Cognitive impairment in the HTLV-1 infection: a comparative study associated with functional performance
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Cognitive impairment in the HTLV-1 infection: a comparative study associated with functional performance Jonas Jardim de Paula 1 & Luiz Claúdio Romanelli 2 & Renata Caetano Vieira de Faria 1 & Anna Barbara Proietti 2 & Leandro Fernandes Malloy-Diniz 1,3 & Marco Aurélio Romano-Silva 1,3 & Debora Marques de Miranda 1,4 & Rodrigo Nicolato 1,3 Received: 22 October 2019 / Revised: 30 June 2020 / Accepted: 28 August 2020 # Journal of NeuroVirology, Inc. 2020
Abstract Human T cell leukemia virus type-I (HTLV-1) infection courses with a myelopathy, the tropical spastic paraparesis (HAM/TSP). In a case-control study, we compared the neuropsychological profile and functional characteristics in two case HTLV-1-infected groups (asymptomatic and with HAM/TSP) with a control group negative for HTLV-1. Subjects were paired for age, sex, and educational features. The case group differed from control group in neuropsychological measures such as in episodic memory recall, executive functions, and fine motor dexterity measure. Individuals with HAM/TSP have more depressive symptoms and worst performance in activities of daily living (ADL) presenting a less functionality. In multivariate models, the fine motor performance, the executive functioning, the recognition memory, and the depressive symptoms explained part of the variance in functionality. Those findings may contribute to understand of everyday life impairments and limitations of HTLV-1-infected population and to organize the rehabilitation. Once more, based in neuropsychological and functional data, we can reaffirm that HTLV-1 is never a benign condition, but sometimes it is only in a stage coursing with less symptoms. Keywords HTLV-1 . HAM/TSP . Myelopathy . Neuropsychology . Depression . Activities of daily living
Introduction Human T cell leukemia virus type-I (HTLV-1) infects around 15 to 20 million people worldwide (Tuppin et al. 1996). HTLV-1 is a causal agent of a broad clinical spectrum of lymphoproliferative diseases, such as adult T cell leukemia (ATL), HTLV-associated myelopathy/tropical spastic paraparesis (HAM/TSP), arthritis, uveitis, dermatitis, and mild immunosuppression (Dekaban et al. 1994). The HAM/TSP affects less than 5% of individuals infected with HTLV-1,
* Jonas Jardim de Paula [email protected] 1
Centro de Tecnologia em Medicina Molecular, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
2
GIPH, Fundação HEMOMINAS, Belo Horizonte, MG, Brazil
3
Departamento de Saúde Mental, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
4
Departamento de Pediatria Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
but it is the most severe neurological expression of this infection. The commonest clinical presentations of HAM/TSP are spastic paraplegia or paraparesis, coursing with progressive upper motor neuron involvement and mild sensory deficit associated with sphincteric disturbance (Hollsberg and Hafler 1993; Gessain and Gout 1992; Os
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