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持续性感染神经嗜性疱疹病毒与认知障碍。

Persistent infection with neurotropic herpes viruses and cognitive impairment.

机构信息

Departments of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA.

出版信息

Psychol Med. 2013 May;43(5):1023-31. doi: 10.1017/S003329171200195X. Epub 2012 Sep 14.

Abstract

BACKGROUND

Herpes virus infections can cause cognitive impairment during and after acute encephalitis. Although chronic, latent/persistent infection is considered to be relatively benign, some studies have documented cognitive impairment in exposed persons that is untraceable to encephalitis. These studies were conducted among schizophrenia (SZ) patients or older community dwellers, among whom it is difficult to control for the effects of co-morbid illness and medications. To determine whether the associations can be generalized to other groups, we examined a large sample of younger control individuals, SZ patients and their non-psychotic relatives (n=1852). Method Using multivariate models, cognitive performance was evaluated in relation to exposures to herpes simplex virus type 1 (HSV-1), herpes simplex virus type 2 (HSV-2) and cytomegalovirus (CMV), controlling for familial and diagnostic status and sociodemographic variables, including occupation and educational status. Composite cognitive measures were derived from nine cognitive domains using principal components of heritability (PCH). Exposure was indexed by antibodies to viral antigens.

RESULTS

PCH1, the most heritable component of cognitive performance, declines with exposure to CMV or HSV-1 regardless of case/relative/control group status (p = 1.09 × 10-5 and 0.01 respectively), with stronger association with exposure to multiple herpes viruses (β = -0.25, p = 7.28 × 10-10). There were no significant interactions between exposure and group status.

CONCLUSIONS

Latent/persistent herpes virus infections can be associated with cognitive impairments regardless of other health status.

摘要

背景

疱疹病毒感染可导致急性脑炎期间和之后的认知障碍。虽然慢性潜伏/持续性感染被认为相对良性,但一些研究记录了暴露于病毒的个体存在无法追踪到脑炎的认知障碍。这些研究是在精神分裂症(SZ)患者或老年社区居民中进行的,其中很难控制合并症和药物的影响。为了确定这些关联是否可以推广到其他群体,我们检查了一大群年轻的对照个体、SZ 患者及其非精神病亲属(n=1852)。方法:使用多变量模型,评估了与单纯疱疹病毒 1(HSV-1)、单纯疱疹病毒 2(HSV-2)和巨细胞病毒(CMV)暴露相关的认知表现,控制了家族和诊断状况以及社会人口统计学变量,包括职业和教育状况。使用基于遗传成分的主要成分(PCH),从九个认知域中得出综合认知测量。暴露由病毒抗原的抗体来标记。

结果

认知表现最具遗传性的 PCH1 成分,无论病例/亲属/对照者群体状态如何,随着 CMV 或 HSV-1 的暴露而下降(分别为 p=1.09×10-5 和 0.01),与暴露于多种疱疹病毒的关联更强(β=-0.25,p=7.28×10-10)。暴露与群体状态之间没有显著的相互作用。

结论

潜伏/持续性疱疹病毒感染与认知障碍有关,而与其他健康状况无关。

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