Neurological and biological aspects of Konzo: new perspectives
Background: Cassava is a tropical crop that constitutes a staple food for millions of people worldwide. Toxic (bitter) varieties of cassava require efficient treatment in order to reduce the rate of cyanogenic glucosides in the plant before safe consumption. Populations undergoing severe food deprivation rely more exclusively on poorly processed (toxic) cassava and have poor protein intake, both factors favouring appearance of konzo, a neglected crippling disease characterised by an abrupt, permanent and non-progressive spastic paraparesis handicapping the most active portion of the population at high frequency in affected communities. A recent study suggests that, in addition to limb paresis, konzo-affected patients display cognitive impairment of which determinants have still to be specified. In addition, despite the two well-reported risk factors (of which respective importance should be better understood), the cause of konzo remains undetermined. The contribution of other factors like infections and vitamin deficiency has also to be clarified. Objectives: to evaluate the respective importance of the malnutrition and cyanide intoxication in konzo and the contribution of thyroid dysfunction in poor cognitive performance of konzo patients; to further study the causal factor and review the contribution of other factors (infections, vitamin deficiency, etc) to konzo. Methodology: We will conduct an observational case-control field study in South-Kivu recording data from patients with konzo and goitre. An additional experimental study will evaluate in vitro toxicity of experimentally generated or synthetic cyanide metabolites on cultured motoneurons, as a contribution to better understand the cause of konzo.
Period of project
15 September 2017 - 31 December 2017