Veleva Ivanka, Stoychev Kaloyan, Stoimenova-Popova Maya, Stoyanov Lyudmil, Mineva-Dimitrova Eleonora, Angelov Ivelin
Department of Psychiatry and Medical Psychology, Medical University Pleven, Bulgaria.
Department of Infectious Diseases, Epidemiology, Parasitology and Tropical Medicine, Medical University Pleven, Bulgaria.
Schizophr Res Cogn. 2022 Aug 27;30:100269. doi: 10.1016/j.scog.2022.100269. eCollection 2022 Dec.
Based on the limited research focusing on the severity of cognitive deterioration in schizophrenia with preceding toxoplasmosis, we sampled 89 demographically matched paranoid schizophrenia patients (mean age 38.97 years) with (n = 42) and without (n = 47) seroprevalence of IgG type anti antibodies as marker of past infection. They underwent examination of verbal memory (10 words Luria test), logical memory and visual memory (BVRT), processing speed (TMT-A/DSST) and executive functions (TMT-B/verbal fluency). We compared the results of both groups, taking into account the normative values for the Bulgarian population where available. We also compared the two groups in terms of clinical severity as evidenced by positive, negative and disorganization sub-scores of the PANSS.
While both groups were expectedly under the population norms for verbal and logical memory, seropositive patients showed significantly bigger impairment in verbal memory (Luria Smax = 72.85 vs 78.51; p = 0.029), psychomotor speed (TMT-A 50.98 s vs 44.64 s; p = 0.017), semantic verbal fluency (27.12 vs 30.02; p = 0.011) and literal verbal fluency (17.17 vs 18.78; p = 0.014) compared to the seronegative ones. In addition to that, they gave less correct answers on the BVRT (2.98 vs 4.09; p = 0.006) while making markedly more errors (13.95 vs 10.21; p = 0.002). Despite not reaching statistical significance, past toxoplasmosis was associated with higher score on the PANSS disorganization sub-scale (16.50 points vs 14.72 points) and with lower educational attainment.
Our results suggest a more profound neuropathological insult(s) resulting in greater cognitive impairment in schizophrenia cases that are exposed to infection.
基于针对先前患有弓形虫病的精神分裂症患者认知衰退严重程度的有限研究，我们选取了89例人口统计学匹配的偏执型精神分裂症患者（平均年龄38.97岁），其中42例有IgG型抗 抗体血清阳性率作为既往感染标记物（有感染组），47例无该血清阳性率（无感染组）。他们接受了言语记忆（10个单词的鲁利亚测试）、逻辑记忆和视觉记忆（本顿视觉保持测验）、处理速度（连线测验A/数字符号替换测验）以及执行功能（连线测验B/言语流畅性）的检查。我们比较了两组的结果，并参考了保加利亚人群的常模数据（如有）。我们还根据阳性和阴性症状量表（PANSS）的阳性、阴性和紊乱分量表所显示的临床严重程度对两组进行了比较。
虽然两组在言语和逻辑记忆方面均低于人群常模，但血清阳性患者在言语记忆（鲁利亚测试最大得分=72.85对78.51；p=0.029）、精神运动速度（连线测验A为50.98秒对44.64秒；p=0.017）、语义言语流畅性（27.12对30.02；p=0.011）和字面言语流畅性（17.17对18.78；p=0.014）方面比血清阴性患者有更明显的损害。此外，他们在本顿视觉保持测验中的正确答案更少（2.98对4.09；p=0.006），而错误明显更多（13.95对10.21；p=0.002）。尽管未达到统计学显著性，但既往弓形虫病与PANSS紊乱分量表得分较高（16.50分对14.72分）以及受教育程度较低有关。
我们的结果表明，在感染过弓形虫的精神分裂症病例中，存在更严重的神经病理学损伤，导致更严重的认知障碍。
