title: Effects of Cumulative Herpesviridae and Toxoplasma gondii Infections on Cognitive Function in Healthy, Bipolar, and Schizophrenia Subjects.
abstract: Schizophrenia and bipolar disorder are associated with cognitive impairment leading to social disruption. While previous studies have focused on the effect of individual infectious exposure, namely, Herpesviridae viruses or Toxoplasma gondii (T gondii), on cognitive functioning, the objective of the present study was to examine the effect of multiple infections on cognitive functioning in patients with schizophrenia and bipolar disorder and in healthy controls.
  
  
  
  Seropositivity to herpes simplex virus type 1 (HSV-1), herpes simplex virus type 2 (HSV-2), cytomegalovirus (CMV), and T gondii was related to cognitive status among 423 participants (recruited between 2008 and 2014; 138 patients with bipolar disorder, 105 patients with schizophrenia [DSM-IV criteria], and 180 healthy controls) for episodic verbal memory (California Verbal Learning Test), working memory (Wechsler Adult Intelligence Scale, third edition), and premorbid intelligence quotient (National Adult Reading Test).
  
  
  
  Seropositivity to and antibody levels of HSV-1 were significantly associated with working memory, which persisted after correction (backward digit span: β = -0.10 [0.05], χ² = 33.89, P = .0001) in the overall sample. This association was particularly strong in the control group (β = -0.18 [0.08], P = .04, Z = -3.55, P = .0008; corrected P = .012). Further, cumulative exposure to HSV-1, HSV-2, and CMV viruses and T gondii parasite was also associated with lower scores on working memory as measured by backward digit span in the overall sample (Z = 2.86, P = .004; Z = 2.47, P = .01; and Z = 3.35, P = .01, respectively).
  
  
  
  Exposures to Herpesviridae and T gondii parasite seem to impact cognitive functioning. Because infections caused by Herpesviridae and/or T gondii parasite are quite common in the (general) population, assessing and confirming the cognitive impairment among those who have cumulative exposures is useful and of interest.
authors.affiliation: Pole de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor, Hôpital A Chenevier, 40 rue de Mesly, Créteil 94000, France. nora.hamdani@ach.aphp.fr.|Inserm U955, Team 15 (Genetic Psychiatry), Créteil, France.|AP-HP, DHU Pe PSY, Paris-Est Créteil University, Henri Mondor-Albert Chenevier group, Psychiatry, Créteil, France.|Fondation Fondamental, Scientific Cooperation Foundation, Créteil, France.
authors.forename: Nora
authors.initials: N
authors.lastname: Hamdani
authors.affiliation: Inserm U955, Team 15 (Genetic Psychiatry), Créteil, France.|AP-HP, DHU Pe PSY, Paris-Est Créteil University, Henri Mondor-Albert Chenevier group, Psychiatry, Créteil, France.|Fondation Fondamental, Scientific Cooperation Foundation, Créteil, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Daban-Huard
authors.affiliation: Inserm U955, Team 15 (Genetic Psychiatry), Créteil, France.|Fondation Fondamental, Scientific Cooperation Foundation, Créteil, France.
authors.forename: Ophelia
authors.initials: O
authors.lastname: Godin
authors.affiliation: Fondation Fondamental, Scientific Cooperation Foundation, Créteil, France.
authors.forename: Hakim
authors.initials: H
authors.lastname: Laouamri
authors.affiliation: Inserm U955, Team 15 (Genetic Psychiatry), Créteil, France.|Fondation Fondamental, Scientific Cooperation Foundation, Créteil, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Jamain
authors.affiliation: Fondation Fondamental, Scientific Cooperation Foundation, Créteil, France.
authors.forename: Dodji
authors.initials: D
authors.lastname: Attiba
authors.affiliation: AP-HP, Paris Diderot University, Psychiatry, Lariboisiere Fernand Widal Hospital, Paris, France.
authors.forename: Marine
authors.initials: M
authors.lastname: Delavest
authors.affiliation: AP-HP, Paris Diderot University, Psychiatry, Lariboisiere Fernand Widal Hospital, Paris, France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Lépine
authors.affiliation: CIC 006 Henri Mondor Inserm and Biological Resource Platform, Paris Est University, Créteil, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Le Corvoisier
authors.affiliation: Inserm U955, Team 15 (Genetic Psychiatry), Créteil, France.|AP-HP, DHU Pe PSY, Paris-Est Créteil University, Henri Mondor-Albert Chenevier group, Psychiatry, Créteil, France.|Fondation Fondamental, Scientific Cooperation Foundation, Créteil, France.|CEA Saclay, Neurospin, Gif-Sur-Yvette, France.
authors.forename: Josselin
authors.initials: J
authors.lastname: Houenou
authors.affiliation: Inserm U955, Team 15 (Genetic Psychiatry), Créteil, France.|Fondation Fondamental, Scientific Cooperation Foundation, Créteil, France.
authors.forename: Jean-Romain
authors.initials: JR
authors.lastname: Richard
authors.affiliation: Stanley Laboratory of Developmental Neurovirology, Johns Hopkins University Medical Center, Baltimore, Maryland, USA.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Yolken
authors.affiliation: Fondation Fondamental, Scientific Cooperation Foundation, Créteil, France.
authors.forename: Rajagopal
authors.initials: R
authors.lastname: Krishnamoorthy
authors.affiliation: Fondation Fondamental, Scientific Cooperation Foundation, Créteil, France.|Jean Dausset Laboratory, LabEx Transplantex and Inserm, UMRS Paris Diderot University, Paris, France.
authors.forename: Ryad
authors.initials: R
authors.lastname: Tamouza
authors.affiliation: Inserm U955, Team 15 (Genetic Psychiatry), Créteil, France.|AP-HP, DHU Pe PSY, Paris-Est Créteil University, Henri Mondor-Albert Chenevier group, Psychiatry, Créteil, France.|Fondation Fondamental, Scientific Cooperation Foundation, Créteil, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Leboyer
authors.affiliation: Stanley Research Program, Sheppard Pratt, Baltimore, Maryland, USA.
authors.forename: Faith B
authors.initials: FB
authors.lastname: Dickerson
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000453:epidemiology*; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D020803:Encephalitis, Herpes Simplex / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics / Q000706:statistics & numerical data; D012016:Reference Values; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis* / Q000453:epidemiology*; D016781:Toxoplasmosis, Cerebral / Q000175:diagnosis* / Q000453:epidemiology*