Samaan Zainab, McDermid Vaz Stephanie, Bawor Monica, Potter Tammy Hlywka, Eskandarian Sasha, Loeb Mark
Department of Psychiatry & Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada.
Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada.
PLoS One. 2016 Jun 28;11(6):e0158364. doi: 10.1371/journal.pone.0158364. eCollection 2016.
West Nile virus emerged as an important human pathogen in North America and continues to pose a risk to public health. It can cause a highly variable range of clinical manifestations ranging from asymptomatic to severe illness. Neuroinvasive disease due to West Nile virus can lead to long-term neurological deficits and psychological impairment. However, these deficits have not been well described. The objective of this study was to characterize the neuropsychological manifestations of West Nile virus infection with a focus on neuroinvasive status and time since infection.
Patients from Ontario Canada with a diagnosis of neuroinvasive disease (meningitis, encephalitis, or acute flaccid paralysis) and non-neuroinvasive disease who had participated in a cohort study were enrolled. Clinical and laboratory were collected, as well as demographics and medical history. Cognitive functioning was assessed using a comprehensive battery of neuropsychological tests.
Data from 49 individuals (32 with West Nile fever and 17 with West Nile neuroinvasive disease) were included in the present cross-sectional analysis. Patterns of neuropsychological impairment were comparable across participants with both neuroinvasive and non-neuroinvasive West Nile virus infection on all cognitive measures. Neuropsychiatric impairment was also observed more frequently at two to four years post-infection compared to earlier stages of illness.
Our data provide objective evidence for cognitive difficulties among patients who were infected with West Nile virus; these deficits appear to manifest regardless of severity of West Nile virus infection (West Nile fever vs. West Nile neuroinvasive disease), and are more prevalent with increasing illness duration (2-4 years vs. 1 month). Data from this study will help inform patients and healthcare providers about the expected course of recovery, as well as the need to implement effective treatment strategies that include neuropsychological interventions.
西尼罗河病毒在北美成为一种重要的人类病原体，并继续对公众健康构成风险。它可导致从无症状到严重疾病的一系列高度可变的临床表现。西尼罗河病毒引起的神经侵袭性疾病可导致长期神经功能缺损和心理障碍。然而，这些缺损尚未得到充分描述。本研究的目的是描述西尼罗河病毒感染的神经心理学表现，重点关注神经侵袭状态和感染后的时间。
纳入加拿大安大略省参与队列研究的诊断为神经侵袭性疾病（脑膜炎、脑炎或急性弛缓性麻痹）和非神经侵袭性疾病的患者。收集临床和实验室数据，以及人口统计学和病史。使用一系列全面的神经心理学测试评估认知功能。
本横断面分析纳入了49名个体的数据（32例西尼罗河热患者和17例西尼罗河神经侵袭性疾病患者）。在所有认知测量中，神经侵袭性和非神经侵袭性西尼罗河病毒感染的参与者的神经心理学损害模式具有可比性。与疾病早期相比，感染后两到四年神经精神损害也更频繁地被观察到。
我们的数据为感染西尼罗河病毒的患者存在认知困难提供了客观证据；这些缺损似乎无论西尼罗河病毒感染的严重程度如何（西尼罗河热与西尼罗河神经侵袭性疾病）都会出现，并且随着病程延长（2 - 4年与1个月）更为普遍。本研究的数据将有助于告知患者和医疗保健提供者预期的恢复过程，以及实施包括神经心理学干预在内的有效治疗策略的必要性。
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