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. 2023 Mar;81(3):253-262.
doi: 10.1055/s-0043-1763486. Epub 2023 Apr 14.

Elderly people with human T-cell leukemia virus type 1-associated myelopathy present an early impairment in cognitive skills

Beatriz Rezende Matos de Sousa  1 , Ludimila Labanca  1   2   3 , Maria Luiza Diniz  3 , Nathália de Castro Botini Rausse  1 , Denise Utsch Gonçalves  1   2   4
Affiliations

Elderly people with human T-cell leukemia virus type 1-associated myelopathy present an early impairment in cognitive skills

Beatriz Rezende Matos de Sousa et al. Arq Neuropsiquiatr. 2023 Mar.

Abstract
in English, Portuguese

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.

Antecedentes: Alterações cerebrais ocorrem em indivíduos com mielopatia associada ao vírus da leucemia de células T humanas tipo 1 (HTLV-1) (HAM) e parecem predominar em áreas subcorticais. Pouco se sabe sobre o declínio cognitivo em idosos vivendo com HTLV-1.

Objetivo: Avaliar o envelhecimento cognitivo de indivíduos infectados pelo HTLV-1 com idade ≥ 50 anos. MéTODOS: Trata-se de um estudo transversal com ex-doadores de sangue infectados pelo HTLV-1 acompanhados na coorte do Grupo Interdisciplinar de Pesquisa em HTLV-1 há 20 anos. Os grupos de estudo foram compostos por 79 indivíduos infectados pelo HTLV-1 com idade ≥ 50 anos, sendo que 41 apresentavam HAM e 38 eram portadores assintomáticos, e 59 indivíduos soronegativos (controles) com idade ≥ 60 anos. Todos foram submetidos ao teste eletrofisiológico P300 e testes neuropsicológicos.

Resultados: Indivíduos com HAM apresentaram atraso na latência do P300 em relação aos demais grupos, e esse atraso de latência aumentou progressivamente com o envelhecimento. O desempenho desse grupo nos testes neuropsicológicos também foi o pior. O desempenho do grupo HTLV-1- assintomático foi semelhante ao do grupo controle. CONCLUSãO: Indivíduos com HAM apresentaram declínio cognitivo que progrediu com o envelhecimento e, embora os portadores assintomáticos do HTLV-1 pareçam apresentar envelhecimento cognitivo semelhante ao dos idosos saudáveis, justifica-se a preocupação com um comprometimento cognitivo subclínico nessa população.

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Conflict of interest statement

The authors have no conflict of interests to declare.

Figures

Figure 1
Figure 1
Between-groups comparison of P300 latency obtained from the seronegative group (n = 59), human T-cell lymphotropic virus type 1 (HTLV-1)-asymptomatic group (n = 38) and HTLV-1 associated myelopathy (HAM) group (n = 41). Note: The boxes denote the P300 latency in each of the three groups. The horizontal line in the box represents the median; the box hinges represent the first (Q1) and third quartiles (Q3). Upper and lower whiskers extend from the hinge to the highest/lowest value that lies within the 1.5 interquartile range (IQR) of the hinge.Notes: * p  < 0.001; p , significance probability (independent-samples Kruskal-Wallis test for specific comparisons).
Figure 2
Figure 2
Scatter graph showing the correlation between P300 latency and the aging of (A) individuals with HTLV-1-associated myelopathy (HAM), (B) HTLV-1-asymptomatic carriers, and (C) seronegative controls distributed by age. Note: A positive correlation between increasing age and prolongation of P300 latency was detected only for the HAM group.Notes: p , significance probability; r, correlation coefficient; Spearman rho test.
See this image and copyright information in PMC

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