Peixoto Vanessa Giffoni M N P, Azevedo Julianna P, Luz Kleber G, Almondes Katie M
Post-graduation Program in Psychobiology, Universidade Federal do Rio Grande do Norte, Natal, Brazil.
Department of Clinical Medicine, Universidade Federal do Rio Grande do Norte, Natal, Brazil.
Front Psychiatry. 2022 Apr 5;13:823218. doi: 10.3389/fpsyt.2022.823218. eCollection 2022.
Chikungunya fever is a disabling articular disease caused by chikungunya virus (CHIKV). In the past decade it has affected millions of people across America, Africa, Asia, and Europe, turning this infection into a public health concern. The acute phase of chikungunya infection is usually self-limiting, characterized by severe arthralgia, fever, chills, myalgia, headache, and rash. CHIKV neurovirulence is evident and seems to be higher among elders. Considering their susceptibility to cognitive decline and dementia, the aim of our study was to investigate whether CHIKV infection might cause long-term cognitive impairment in aged people.
A cross-sectional study was conducted with volunteers aged from 60 to 90 who had been affected by chikungunya and also with healthy controls. A structured questionnaire was used to record demographic and clinical data, functional status, and depression. Global cognitive function was assessed through MoCA. A comprehensive neuropsychological battery was performed to assess specific cognitive functions.
Subjective memory complaints were present in 70% of subjects with previous chikungunya. This group had a poorer performance in MoCA ( = 0.000) and specific cognitive tests: Semantic ( = 0.05) and Phonemic Verbal Fluency ( = 0.003), 5-Digit (choice, reading, counting and alternance, = 0.003, = 0.014, = 0.021, and = 0.021, respectively), Stroop test (time, errors and interference, = 0.000, = 0.027 and = 0.015, respectively), and RAVLT (word total session = 0.05). These tests reflect performance on general executive functions, cognitive flexibility, inhibitory control, processing speed, semantic memory and episodic memory.
Our data suggest that CHIKV infection may cause long-term cognitive decline in aged people and might be a risk factor for future dementia in this population.
基孔肯雅热是一种由基孔肯雅病毒（CHIKV）引起的致残性关节疾病。在过去十年中，它已影响了美洲、非洲、亚洲和欧洲数百万人，使这种感染成为一个公共卫生问题。基孔肯雅感染的急性期通常是自限性的，其特征为严重关节痛、发热、寒战、肌痛、头痛和皮疹。CHIKV的神经毒性很明显，且在老年人中似乎更高。考虑到老年人易患认知能力下降和痴呆症，我们研究的目的是调查CHIKV感染是否可能导致老年人长期认知障碍。
对60至90岁曾感染基孔肯雅热的志愿者以及健康对照者进行了一项横断面研究。使用结构化问卷记录人口统计学和临床数据、功能状态及抑郁情况。通过蒙特利尔认知评估量表（MoCA）评估整体认知功能。进行了一套全面的神经心理学测试以评估特定认知功能。
70%既往感染基孔肯雅热的受试者存在主观记忆主诉。该组在MoCA（P = 0.000）及特定认知测试中表现较差：语义（P = 0.05）和音素言语流畅性（P = 0.003）、5位数（选择、阅读、计数和交替，分别为P = 0.003、P = 0.014、P = 0.021和P = 0.021）、斯特鲁普测试（时间、错误和干扰，分别为P = 0.000、P = 0.027和P = 0.015）以及雷伊听觉词语学习测验（单词总量，P = 0.05）。这些测试反映了一般执行功能、认知灵活性、抑制控制、处理速度、语义记忆和情景记忆方面的表现。
我们的数据表明，CHIKV感染可能导致老年人长期认知能力下降，并且可能是该人群未来患痴呆症的一个风险因素。
