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Association of cognitive function and liability to addiction with childhood herpesvirus infections: A prospective cohort study

Published online by Cambridge University Press:  19 April 2017

Michael M. Vanyukov
Affiliation:
University of Pittsburgh
Vishwajit L. Nimgaonkar
Affiliation:
University of Pittsburgh
Levent Kirisci
Affiliation:
University of Pittsburgh
Galina P. Kirillova
Affiliation:
University of Pittsburgh
Maureen D. Reynolds
Affiliation:
University of Pittsburgh
Konasale Prasad
Affiliation:
University of Pittsburgh
Ralph E. Tarter
Affiliation:
University of Pittsburgh
Robert H. Yolken
Affiliation:
Johns Hopkins University School of Medicine
Corresponding
E-mail address:

Abstract

Liability to substance use disorder (SUD) is largely nonspecific to particular drugs and is related to behavior dysregulation, including reduced cognitive control. Recent data suggest that cognitive mechanisms may be influenced by exposure to neurotropic infections, such as human herpesviruses. In this study, serological evidence of exposure to human herpesvirus Herpes simplex virus Type 1 (HSV-1), cytomegalovirus (CMV), and Epstein–Barr virus (EBV) as well as Toxoplasma gondii was determined in childhood (age ~11 years) in 395 sons and 174 daughters of fathers with or without SUD. Its relationships with a cognitive characteristic (IQ) in childhood and with risk for SUD in adulthood were examined using correlation, regression, survival, and path analyses. Exposure to HSV-1, EBV, and T. gondii in males and females, and CMV in males, was associated with lower IQ. Independent of that relationship, EBV in females and possibly in males, and CMV and possibly HSV-1 in females were associated with elevated risk for SUD. Therefore, childhood neurotropic infections may influence cognitive development and risk for behavior disorders such as SUD. The results may point to new avenues for alleviating cognitive impairment and SUD risk.

Type
Regular Articles
Copyright
Copyright © Cambridge University Press 2017 

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Footnotes

This study was supported by National Institute on Drug Abuse Grant P50DA005605, Stanley Medical Research Institute Grant 07R-1712, and National Institute of Mental Health Grant MH63480. The authors are indebted to the staff of the Center for Education and Drug Abuse Research, particularly laboratory assistants Kathleen A. Hartle and Senthil Thillainathan, for their effort and dedication. The authors have no biomedical financial interests or potential conflicts of interest.

References

Ahn, K., Meyer, T. H., Uebel, S., Sempé, P., Djaballah, H., Yang, Y., … Tampé, R. (1996). Molecular mechanism and species specificity of TAP inhibition by herpes simplex virus ICP47. EMBO Journal, 15, 32473255.Google ScholarPubMed
Aiello, A. E., Haan, M. N., Pierce, C. M., Simanek, A. M., & Liang, J. (2008). Persistent infection, inflammation, and functional impairment in older Latinos. Journals of Gerontology: Series A, Biological Sciences and Medical Sciences, 63, 610618.CrossRefGoogle Scholar
Arbuckle, J. L. (2016). IBM® SPSS® Amos™ 24 user's guide. Chicago: IBM SPSS.Google Scholar
Aytaclar, S., Tarter, R. E., Kirisci, L., & Lu, S. (1999). Association between hyperactivity and executive cognitive functioning in childhood and substance use in early adolescence. Journal of the American Academy of Child & Adolescent Psychiatry, 38, 172178.CrossRefGoogle Scholar
Baringer, J. R., & Pisani, P. (1994). Herpes simplex virus genomes in human nervous system tissue analyzed by polymerase chain reaction. Annals of Neurology, 36, 823829.CrossRefGoogle ScholarPubMed
Barna, M., Komatsu, T., Bi, Z., & Reiss, C. S. (1996). Sex differences in susceptibility to viral infection of the central nervous system. Journal of Neuroimmunology, 67, 3139.CrossRefGoogle ScholarPubMed
Becker, J. B., & Hu, M. (2008). Sex differences in drug abuse. Frontiers in Neuroendocrinology, 29, 3647.CrossRefGoogle ScholarPubMed
Becker, J. B., McClellan, M. L., & Reed, B. G. (2017). Sex differences, gender and addiction. Journal of Neuroscience Research, 95, 136147. doi:10.1002/jnr.23963 CrossRefGoogle Scholar
Casey, B. J., & Jones, R. M. (2010). Neurobiology of the adolescent brain and behavior: Implications for substance use disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 49, 11891201. doi:10.1016/j.jaac.2010.08.017 Google ScholarPubMed
Cohen, J. I. (2000). Epstein-Barr virus infection. New England Journal of Medicine, 343, 481492.CrossRefGoogle ScholarPubMed
Cohen, J. I. (2015). Epstein-Barr virus vaccines. Clinical & Translational Immunology, 4, e32. doi:10.1038/cti.2014.27CrossRefGoogle ScholarPubMed
D'Aiuto, L., Prasad, K. M., Upton, C. H., Viggiano, L., Milosevic, J., Raimondi, G., … Nimgaonkar, V. L. (2015). Persistent infection by HSV-1 is associated with changes in functional architecture of iPSC-derived neurons and brain activation patterns underlying working memory performance. Schizophrenia Bulletin, 41, 123132. doi:10.1093/schbul/sbu032 CrossRefGoogle ScholarPubMed
Dickerson, F. B., Boronow, J. J., Stallings, C., Origoni, A. E., Cole, S., Krivogorsky, B., & Yolken, R. H. (2004). Infection with herpes simplex virus type 1 is associated with cognitive deficits in bipolar disorder. Biological Psychiatry, 55, 588593. doi:10.1016/j.biopsych.2003.10.008 CrossRefGoogle ScholarPubMed
Dickerson, F. B., Boronow, J. J., Stallings, C., Origoni, A. E., Ruslanova, I., & Yolken, R. H. (2003). Association of serum antibodies to herpes simplex virus 1 with cognitive deficits in individuals with schizophrenia. Archives of General Psychiatry, 60, 466472. doi:10.1001/archpsyc.60.5.466 CrossRefGoogle ScholarPubMed
Dickerson, F., Schroeder, J., Stallings, C., Origoni, A., Katsafanas, E., Schwienfurth, L. A., … Yolken, R. (2014). A longitudinal study of cognitive functioning in schizophrenia: Clinical and biological predictors. Schizophrenia Research, 156, 248253. doi:10.1016/j.schres.2014.04.019 CrossRefGoogle ScholarPubMed
Dickerson, F., Stallings, C., Origoni, A., Katsafanas, E., Schweinfurth, L. A., Savage, C. L., & Yolken, R. (2014). Association between cytomegalovirus antibody levels and cognitive functioning in non-elderly adults. PLOS ONE, 9, e95510. doi:10.1371/journal.pone.0095510 CrossRefGoogle ScholarPubMed
Dickerson, F., Stallings, C., Origoni, A., Vaughan, C., Khushalani, S., & Yolken, R. (2012). Additive effects of elevated C-reactive protein and exposure to herpes simplex virus type 1 on cognitive impairment in individuals with schizophrenia. Schizophrenia Research, 134, 8388. doi:10.1016/j.schres.2011.10.003 CrossRefGoogle ScholarPubMed
Dickerson, F., Stallings, C., Sullens, A., Origoni, A., Leister, F., Krivogorsky, B., & Yolken, R. (2008). Association between cognitive functioning, exposure to herpes simplex virus type 1, and the COMT Val158Met genetic polymorphism in adults without a psychiatric disorder. Brain, Behavior, and Immunity, 22, 11031107. doi:10.1016/j.bbi.2008.04.156 CrossRefGoogle ScholarPubMed
Dowd, J. B., Palermo, T., Brite, J., McDade, T. W., & Aiello, A. (2013). Seroprevalence of Epstein-Barr virus infection in U.S. children ages 6–19, 2003–2010. PLOS ONE, 8, e64921. doi:10.1371/journal.pone.0064921 CrossRefGoogle ScholarPubMed
Falconer, D. S. (1965). The inheritance of liability to certain diseases, estimated from the incidence among relatives. Annals of Human Genetics, 29, 5176.CrossRefGoogle Scholar
Flegr, J., Preiss, M., Klose, J., Havlicek, J., Vitakova, M., & Kodym, P. (2003). Decreased level of psychobiological factor novelty seeking and lower intelligence in men latently infected with the protozoan parasite Toxoplasma gondii dopamine, a missing link between schizophrenia and toxoplasmosis? Biological Psychology, 63, 253268.CrossRefGoogle ScholarPubMed
Geurs, T. L., Hill, E. B., Lippold, D. M., & French, A. R. (2012). Sex differences in murine susceptibility to systemic viral infections. Journal of Autoimmunology, 38, 245253. doi:10.1016/j.jaut.2011.12.003 CrossRefGoogle ScholarPubMed
Giancola, P. R., Martin, C. S., Tarter, R. E., Pelham, W. E., & Moss, H. B. (1996). Executive cognitive functioning and aggressive behavior in preadolescent boys at high risk for substance abuse/dependence. Journal of Studies on Alcohol, 57, 352359.CrossRefGoogle ScholarPubMed
Gierski, F., Hubsch, B., Stefaniak, N., Benzerouk, F., Cuervo-Lombard, C., Bera-Potelle, C., … Limosin, F. (2013). Executive functions in adult offspring of alcohol-dependent probands: Toward a cognitive endophenotype? Alcoholism, Clinical and Experimental Research, 37(Suppl. 1), E356E363. doi:10.1111/j.1530-0277.2012.01903.x CrossRefGoogle Scholar
Gilden, D. H., Mahalingam, R., Cohrs, R. J., & Tyler, K. L. (2007). Herpesvirus infections of the nervous system. Nature Clinical Practice. Neurology, 3, 8294. doi:10.1038/ncpneuro0401 CrossRefGoogle ScholarPubMed
Gould, T. J. (2010). Addiction and cognition. Addiction Science & Clinical Practice, 5, 414.Google ScholarPubMed
Greenland, S. (2000). An introduction to instrumental variables for epidemiologists. International Journal of Epidemiology, 29, 722729.CrossRefGoogle ScholarPubMed
Hibar, D. P., Stein, J. L., Renteria, M. E., Arias-Vasquez, A., Desrivières, S., Jahanshad, N., … Medland, S. E. (2015). Common genetic variants influence human subcortical brain structures. Nature, 520, 224229. doi:10.1038/nature14101 CrossRefGoogle ScholarPubMed
Hollingshead, A. B. (1975). Four-Factor Index of Social Status. Unpublished manuscript, Yale University.Google Scholar
Jonker, I., Klein, H. C., Duivis, H. E., Yolken, R. H., Rosmalen, J. G., & Schoevers, R. A. (2014). Association between exposure to HSV1 and cognitive functioning in a general population of adolescents. The TRAILS study. PLOS ONE, 9, e101549. doi:10.1371/journal.pone.0101549 CrossRefGoogle Scholar
Karatas, H., Gurer, G., Pinar, A., Soylemezoglu, F., Tezel, G. G., Hascelik, G., … Saygi, S. (2008). Investigation of HSV-1, HSV-2, CMV, HHV-6 and HHV-8 DNA by real-time PCR in surgical resection materials of epilepsy patients with mesial temporal lobe sclerosis. Journal of the Neurological Sciences, 264, 151156. doi:10.1016/j.jns.2007.08.010 CrossRefGoogle Scholar
Khandaker, G. M., Stochl, J., Zammit, S., Lewis, G., & Jones, P. B. (2014). Childhood Epstein-Barr Virus infection and subsequent risk of psychotic experiences in adolescence: A population-based prospective serological study. Schizophrenia Research, 158, 1924. doi:10.1016/j.schres.2014.05.019 CrossRefGoogle Scholar
Kimberlin, D. W., Jester, P. M., Sánchez, P. J., Ahmed, A., Arav-Boger, R., Michaels, M. G., … National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group. (2015). Valganciclovir for symptomatic congenital cytomegalovirus disease. New England Journal of Medicine, 372, 933943. doi:10.1056/NEJMoa1404599 CrossRefGoogle ScholarPubMed
Kirillova, G. P., Vanyukov, M. M., Kirisci, L., & Reynolds, M. (2008). Physical maturation, peer environment, and the ontogenesis of substance use disorders. Psychiatry Research, 158, 4353. doi:10.1016/j.psychres.2007.02.017 CrossRefGoogle ScholarPubMed
Kirisci, L., Tarter, R. E., Vanyukov, M., Reynolds, M., & Habeych, M. (2004). Relation between cognitive distortions and neurobehavior disinhibition on the development of substance use during adolescence and substance use disorder by young adulthood: A prospective study. Drug and Alcohol Dependence, 76, 125133. doi:10.1016/j.drugalcdep.2004.04.015 CrossRefGoogle ScholarPubMed
Klein, S. L. (2012). Sex influences immune responses to viruses, and efficacy of prophylaxis and treatment for viral diseases. BioEssays, 34, 10501059. doi:10.1002/bies.201200099 CrossRefGoogle ScholarPubMed
Kosten, T. A., & Rounsaville, B. J. (1992). Sensitivity of psychiatric diagnosis based on the best estimate procedure. American Journal of Psychiatry, 149, 12251227.Google Scholar
Kruszon-Moran, D., Porter, K. S., McQuillan, G., Billioux, V. G., Kim-Farley, R., & Hirsch, R. (2012). Infectious disease prevalence in Los Angeles county—A comparison to national estimates, 1999–2004 birth rates for U.S. teenagers reach historic lows for all age and ethnic groups. NCHS Data Brief, 90, 18.Google Scholar
Lee, S. Y., & Song, X. Y. (2004). Evaluation of the Bayesian and maximum likelihood approaches in analyzing structural equation models with small sample sizes. Multivariate Behavioral Research, 39, 653686. doi:10.1207/s15327906mbr3904_4 CrossRefGoogle ScholarPubMed
Levy, R. (2011). Bayesian data-model fit assessment for structural equation modeling. Structural Equation Modeling, 18, 663685. doi:10.1080/10705511.2011.607723 CrossRefGoogle Scholar
MacKinnon, D. P. (2008). Introduction to statistical mediation analysis. New York: Erlbaum.Google Scholar
Maher, B. S., Vladimirov, V. I., Latendresse, S. J., Thiselton, D. L., McNamee, R., Kang, M., … Vanyukov, M. M. (2011). The AVPR1A gene and substance use disorders: Association, replication, and functional evidence. Biological Psychiatry, 70, 519527. doi:10.1016/j.biopsych.2011.02.023 CrossRefGoogle Scholar
Maller, S. J. (2001). Differential item functioning in the WISC-III: Item parameters for boys and girls in the National Standardization Sample. Educational and Psychological Measurement, 61, 793817.CrossRefGoogle Scholar
Moore, P. S., & Chang, Y. (2014). The conundrum of causality in tumor virology: The cases of KSHV and MCV. Seminars in Cancer Biology, 26, 412. doi:10.1016/j.semcancer.2013.11.001 CrossRefGoogle ScholarPubMed
Muenchhoff, M., & Goulder, P. J. R. (2014). Sex differences in pediatric infectious diseases. Journal of Infectious Diseases, 209(Suppl. 3), S120S126. doi:10.1093/infdis/jiu232 CrossRefGoogle ScholarPubMed
Ngun, T. C., Ghahramani, N., Sanchez, F. J., Bocklandt, S., & Vilain, E. (2011). The genetics of sex differences in brain and behavior. Frontiers in Neuroendocrinology, 32, 227246. doi:10.1016/j.yfrne.2010.10.001 CrossRefGoogle Scholar
NIH. (2015). Consideration of sex as a biological variable in NIH-funded research. Retrieved from http://grants.nih.gov/grants/guide/notice-files/NOT-OD-15-102.html Google Scholar
NIH. (2016). Rigor and reproducibility. Retrieved from http://grants.nih.gov/reproducibility/index.htm#guidance Google Scholar
Nimgaonkar, V. L., Yolken, R. H., Wang, T., Chung-Chou, H. C., McClain, L., McDade, E., … Ganguli, M. (2016). Temporal cognitive decline associated with exposure to infectious agents in a population-based, aging cohort. Alzheimer Disease and Associated Disorders, 30, 216222. doi:10.1097/WAD.0000000000000133 CrossRefGoogle Scholar
Picone, O., Costa, J. M., Dejean, A., & Ville., Y. (2005). Is fetal gender a risk factor for severe congenital cytomegalovirus infection? Prenatal Diagnosis, 25, 3438. doi:10.1002/pd.944 CrossRefGoogle Scholar
Prasad, K. M., Eack, S. M., Goradia, D., Pancholi, K. M., Keshavan, M. S., Yolken, R. H., & Nimgaonkar, V. L. (2011). Progressive gray matter loss and changes in cognitive functioning associated with exposure to herpes simplex virus 1 in schizophrenia: A longitudinal study. American Journal of Psychiatry, 168, 822830. doi:10.1176/appi.ajp.2011.10101423 CrossRefGoogle Scholar
Prasad, K. M., Eack, S. M., Keshavan, M. S., Yolken, R. H., Iyengar, S., & Nimgaonkar, V. L. (2013). Antiherpes virus-specific treatment and cognition in schizophrenia: A test-of-concept randomized double-blind placebo-controlled trial. Schizophrenia Bulletin, 39, 857866. doi:10.1093/schbul/sbs040.CrossRefGoogle ScholarPubMed
Prasad, K. M., Shirts, B. H., Yolken, R. H., Keshavan, M. S., & Nimgaonkar, V. L. (2007). Brain morphological changes associated with exposure to HSV1 in first-episode schizophrenia. Molecular Psychiatry, 12, 105113. doi:10.1038/sj.mp.4001915 CrossRefGoogle Scholar
Prasad, K. M., Watson, A. M., Dickerson, F. B., Yolken, R. H., & Nimgaonkar, V. L. (2012). Exposure to herpes simplex virus type 1 and cognitive impairments in individuals with schizophrenia. Schizophrenia Bulletin, 38, 11371148. doi:10.1093/schbul/sbs046 CrossRefGoogle ScholarPubMed
Saccone, N. L., Saccone, S. F., Hinrichs, A. L., Stitzel, J. A., Duan, W., Pergadia, M. L., … Bierut, L. J. (2009). Multiple distinct risk loci for nicotine dependence identified by dense coverage of the complete family of nicotinic receptor subunit (CHRN) genes. American Journal of Medical Genetics, 150B, 453466. doi:10.1002/ajmg.b.30828 CrossRefGoogle ScholarPubMed
Sanchis-Segura, C., & Becker, J. B. (2016). Why we should consider sex (and study sex differences) in addiction research. Addiction Biology, 21, 9951006. doi:10.1111/adb.12382 CrossRefGoogle Scholar
Schretlen, D. J., Vannorsdall, T. D., Winicki, J. M., Mushtaq, Y., Hikida, T., Sawa, A., … Cascella, N. G. (2010). Neuroanatomic and cognitive abnormalities related to herpes simplex virus type 1 in schizophrenia. Schizophrenia Research, 118, 224231. doi:10.1016/j.schres.2010.01.008 CrossRefGoogle Scholar
Shirts, B. H., Prasad, K. M., Pogue-Geile, M. F., Dickerson, F., Yolken, R. H., & Nimgaonkar, V. L. (2008). Antibodies to cytomegalovirus and herpes simplex virus 1 associated with cognitive function in schizophrenia. Schizophrenia Research, 106, 268274. doi:10.1016/j.schres.2008.07.017 CrossRefGoogle Scholar
Spitzer, R., Williams, J., & Gibbon, M. (1996). Structured Clinical Interview for DSM-IV, Outpatient Version (SCID-OP). New York: New York State Psychiatric Institute, Biometrics Research Department.Google Scholar
Steiner, I., Kennedy, P. G., & Pachner, A. R. (2007). The neurotropic herpes viruses: Herpes simplex and varicella-zoster. Lancet Neurology, 6, 10151028. doi:10.1016/S1474-4422(07)70267-3 CrossRefGoogle ScholarPubMed
Strandberg, T. E., Pitkala, K. H., Linnavuori, K. H., & Tilvis, R. S. (2003). Impact of viral and bacterial burden on cognitive impairment in elderly persons with cardiovascular diseases. Stroke, 34, 21262131. doi:10.1161/01.STR.0000086754.32238.DA CrossRefGoogle Scholar
Tarter, K. D., Simanek, A. M., Dowd, J. B., & Aiello, A. E. (2014). Persistent viral pathogens and cognitive impairment across the life course in the third national health and nutrition examination survey. Journal of Infectious Diseases, 209, 837844. doi:10.1093/infdis/jit616 CrossRefGoogle Scholar
Tarter, R. E., & Vanyukov, M. (1994). Alcoholism: A developmental disorder. Journal of Consulting and Clinical Psychology, 62, 10961107.CrossRefGoogle ScholarPubMed
Tarter, R. E., & Vanyukov, M. M. (2001). Introduction: Theoretical and operational framework for research into the etiology of substance use disorders. Journal of Child & Adolescent Substance Abuse, 10, 112.CrossRefGoogle Scholar
Tarter, R. E., Vanyukov, M., Kirisci, L., Reynolds, M., & Clark, D. (2006). Predictors of marijuana use in adolescents before and after licit drug use: Examination of the gateway hypothesis. American Journal of Psychiatry, 163, 21342140. doi:10.1176/ajp.2006.163.12.2134 CrossRefGoogle Scholar
Thomas, P., Bhatia, T., Gauba, D., Wood, J., Long, C., Prasad, K., … Deshpande, S. N. (2013). Exposure to herpes simplex virus, type 1 and reduced cognitive function. Journal of Psychiatric Research, 47, 16801685. doi:10.1016/j.jpsychires.2013.07.010 CrossRefGoogle Scholar
Vanyukov, M. M., Kim, K., Irons, D., Kirisci, L., Neale, M., Ridenour, T., … Iacono, W. (2015). Genetic relationship between the addiction diagnosis in adults and their childhood measure of addiction liability. Behavior Genetics, 45, 111. doi:10.1007/s10519-014-9684-4 CrossRefGoogle Scholar
Vanyukov, M. M., & Tarter, R. E. (2000). Genetic studies of substance abuse. Drug and Alcohol Dependence, 59, 101123.CrossRefGoogle Scholar
Vanyukov, M. M., Tarter, R. E., Kirillova, G. P., Kirisci, L., Reynolds, M. D., Kreek, M. J., … Ridenour, T. A. (2012). Common liability to addiction and “gateway hypothesis”: Theoretical, empirical and evolutionary perspective. Drug and Alcohol Dependence, 123(Suppl. 1), S3S17. doi:10.1016/j.drugalcdep.2011.12.018 CrossRefGoogle ScholarPubMed
Volkow, N. D. (2012). Fiscal Year 2013 Budget Request. Testimony Before the House Subcommittee on Labor-HHS-Education Appropriations. National Institute on Drug Abuse. Retrieved from https://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2012/03/fiscal-year-2013-budget-request Google Scholar
Watson, A. M., Prasad, K. M., Klei, L., Wood, J. A., Yolken, R. H., Gur, R. C., … Nimgaonkar, V. L. (2013). Persistent infection with neurotropic herpes viruses and cognitive impairment. Psychological Medicine, 43, 10231031. doi:10.1017/S003329171200195X.CrossRefGoogle ScholarPubMed
Wechsler, D. (1991). Wechsler Intelligence Scale for Children manual (3rd ed.). San Antonio, TX: Psychological Corporation.Google Scholar
Yolken, R. H., Torrey, E. F., Lieberman, J. A., Yang, S., & Dickerson, F. B. (2011). Serological evidence of exposure to herpes simplex virus type 1 is associated with cognitive deficits in the CATIE schizophrenia sample. Schizophrenia Research, 128, 6165. doi:10.1016/j.schres.2011.01.020 CrossRefGoogle Scholar
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