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Dysfunctional Emotion Discrimination in Schizophrenia is Associated with HSV-1 Infection and Improves with Antiviral Treatment


#1

Background

Herpes simplex virus, type 1 (HSV-1) produces intermittent lytic, productive infection in many organs, alongside lifelong, latent infection in neurons. HSV-1 infected individuals have greater cognitive dysfunction than uninfected individuals, particularly persons with schizophrenia – even without encephalitis. We investigated whether HSV-1 related cognitive dysfunction is progressive or remediable.
Methods

In a prospective naturalistic follow up sample (PNFU), temporal changes in cognitive functions were analyzed in relation to baseline HSV-1 infection in persons with or without schizophrenia (N=226). Separately, in a randomized controlled trial (RCT), HSV-1 infected, clinically stabilized outpatients with SZ received Valacyclovir (VAL, an antiviral, 1.5 G twice daily for 16 weeks) or placebo (PLA) added to standard antipsychotic treatment, using a stratified randomization design, following placebo run-in (N=67). In both samples, HSV-1 infection (seropositivity) was estimated using serum IgG antibodies. All clinical evaluations were blinded to HSV-1 or treatment. Standardized Z scores for accuracy on eight cognitive domains were analyzed for temporal trajectories using generalized linear models (PNFU) and VAL/PLA differences compared with intent to treat analyses (RCT).
Results

PNFU: At baseline, HSV-1 infected participants had significantly lower accuracy scores for Emotion Identification and Discrimination (EMOD), Spatial memory and Spatial ability (p=0.025, 0.029, 0.046, respectively), regardless of SZ diagnosis. They also had a significantly steeper temporal worsening for EMOD (p=0.03). RCT: EMOD improved significantly in VAL-treated patients (p=0.048, Cohen’s d=0.43).
Conclusions

HSV-1 infection is associated with time-related dysfunction in EMOD, which indexes social cognition. Conversely, VAL treatment improves EMOD. A portion of HSV-1 associated cognitive dysfunction is progressive, but remediable.

http://www.biologicalpsychiatryjournal.com/article/S0006-3223(17)30538-3/fulltext?rss=yes


#2

So complex. .151515


#3

Basically, if you get cold sores/fever blisters (they are caused by HSV-1) you may have more problems. But there is an antiviral that can reduce the problems.

A sizable portion of the population is infected with HSV-1, 60% or more.


#4

I don’t have Herpes… I once turned down a cute girl because she had it…
Anyway my cognition is more or less intact.
But kudos to researchers who came up with this connection. Things are moving in the right direction, though too slowly for my liking.


#5

I’ve had cold sores in the winter ever since childhood, so I have HSV-1. This study will be a great talking point with my pdoc during my next appointment with him.

If I can improve my cognition in any way that would be great.


#6

I have HSV-1, and I have it bad. Just on my lips, though. I hope they will approve this medication for normal cold sores on the lip in my country.