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Persistent infection with neurotropic herpes viruses and cognitive impairment

  • A. M. M. Watson (a1), K. M. Prasad (a1), L. Klei (a1), J. A. Wood (a1), R. H. Yolken (a2), R. C. Gur (a3) (a4), L. D. Bradford (a5), M. E. Calkins (a3), J. Richard (a3), N. Edwards (a6), R. M. Savage (a7), T. B. Allen (a8), J. Kwentus (a9), J. P. McEvoy (a8), A. B. Santos (a10), H. W. Wiener (a11), R. C. P. Go (a11), R. T. Perry (a11), H. A. Nasrallah (a12), R. E. Gur (a3), B. Devlin (a13) and V. L. Nimgaonkar (a1) (a13)...

Herpes virus infections can cause cognitive impairment during and after acute encephalitis. Although chronic, latent/persistent infection is considered to be relatively benign, some studies have documented cognitive impairment in exposed persons that is untraceable to encephalitis. These studies were conducted among schizophrenia (SZ) patients or older community dwellers, among whom it is difficult to control for the effects of co-morbid illness and medications. To determine whether the associations can be generalized to other groups, we examined a large sample of younger control individuals, SZ patients and their non-psychotic relatives (n=1852).


Using multivariate models, cognitive performance was evaluated in relation to exposures to herpes simplex virus type 1 (HSV-1), herpes simplex virus type 2 (HSV-2) and cytomegalovirus (CMV), controlling for familial and diagnostic status and sociodemographic variables, including occupation and educational status. Composite cognitive measures were derived from nine cognitive domains using principal components of heritability (PCH). Exposure was indexed by antibodies to viral antigens.


PCH1, the most heritable component of cognitive performance, declines with exposure to CMV or HSV-1 regardless of case/relative/control group status (p = 1.09 × 10−5 and 0.01 respectively), with stronger association with exposure to multiple herpes viruses (β = −0.25, p = 7.28 × 10−10). There were no significant interactions between exposure and group status.


Latent/persistent herpes virus infections can be associated with cognitive impairments regardless of other health status.

Corresponding author
*Address for correspondence: V. L. Nimgaonkar, M.D., Ph.D., TDH, Room 441, 3811 O'Hara St., Pittsburgh, PA 15213, USA. (Email:
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