Association between high proviral load, cognitive impairment, and white matter brain lesions in HTLV-1-infected individuals
Association between high proviral load, cognitive impairment, and white matter brain lesions in HTLV-1-infected individuals
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DOI：
10.1007/s13365-021-00944-6
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发表时间：
2021-02-02
影响因子：
3.2
通讯作者：
Puccioni-Sohler, Marzia
中科院分区：
文献类型：
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作者：
Kalil, Rosangela Souza;Vasconcellos, Isabelle;Puccioni-Sohler, Marzia
HTLV-1 感染者外周血单核细胞 (PBMC) 中的高原病毒载量 (PVL)、认知障碍和脑白质病变之间的关联仍不清楚。一项横断面研究包括 62 名参与者：22 名无症状携带者（平均年龄 43.4 +/- 13.1 岁）、22 名 HTLV-1 相关脊髓病 (HAM/TSP) 患者（平均年龄 51.5 +/- 8.7 岁）和 18 名未感染对照者（平均年龄 52.3 +/- 11.1 岁）。所有个体均满足以下标准：年龄在 18 岁至 65 岁之间，接受过 4 年以上正规教育，并完成了神经心理学评估和 HTLV-1 血清学检查。感染者接受了脑部常规磁共振成像和 PVL 定量 PCR (qPCR)。模型中的统计分析根据年龄和教育程度进行了调整。所有组中均观察到认知缺陷。 HAM/TSP 患者在注意力和运动技能方面表现出较高的神经认知偏差、较高的脑白质病变频率 (84%) 以及较高的 PVL 中值（范围）8.45 (0.5-71.4) 拷贝/100 PBMC。 HTLV-1 感染者（HAM/TSP 和无症状携带者）的脑白质病变与言语记忆缺陷相关（p = 0.026）。此外，HTLV-1 感染患者较高的 PVL 与神经认知功能障碍评分（视觉运动信息和视觉建构实践的处理速度）之间存在相关性。该研究证明了 HTLV-1 感染、神经认知障碍和 MRI 上的白质脑损伤之间的关联，以及与较高 HTLV-1 PVL 的相关性，表明 HTLV-1 所累及的中枢神经系统不仅限于脊髓，还涉及整个神经轴。 HTLV-1 感染者应接受认知障碍测试。
The association between high proviral load (PVL) in peripheral blood mononuclear cells (PBMC), cognitive disturbance and white matter brain lesions in HTLV-1-infected individuals is still undefined. A cross-sectional study included 62 participants: 22 asymptomatic carriers (mean age 43.4 +/- 13.1 years old), 22 patients with HTLV-1-associated myelopathy (HAM/TSP) (mean age 51.5 +/- 8.7 years old), and 18 uninfected controls (mean age 52.3 +/- 11.1 years old). All individuals fulfilled the following criteria: between 18 and 65 years of age, more than 4 years of formal education, and completed neuropsychological evaluation and HTLV-1 serology. Infected individuals underwent brain conventional magnetic resonance imaging and PVL quantitative PCR (qPCR). Statistical analysis was adjusted in the models by age and education. Cognitive deficit was observed in all groups. Patients with HAM/TSP showed higher neurocognitive deviation in attention and motor skills, higher frequency (84%) of brain white matter lesions, and higher PVL median (range) 8.45 (0.5-71.4) copies/100 PBMC. Brain white matter lesion was associated with verbal memory deficit in HTLV-1-infected individuals (HAM/TSP and asymptomatic carriers) (p = 0.026). In addition, there was a correlation between higher PVL and neurocognitive dysfunction score (processing speed of visuomotor information and visuoconstructive praxis) in HTLV-1-infected patients. The study demonstrates an association between HTLV-1 infection, neurocognitive disorder, and white matter brain lesions on MRI as well as a correlation with higher HTLV-1 PVL, suggesting that the central nervous system involvement by HTLV-1 is not restricted to the spinal cord but involves the whole neuro-axis. HTLV-1-infected individuals should be tested for cognitive impairment.