R.; Anvari, D.; Gohardehi, S.; Daryani, A. Is there any association between Toxoplasma gondii infection and depression? A systematic review and meta-analysis. PLoS One, 2019, 14(6)e0218524
[PMID: 31194852]
Nayeri, T.; Sarvi, S.; Moosazadeh, M.; Hosseininejad, Z.; Amouei, A.; Daryani, A. Toxoplasma gondii infection and risk of attention-deficit hyperactivity disorder: a systematic review and meta-analysis. Pathog. Glob. Health, 2020, 114(3), 117-126.
[PMID: 32186992]
Perry, C.E.; Gale, S.D.; Erickson, L.; Wilson, E.; Nielsen, B.; Kauwe, J.; Hedges, D.W. Seroprevalence and serointensity of latent Toxoplasma gondii in a sample of elderly adults with and without Alzheimer disease. Alzheimer Dis. Assoc. Disord., 2016, 30(2), 123-126.
[PMID: 26421353]
Carruthers, V.B.; Suzuki, Y. Effects of Toxoplasma gondii infection on the brain. Schizophr. Bull., 2007, 33(3), 745-751.
[PMID: 17322557]
Suzuki, Y. Host resistance in the brain against Toxoplasma gondii. J. Infect. Dis., 2002, 185(Suppl. 1), S58-S65.
[PMID: 11865441]
Tan, L.; Yu, J.T.; Tan, L. The kynurenine pathway in neurodegenerative diseases: mechanistic and therapeutic considerations. J. Neurol. Sci., 2012, 323(1-2), 1-8.
[] [PMID: 22939820]
Cerávolo, I.P.; Chaves, A.C.; Bonjardim, C.A.; Sibley, D.; Romanha, A.J.; Gazzinelli, R.T. Replication of Toxoplasma gondii, but not Trypanosoma cruzi, is regulated in human fibroblasts activated with gamma interferon: Requirement of a functional JAK/STAT pathway. Infect. Immun., 1999, 67(5), 2233-2240.
[PMID: 10225879]
Lane, R.D.P. Migraine; Taylor & Francis: New York, 2006.
Guk, S.M.; Kook, J.; Jeon, Y.H.; Choi, J.H.; Han, E.T.; Shin, E.H.; Chai, J.Y. Suppressed cytokine and immunoglobulin secretions by murine splenic lymphocytes infected in vitro with Toxoplasma gondii tachyzoites. J. Parasitol., 2005, 91(2), 467-470.
[PMID: 15986629]
Lüder, C.G.; Algner, M.; Lang, C.; Bleicher, N.; Gross, U. Reduced expression of the inducible nitric oxide synthase after infection with Toxoplasma gondii facilitates parasite replication in activated murine macrophages. Int. J. Parasitol., 2003, 33(8), 833-844.
[PMID: 12865083]
Flegr, J. Neurological and neuropsychiatric consequences of chronic Toxoplasma infection. Curr Clin Micro Rpt, 2015, 2(4), 163-172.

Rights & Permissions Print Export Cite as
© 2023 Bentham Science Publishers | Privacy Policy