背景:已经提出疱疹病毒作为潜在的可改变的病理触发因素参与阿尔茨海默病的发展。
目的:研究单纯疱疹病毒(HSV)-1和巨细胞病毒(CMV)的血清抗体以及抗疱疹病毒治疗与认知结果的关系,以及与APOE4相互作用的关系。
方法:该研究纳入了基于人群的乌普萨拉老年人脉管系统前瞻性研究的849名参与者。使用迷你精神状态检查(MMSE)评估75和80岁的认知能力,跟踪测试(TMT)A和B,和7分钟筛选试验(7MS)。
结果:抗HSV-1IgG阳性在横截面上与MMSE表现较差相关,TMT-A,TMT-B,7MS,增强免费召回,和言语流畅性测试(分别为p=0.016,p=0.016,p<0.001,p=0.001,p=0.033和p<0.001),但不是方向或时钟绘图。根据HSV-1阳性,认知评分不会随时间下降,纵向变化也没有差异。抗CMVIgG阳性在横截面上与认知无关,但抗CMVIgG携带者的TMT-B评分下降更多。抗HSV-1IgG与APOE-4相互作用,与更差的TMT-A和更好的增强提示回忆有关。抗HSVIgM与APOE®4相互作用,抗疱疹病毒治疗与更差的TMT-A和时钟绘制相关,分别。
结论:这些研究结果表明,在认知健康的老年人中,HSV-1与认知能力较差有关,包括执行功能受损,记忆,和富有表现力的语言。认知表现并没有随着时间的推移而下降,纵向下降也不与HSV-1相关。
BACKGROUND: Herpesviruses have been proposed to be involved in Alzheimer\'s disease development as potentially modifiable pathology triggers.
OBJECTIVE: To investigate associations of serum antibodies for herpes simplex virus (HSV)-1 and cytomegalovirus (CMV) and anti-herpesvirus treatment with cognitive outcomes in relation to interactions with APOE ɛ4.
METHODS: The study included 849 participants in the population-based Prospective Investigation of the Vasculature in Uppsala Seniors study. Cognitive performance at the ages of 75 and 80 years was assessed using the Mini-Mental State Examination (MMSE), trail-making test (TMT) A and B, and 7-minute screening test (7MS).
RESULTS: Anti- HSV-1 IgG positivity was associated cross-sectionally with worse performance on the MMSE, TMT-A, TMT-B, 7MS, enhanced free recall, and verbal fluency tests (p = 0.016, p = 0.016, p < 0.001, p = 0.001, p = 0.033, and p < 0.001, respectively), but not orientation or clock drawing. Cognitive scores did not decline over time and longitudinal changes did not differ according to HSV-1 positivity. Anti- CMV IgG positivity was not associated cross-sectionally with cognition, but TMT-B scores declined more in anti- CMV IgG carriers. Anti- HSV-1 IgG interacted with APOE ɛ4 in association with worse TMT-A and better enhanced cued recall. Anti- HSV IgM interacted with APOE ɛ4 and anti-herpesvirus treatment in association with worse TMT-A and clock drawing, respectively.
CONCLUSIONS: These findings indicate that HSV-1 is linked to poorer cognition in cognitively healthy elderly adults, including impairments in executive function, memory, and expressive language. Cognitive performance did not decline over time, nor was longitudinal decline associated with HSV-1.