Gascón M R P, Casseb J, Smid J, Vidal J E, Fonseca L A M, Paiva A, Haziot M J, Penalva de Oliveira A C
Department of Psychology, Hospital das Clinicas, São Paulo University Medical School, São Paulo, Brazil.
Institute of Tropical Medicine, São Paulo University, São Paulo, Brazil.
J Neurol Sci. 2017 Jun 15;377:185-189. doi: 10.1016/j.jns.2017.04.019. Epub 2017 Apr 13.
The main goal of this study was to investigate the presence of cognitive impairment in patients infected with HTLV-1 presenting or not TSP/HAM.
Cross-sectional study including 104 participants: 37 asymptomatic HTLV-1 carriers, 37 patients diagnosed with TSP/HAM and 30 HTLV-1 negative control patients. Within the HTLV-1 positive group, 53 were female and 21 were male, the average age was 46 (SD=13.5) and the average schooling time was 7.7years (SD=3.3).The sociodemographic variables (genre, age and education) were compared between the three groups. The assessment tools used were: Beck Depression Inventory, Lawton's Activities of Daily Life Scale and a complete neuropsychological battery. The application of these assessment tools was carried out in blind. Both HTLV-1 asymptomatic subjects and HAM/TSP patients showed a lower performance on neuropsychological tests and higher depression scores when compared to the control group. HTLV-1 patients performed poorly in several cognitive domains, but only fluid intelligence, estimated intellectual functioning, immediate and delayed recall of visual memory and information processing speed (in the specific case of patients with TSP/HAM) reached statistical significance when compared with controls. Depression was not associated with cognitive impairment. HTLV-1 carriers presented a higher frequency of cognitive impairment than normal controls.
本研究的主要目的是调查感染人类嗜T细胞病毒1型(HTLV-1)且有或无热带痉挛性截瘫/人类免疫缺陷病毒相关脊髓病(TSP/HAM)的患者中认知障碍的存在情况。
横断面研究纳入104名参与者:37名无症状HTLV-1携带者、37名诊断为TSP/HAM的患者和30名HTLV-1阴性对照患者。在HTLV-1阳性组中,女性53名,男性21名,平均年龄为46岁(标准差=13.5),平均受教育时间为7.7年(标准差=3.3)。比较了三组之间的社会人口统计学变量(性别、年龄和教育程度)。使用的评估工具包括:贝克抑郁量表、劳顿日常生活活动量表和一套完整的神经心理测试组。这些评估工具的应用是在盲态下进行的。与对照组相比,HTLV-1无症状受试者和HAM/TSP患者在神经心理测试中的表现较差,抑郁评分较高。HTLV-1患者在几个认知领域表现不佳,但与对照组相比,只有流体智力、估计智力功能、视觉记忆的即时和延迟回忆以及信息处理速度(在TSP/HAM患者的特定情况下)达到统计学意义。抑郁与认知障碍无关。HTLV-1携带者认知障碍的发生率高于正常对照组。