Seroprevalence of latent toxoplasmosis and its association with clinical outcomes in patients with acute ischemic stroke; a case-control study in northeastern Iran

Abstract

This study examined the seroprevalence of Toxoplasma gondii (T. gondii), a neurotropic protozoan associated with neuropsychiatric disorders, in patients with acute ischemic stroke (AIS) and its influence on clinical outcomes. This case-control study included 100 AIS patients at Imam Hassan Hospital, Bojnourd. Stroke severity was assessed using the NIHSS on days one and seven post-admission. Disability was evaluated three months post-discharge with the mRS. A control group of 100 age- and sex-matched healthy individuals was included. Serum samples were tested for anti-T. gondii IgG and IgM antibodies using indirect ELISA. IgG avidity was measured with modified ELISA using urea treatment. No significant difference was observed in anti-Toxoplasma gondii IgG seroprevalence between AIS patients (48 %) and controls (35 %, P = 0.084), with all subjects seronegative for IgM. However, seropositive AIS patients had significantly higher 3-month mRS scores, indicating greater disability. Anti-T. gondii IgG levels were significantly elevated in the AIS group and correlated with higher 24-h NIHSS scores, reflecting increased stroke severity. No differences in IgG avidity were found. Although our findings do not establish T. gondii infection as a direct risk factor for AIS, they suggest a potential role in disease pathogenesis and outcomes. However, further studies are needed to validate these observations.