Emotion discrimination in humans: Its association with HSV-1 infection and its improvement with antiviral treatment

SCHIZOPHRENIA RESEARCH

卷:193

Article

Bhatia, Triptish¹  Wood, Joel²  Iyengar, Satish^2,3  Narayanan, Sreelatha S.⁴  Beniwal, Ram Pratap⁸  Prasad, Konasale M.²  Chen, Kehui^2,3  Yolken, Robert H.⁵  Dickerson, Faith⁶  Gur, Ruben C.⁷  Gur, Raquel E.⁷  Deshpande, Smita N.⁸  Nimgaonkar, Vishwajit L.^2,9 

[1] PGIMER Dr Ram Manohar Lohia Hosp, Ctr Excellence Mental Hlth, Dept Psychiat, Indo US Projects, Pk St, New Delhi 110001, India

[2] Univ Pittsburgh, WPIC, Dept Psychiat, Pittsburgh, PA 15213 USA

[3] Univ Pittsburgh, Dept Stat, Pittsburgh, PA 15260 USA

[4] PGIMER Dr Ram Manohar Lohia Hosp, Ctr Excellence Mental Hlth, GRIP NIH Project, Dept Psychiat, Pk St, New Delhi 110001, India

[5] Johns Hopkins Univ, Sch Med, Dept Pediat, Stanley Div Neurovirol, Baltimore, MD 21287 USA

[6] Sheppard Pratt IRB, 6501 North Charles St, Baltimore, MD 21204 USA

[7] Univ Penn, Dept Psychiat, Perelman Sch Med, Philadelphia, PA 19104 USA

[8] PGIMER Dr Ram Manohar Lohia Hosp, Ctr Excellence Mental Hlth, Dept Psychiat, Pk St, New Delhi 110001, India

[9] Univ Pittsburgh, Dept Human Genet, Pittsburgh, PA 15261 USA

关键词: Cognition;    Herpes virus;    HSV-1;    Schizophrenia;    Emotion;    Memory;    Valacyclovir;   

DOI  :  10.1016/j.schres.2017.08.001

来源: Elsevier

【 摘 要 】

Background: Herpes simplex virus, type 1 (HSV-1) infects over 3.4 billion people, world-wide. Though it can cause encephalitis, in the vast majority it is asymptomatic, with lifelong latent infection in neurons. HSV-1 infected individuals have greater cognitive dysfunction than uninfected individuals, particularly persons with schizophrenia - even without encephalitis. We investigated whether HSV-1 related cognitive dysfunction is progressive or remediable. Methods: In a prospective naturalistic followup sample (PNFU), temporal changes in cognitive functions were analyzed in relation to baseline HSV-1 infection in persons with/without schizophrenia (N= 226). Independently, in a randomized controlled trial (RCT), HSV-1 infected, clinically stabilized SZ outpatients received Valacyclovir (VAL, an HSV-1 specific antiviral, 1.5 G twice daily for 16 weeks) or placebo (PLA) added to standard antipsychotic treatment, using a stratified randomization design, following placebo run-in (N= 67). In both samples, HSV-1 infection (seropositivity) was estimated using serum IgG antibodies. Clinical evaluations were blinded to HSV-1 or treatment status. Standardized Z scores for accuracy on eight cognitive domains were analyzed for temporal trajectories using generalized linear models (PNFU) and VAL/PLA differences compared with intent to treat analyses (RCT). Results: PNFU: At baseline, HSV-1 infected participants had significantly lower accuracy scores for Emotion Identification and Discrimination (EMOD), Spatial memory and Spatial ability, regardless of SZ diagnosis (p=0.025, 0.029, 0.046, respectively). They also had significantly steeper temporal worsening for EMOD (p = 0.03). RCT: EMOD improved in VAL-treated patients (p= 0.048, Cohen's d = 0.43). Conclusions: A proportion of age related decline in EMOD is attributable to HSV-1 infection. (c) 2017 Elsevier B.V. All rights reserved.

【 授权许可】

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