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Int J Infect Dis. 2019 Jul;84:121-126. doi: 10.1016/j.ijid.2019.05.010. Epub 2019 May 11.

Cognitive impairment in HTLV-1-associated myelopathy, proviral load and inflammatory markers.

Author information

1
Hospital Sarah Belo Horizonte, Belo Horizonte, MG, Brazil; Programa de Pós-Graduação em Ciências Aplicadas à Saúde do Adulto, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil. Electronic address: anachamps@yahoo.com.br.
2
Faculdade de Ciências Médicas de Minas Gerias, Belo Horizonte, MG, Brazil; Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
3
Hospital Sarah Belo Horizonte, Belo Horizonte, MG, Brazil; Programa de Pós-Graduação em Ciências Aplicadas à Saúde do Adulto, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
4
Departamento de Medicina Preventiva e Social, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
5
Hospital Sarah Belo Horizonte, Belo Horizonte, MG, Brazil.
6
Programa de Pós-Graduação em Ciências Aplicadas à Saúde do Adulto, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.

Abstract

OBJECTIVES:

Myelopathy is a well-established long-term clinical manifestation of HTLV-1 infection. Besides motor dysfunction, cognitive impairment may be another consequence of HTLV-1 infection. Moreover, inflammatory markers may be associated with cognitive impairment in these patients. The present study compared the cognitive performance of HAM/TSP patients with healthy controls and investigated the associations between cognitive performance, proviral load and blood inflammatory markers.

METHODS:

Eighty-three patients fulfilling diagnostic criteria for HAM/TSP were submitted to a comprehensive clinical, cognitive and functional evaluation, brain magnetic resonance imaging and determination of levels of IL-1β, IL-6, TNF-α, immunoglobulins and HTLV-1 proviral load in blood and cerebrospinal fluid. The control group was composed of 88 cognitively healthy subjects, matched for age, sex and educational level.

RESULTS:

Compared to healthy subjects, HAM/TSP patients displayed significant global cognitive impairment and executive function deficits. HAM/TSP cognitive impairment was significantly associated with altered levels of IgM, IgG, IL-6 and TNF-α in blood. There was no association between HAM/TSP cognitive impairment and HTLV-1 proviral load.

CONCLUSIONS:

This study suggests cognitive impairment may be a long-term clinical manifestation of HTLV-1 infection, which seems to be linked to the persistent inflammatory activity that is found in the disease.

KEYWORDS:

Cognitive assessment; HTLV-1; Inflammation; Tropical spastic paraparesis

PMID:
31085316
DOI:
10.1016/j.ijid.2019.05.010
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