Review
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World J Transl Med. Apr 12, 2014; 3(1): 9-16
Published online Apr 12, 2014. doi: 10.5528/wjtm.v3.i1.9
Neurological and behavioral manifestations of cerebral malaria: An update
Marta Chagas Monteiro, Fabio Rodrigues Oliveira, Gedeao Batista Oliveira, Pedro Roosevelt Torres Romao, Cristiane Socorro Ferraz Maia
Marta Chagas Monteiro, Cristiane Socorro Ferraz Maia, Programa de Pos-Graduacao em Ciencias Farmaceuticas, Instituto de Ciencias da Saude, Universidade Federal do Para, Rua Augusto Correa, Campus Universitario do Guama, Belem, PA 66075900, Brazil
Marta Chagas Monteiro, Fabio Rodrigues Oliveira, Gedeao Batista Oliveira, Cristiane Socorro Ferraz Maia, Program in Pharmaceutical Sciences, Faculty of Pharmacy, Laboratory of inflammation and behavior, Federal University of Para/UFPA, Belem, PA 66075900, Brazil
Pedro Roosevelt Torres Romao, Programa de Pos-Graduacao em Ciencias da Saude, Universidade Federal de Ciencias da Saude de Porto Alegre, Porto Alegre, RS 90050170, Brazil
Author contributions: All authors contributed equally to this work.
Correspondence to: Cristiane Socorro Ferraz Maia, PhD, Program in Pharmaceutical Sciences, Faculty of Pharmacy, Laboratory of inflammation and behavior, Federal University of Para/UFPA, Rua Augusto Correia SN, Guama, Belem, PA 66075900, Brazil. crismaia@ufpa.br
Telephone: +55-91-32018826 Fax: +55-91-32017201
Received: December 28, 2013
Revised: March 6, 2014
Accepted: March 13, 2014
Published online: April 12, 2014
Processing time: 106 Days and 19.1 Hours
Abstract

Neglected tropical diseases are a group of tropical diseases endemic in poor countries even though medical treatment and cures are available. They are considered a global health problem due to the severity of the physiological changes they induce in their hosts. Malaria is a disease caused by Plasmodium sp. that in its cerebral form may lead to acute or long-term neurological deficits, even with effective antimalarial therapy, causing vascular obstruction, reduced cerebral blood flow and many other changes. However, Plasmodium falciparum infection can also develop into a cerebral malaria (CM) disease that can produce neurological damage. This review will discuss the mechanisms involved in the neuropathology caused by CM, focusing on alterations in cognitive, behavior and neurological functions in human and experimental models.

Keywords: Malaria; Cerebral malaria; Neuropathology; Plasmodium sp; Plasmodium falciparum

Core tip: This review attempts to compile the limited current knowledge on the behavioral and cognitive effects of cerebral malaria (CM) and the possible pathological mechanisms related to neurobehavioral manifestations. CM induces acute/chronic neurological damage, affecting several Central Nervous System regions responsible for behavioral, neurological and cognitive functions which may result in motor deficits, epilepsy, blindness, speech/hearing and memory/attention disorders, hyperactivity, anxiety-like behavior, neuropsychiatric manifestations of post malaria neurological syndrome, both in humans and animal models. The action mechanisms involved in the alterations are not yet clearly defined; however proinflammatory mediators have been described with consequent axonal damage and demyelination.