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Vasectomy in Men With Primary Progressive Aphasia.

Weintraub S, Fahey C, Johnson N, Mesulam MM, Gitelman DR, Weitner BB, Rademaker A

*Cognitive Neurology and Alzheimerʼs Disease Center Departments of †Neurology ‡Psychiatry and Behavioral Sciences §Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.

OBJECTIVE: To study the frequency of vasectomy in men with primary progressive aphasia (PPA). BACKGROUND: PPA is a dementia syndrome in which aphasia emerges in relative isolation during the initial stages of illness. On the basis of a clinical observation in a patient who dated the onset of symptoms to the period after a vasectomy, and because of the curious sharing of the tau protein exclusively by brain and sperm, vasectomy rates were examined in men with PPA. METHOD: This study used a case control design. Forty-seven men with PPA and 57 men with no cognitive impairment (NC) between 55 and 80 years of age were surveyed about a history of vasectomy. RESULTS: The age-adjusted rate of vasectomy in PPA patients (40%) was higher than in NC (16%, P=0.02). There was a younger age at onset for the patients with vasectomy (58.8 vs. 62.9 y, P=0.03). CONCLUSIONS: Vasectomy may constitute one risk factor for PPA in men. Potential mechanisms mediating risk include vasectomy-induced immune responses to sperm, which shares antigenic epitopes with brain. Antisperm antibodies can also develop in women and become risk factors for PPA.

Published 12 December 2006 in Cogn Behav Neurol, 19(4): 190-193.
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