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Vasectomy in Men With Primary Progressive Aphasia

Weintraub, Sandra PhD* † ‡; Fahey, Christopher MD; Johnson, Nancy PhD* ‡; Mesulam, Marek-Marsel MD* †; Gitelman, Darren R. MD* ‡; Weitner, Bing B. MS* §; Rademaker, Alfred PhD* §

Cognitive & Behavioral Neurology:
doi: 10.1097/01.wnn.0000213923.48632.ab
Original Studies

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.

Author Information

*Cognitive Neurology and Alzheimer's Disease Center

Departments of Neurology

Psychiatry and Behavioral Sciences

§Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL

Funding: Supported in part by Alzheimer's Disease Core Center grant (AG13854) from the National Institute on Aging to Northwestern University, Chicago, IL.

Reprints: Sandra Weintraub, PhD, Cognitive Neurology and Alzheimer's Disease Center, 320 East Superior, Searle 11-467, Chicago, IL 60611 (e-mail:

Received for publication June 1, 2006; accepted August 31, 2006

© 2006 Lippincott Williams & Wilkins, Inc.