Does intra-individual neurocognitive variability relate to neuroinvasive disease and quality of life in West Nile Virus?
Does intra-individual neurocognitive variability relate to neuroinvasive disease and quality of life in West Nile Virus?
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个体内神经认知变异与西尼罗河病毒的神经侵袭性疾病和生活质量有关吗？
DOI：
10.1007/s13365-018-0641-5
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发表时间：
2018
影响因子：
3.2
通讯作者：
Murray,KristyO
中科院分区：
文献类型：
--
作者：
Sheppard,DavidP;Woods,StevenPaul;Hasbun,Rodrigo;Salazar,Lucrecia;Nolan,MelissaS;Murray,KristyO
西尼罗河病毒（WNV）可能是一种神经侵入性病原体，可在某些感染者中产生持续的轻度至中度神经认知障碍。个体内变异性（IIV）是一个人在神经心理测试或电池中的表现指数，这是神经认知控制和前额叶系统完整性的指标。本研究探讨了西尼罗河病毒感染中IIV与神经系统健康和福祉的可能关联。参与者包括84名患有一系列临床WNV疾病的成年人（31名西尼罗河脑炎，16名西尼罗河脑膜炎，37名西尼罗河热），他们完成了神经心理状态评估的可重复电池（RBANS）。IIV可操作为变异协方差（CoV），或5个年龄调整的RBANS标准评分的个体内标准差除以标准评分的平均值。使用兰德36项简式健康调查表（SF-36）评估参与者的健康相关生活质量（QoL）。分析显示，与西尼罗热组相比，西尼罗热组具有更高的神经认知CoV，并且这种差异与中等效应量相关（Cohen'sd= .52）。混合线性模型控制估计的智商，日常生活活动，抑郁症，神经侵袭性疾病组和疲劳表明，较高的RBANS CoV与较低的身体，但不是心理健康生活质量。在西尼罗河病毒感染者中，IIV升高与脑炎之间存在适度关联，甚至神经心理功能的细微中断也显示出与身体健康生活质量测量的重要自我报告功能的关系。未来的研究应该检查IIV是否预测长期健康结果（例如，死亡率）。
West Nile Virus (WNV) can be a neuroinvasive pathogen that may produce persistent mild-to-moderate neurocognitive impairments in some infected persons. Intra-individual variability (IIV) is an index of a person’s performance across a neuropsychological test or battery, which is an indicator of neurocognitive control and integrity of prefrontal systems. The present study examined possible associations of IIV to neurological health and well-being in WNV infection. Participants included 84 adults with a range of clinical WNV disease (31 West Nile Encephalitis, 16 West Nile Meningitis, 37 West Nile Fever) who completed the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). IIV was operationalized as covariance of variation (CoV), or the intra-individual standard deviation across 5 age-adjusted RBANS standard scores divided by the mean of standard scores. Participants were assessed for health-related quality of life (QoL) using the RAND 36-item short form health survey (SF-36). Analyses revealed that the West Nile Encephalitis group had higher neurocognitive CoV compared to the West Nile Fever group, and this difference was associated with a medium effect size (Cohen’sd= .52). Mixed linear models controlling for estimated IQ, activities of daily living, depression, neuroinvasive disease groups, and fatigue showed that higher RBANS CoV was associated with lower physical, but not mental health QoL. In persons with WNV infection, there is a modest association between elevations in IIV and encephalitis, and even subtle disruptions in neuropsychological functioning show relationships with important self-reported functioning as measured by physical health quality of life. Future studies should examine whether IIV predicts long-term health outcomes (e.g., mortality) in individuals infected with WNV.