Neurological and neuropsychological sequelae of Zika virus infection in children in León, Nicaragua.
Neurological and neuropsychological sequelae of Zika virus infection in children in León, Nicaragua.
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尼加拉瓜莱昂儿童的寨卡病毒感染的神经和神经心理学后遗症。
DOI：
10.26633/rpsp.2022.90
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发表时间：
2022
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描述获得性寨卡病毒感染儿童中神经和神经心理后遗症的存在和持久性，并评估这些后遗症在感染寨卡病毒的儿童中是否比未感染寨卡病毒的儿童更常见。我们在尼加拉瓜莱昂对感染和不感染寨卡病毒的儿童进行了一项前瞻性队列研究，使用标准的临床评估工具和问卷收集了三次就诊时的症状数据，间隔约6个月，并使用一系列标准化工具来评估最近两次就诊时的神经认知功能、行为、抑郁和焦虑。62名儿童入选，按感染组划分的人口学数据没有显著差异。感染寨卡病毒的儿童有一系列神经系统症状，其中一些持续了6到12个月；然而，没有观察到一致的症状模式。在基线时，感染寨卡病毒的一小部分儿童有异常的手指对鼻子测试(13%)、冷触反应(13%)和振动反应(15%)，而未感染组的这一比例为0%。神经认知缺陷和行为问题在两组中都很常见，两组之间没有显著差异。在为期6个月的访问中，感染寨卡病毒的儿童的认知效率得分较低。焦虑和抑郁在两组中都很少见。需要进行更大规模的研究，以确定寨卡病毒感染与神经症状和神经认知问题的关系，并调整影响认知和行为的因素，包括情绪和睡眠障碍、家庭学习环境、神经侵入性感染史，以及神经心理问题的详细家族史。
To describe the presence and persistence of neurological and neuropsychological sequelae among children with acquired Zika virus infection and assess whether those sequelae were more common in children infected with Zika virus compared to uninfected children. We conducted a prospective cohort study of children with and without Zika virus infection in León, Nicaragua, using a standard clinical assessment tool and questionnaire to collect data on symptoms at three visits, about 6 months apart, and a battery of standardized instruments to evaluate neurocognitive function, behavior, depression, and anxiety at the last two visits. Sixty-two children were enrolled, with no significant differences in demographics by infection group. Children infected with Zika virus had a range of neurological symptoms, some of which persisted for 6 to 12 months; however, no consistent pattern of symptoms was observed. At baseline a small percentage of children infected with Zika virus had an abnormal finger-to-nose test (13%), cold touch response (13%), and vibration response (15%) versus 0% in the uninfected group. Neurocognitive deficits and behavioral problems were common in both groups, with no significant differences between the groups. Children infected with Zika virus had lower cognitive efficiency scores at the 6-month visit. Anxiety and depression were infrequent in both groups. Larger studies are needed to definitively investigate the relationship between Zika virus infection and neurological symptoms and neurocognitive problems, with adjustment for factors affecting cognition and behavior, including mood and sleep disorders, home learning environment, history of neuroinvasive infections, and detailed family history of neuropsychological problems.