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Ferreira QR, Novaes AF, Santana CS, Umeda AS, de Souza Nascimento JO, de Freitas Santos JPM, Fernandes LA, Moura MN, Amorim RL, Cavalcanti VN, da Cruz ALB, Barreto FK, Costa DT. Neurological aspects of HTLV-1 infection: symptoms in apparently asymptomatic carriers. J Neurovirol 2024:10.1007/s13365-024-01197-9. [PMID: 38653958 DOI: 10.1007/s13365-024-01197-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/08/2024] [Accepted: 02/20/2024] [Indexed: 04/25/2024]
Abstract
Human T-lymphotropic virus type 1 (HTLV-1) is classically associated with the HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), although the mechanisms of this neurological disorder remain unclear. In addition, some patients who develop "minor" neurological signs that do not meet diagnostic criteria for HAM/TSP are classified as asymptomatic carriers. This study aims to demonstrate the neurological symptoms of Brazilian patients living with HTLV-1 classified as not-HAM.TSP. This observational study evaluated patients treated in an HTLV reference center in Bahia, Brazil, between February 2022 and July 2023. The data were obtained through the analysis of medical records and neurological consultation. Those individuals classified as HAM/ TSP were excluded from this study. 74 patients were submitted to a careful neurological evaluation: 23 HAM/TSP, 22 were classified with intermediate syndrome (IS), and 29 were oligosymptomatic. Self-reported symptoms were significantly more common in the IS group, including urinary symptoms such as nocturia, urgency, incontinence, dysuria, weakness, paresthesia, lumbar pain, xerostomia, and xerophthalmia. Physical examination findings consistent with reduced vibratory and tactile sensitivity were more common in the IS group (p = 0.017 and p = 0.013). Alterations in the V and VIII cranial nerves were present in both groups. HTLV-1 can lead to the development of important neurological signs and symptoms in apparently asymptomatic individuals. This data highlights the need for more research into the neurological aspects of HTLV-1 infection and emphasizes the importance of early diagnosis, treatment, and support for individuals living with this virus.
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Affiliation(s)
- Qesya Rodrigues Ferreira
- Universidade Federal da Bahia - Instituto Multidisciplinar em Saúde, 45029-094, Vitória da Conquista, Bahia, Brazil
| | - Ana Flávia Novaes
- Universidade Federal da Bahia - Instituto Multidisciplinar em Saúde, 45029-094, Vitória da Conquista, Bahia, Brazil
| | - Carolina Souza Santana
- Universidade Federal da Bahia - Instituto Multidisciplinar em Saúde, 45029-094, Vitória da Conquista, Bahia, Brazil
| | - Arthur Shigueru Umeda
- Universidade Federal da Bahia - Instituto Multidisciplinar em Saúde, 45029-094, Vitória da Conquista, Bahia, Brazil
| | | | | | - Larissa Alves Fernandes
- Universidade Federal da Bahia - Instituto Multidisciplinar em Saúde, 45029-094, Vitória da Conquista, Bahia, Brazil
| | - Matheus Nascimento Moura
- Universidade Federal da Bahia - Instituto Multidisciplinar em Saúde, 45029-094, Vitória da Conquista, Bahia, Brazil
| | - Rebeca Leão Amorim
- Universidade Federal da Bahia - Instituto Multidisciplinar em Saúde, 45029-094, Vitória da Conquista, Bahia, Brazil
| | - Vinícius Nogueira Cavalcanti
- Faculdade de Saúde Santo Agostinho - Campus Vitória da Conquista, 45028-100, Vitória da Conquista, Bahia, Brazil
| | - Ariana Leal Borges da Cruz
- Universidade Federal da Bahia - Instituto Multidisciplinar em Saúde, 45029-094, Vitória da Conquista, Bahia, Brazil
| | - Fernanda Khouri Barreto
- Universidade Federal da Bahia - Instituto Multidisciplinar em Saúde, 45029-094, Vitória da Conquista, Bahia, Brazil.
| | - Davi Tanajura Costa
- Universidade Federal da Bahia - Instituto Multidisciplinar em Saúde, 45029-094, Vitória da Conquista, Bahia, Brazil
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Sousa BRMD, Labanca L, Diniz ML, Rausse NDCB, Gonçalves DU. Elderly people with human T-cell leukemia virus type 1-associated myelopathy present an early impairment in cognitive skills. ARQUIVOS DE NEURO-PSIQUIATRIA 2023; 81:253-262. [PMID: 37059435 PMCID: PMC10104755 DOI: 10.1055/s-0043-1763486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
BACKGROUND Cerebral changes occur in individuals with human T-cell leukemia virus type 1 (HTLV-1)-associated myelopathy (HAM) and seem to predominate in subcortical areas. Little is known about the cognitive decline in the elderly living with HTLV-1. OBJECTIVE To evaluate the cognitive aging of individuals infected with HTLV-1 aged ≥ 50 years. METHODS This is a cross-sectional study of former blood donors infected with HTLV-1 who have been followed in the cohort of the Interdisciplinary Research Group on HTLV-1 since 1997. The groups of study consisted of 79 HTLV-1 infected individuals aged ≥ 50 years, with 41 of them presenting symptomatic HAM and 38 being asymptomatic carriers, and 59 seronegative individuals (controls) aged ≥ 60 years. All were submitted to the P300 electrophysiological test and neuropsychological tests. RESULTS Individuals with HAM presented delayed P300 latency in relation to the other groups, and this latency delay increased progressively with aging. The performance of this group in the neuropsychological tests was also the worst. The HTLV-1- asymptomatic group performance was similar to that of the control group. CONCLUSIONS Individuals with HAM presented cognitive decline that progressed with aging and, although HTLV-1-asymptomatic carriers appear to present cognitive aging similar to that of healthy elderly people, concern about a subclinical cognitive impairment is warranted in this population.
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Affiliation(s)
- Beatriz Rezende Matos de Sousa
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Infectologia e Medicina Tropical, Belo Horizonte MG, Brazil
| | - Ludimila Labanca
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Infectologia e Medicina Tropical, Belo Horizonte MG, Brazil
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduacão em Ciências Fonoaudiológicas, Belo Horizonte MG, Brazil
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Fonoaudiologia, Belo Horizonte MG, Brazil
| | - Maria Luiza Diniz
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Fonoaudiologia, Belo Horizonte MG, Brazil
| | - Nathália de Castro Botini Rausse
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Infectologia e Medicina Tropical, Belo Horizonte MG, Brazil
| | - Denise Utsch Gonçalves
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Infectologia e Medicina Tropical, Belo Horizonte MG, Brazil
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduacão em Ciências Fonoaudiológicas, Belo Horizonte MG, Brazil
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Otorrinolaringologia, Belo Horizonte MG, Brazil
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Pires APBDÁ, Silva TR, Torres MS, Diniz ML, Tavares MC, Gonçalves DU. Galvanic vestibular stimulation and its applications: a systematic review. Braz J Otorhinolaryngol 2022; 88 Suppl 3:S202-S211. [DOI: 10.1016/j.bjorl.2022.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 04/18/2022] [Accepted: 05/30/2022] [Indexed: 11/02/2022] Open
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Cognitive screening in HTLV-1-infected people using a self-perceived memory score and auditory P300. J Neurovirol 2022; 28:123-132. [PMID: 35167053 DOI: 10.1007/s13365-021-01044-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 11/21/2021] [Accepted: 12/09/2021] [Indexed: 10/19/2022]
Abstract
The HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is the most common neurological manifestation associated with human T-cell lymphotropic virus type-1 (HTLV-1) infection. Although cognitive impairment has been highlighted in the spectrum of HTLV-1 neurological manifestations, it may go unnoticed in those who do not spontaneously report it. We aimed at evaluating the applicability of a self-perceived memory score (SMS) and the cognitive event-related potential (P300) for early detection of cognitive impairment in HTLV-1-infected people. The SMS was measured by a 0-10 point numeric scale combined with a sad-happy face rating scale. The higher the number, the better was the SMS. The P300 was obtained through an oddball paradigm with a mental counting task. The participants were 15 (21.4%) individuals with HAM/TSP, 20 (28.6%) HTLV-1 asymptomatic carriers, and 35 (50%) seronegative controls. We found that SMS (p < 0.001) and P300 latency (p < 0.001) got progressively worse from the seronegative controls to the asymptomatic carriers and then to the HAM/TSP. The results that indicated cognitive impairment were SMS < 7.2 points and P300 latency > 369.0 ms. The HAM/TSP group showed the highest prevalence of altered P300 (80%) and SMS (87%). Interestingly, the asymptomatic group also presented significantly higher prevalence of altered SMS (60%) and P300 (35%) when compared to controls (< 10%). The frequency of cognitive impairment was 16 times higher in the HTLV-1 asymptomatic group and 69 times higher in the HAM/TSP group when compared to controls. The use of SMS in the medical consultation was a useful and easy-to-apply method to screen HTLV-1-infected subjects for everyday memory complaints.
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