Congenital Cytomegalovirus Infection in Fraternal Twins: A Longitudinal Case Study Examining Neurocognitive and Neurobehavioral Correlates

a Department of Pediatrics , University of Maryland School of Medicine , Baltimore , Maryland.
Applied neuropsychology. Child 01/2012; 1(1):63-73. DOI: 10.1080/21622965.2012.677605
Source: PubMed


Cytomegalovirus (CMV) is the most ubiquitous member of the herpes virus family and is the leading cause of congenital (vertical) infection in newborns (Fowler, Stagno, & Pass, 2003 ; Llorente, Steigmeyer, Cooper, Rivers, & Gazley, 2011; Noyola et al., 2000 ; Steigmeyer & Llorente, 2010 ). CMV is related to the group of viruses capable of causing more pernicious infectious diseases, such as chicken pox (Santos de Barona, 1998 ). Although the virus generally remains dormant, individuals whose symptoms are clinically apparent often are dramatically affected. Common symptomatic characteristics of the virus include microcephaly, jaundice, liver-spleen infections, pneumonia, cardiac anomalies, chorioretinitis, vision loss, sensory-neural hearing loss, mental retardation, and mononucleosis (Demmler, 1991 ; Kashden, Frison, Fowler, Pass, & Boll, 1998; Noyola et al., 2000 ; Pass, 2005 ; Santos de Barona). The prognosis of individuals with CMV is highly variable, and the prognosis of individuals with congenital CMV can usually be determined based on the extent of infection at birth. The purpose of this investigation is to present longitudinal results of neuropsychological evaluation of two dizygotic twin sets (one twin of each set is asymptomatic CMV-positive and the other is uninfected) who were reared in the same environment. In addition, the present findings are discussed within the context of emerging murine and other animal analogues of CMV as well as within the extant CMV literature.

18 Reads
  • Source
    • "In a recent case study, two adolescent homozygote twin pairs were followed, in which one of the pair was seropositive for CMV and the other seronegative. In both pairs, there was no difference in neurocognitive development between the seropositive and the seronegative twin [51]. Together with our findings, this suggests that CMV is not predictive for cognitive performance in adolescents. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Infections with different herpes viruses have been associated with cognitive functioning in psychiatric patients and healthy adults. The aim of this study was to find out whether antibodies to different herpes viruses are prospectively associated with cognitive functioning in a general adolescent population. Methods This study was performed in TRAILS, a large prospective general population cohort (N = 1084, 54% female, mean age 16.2 years (SD 0.6)). At age 16, immunoglobulin G antibodies against HSV1, HSV2, CMV and EBV were measured next to high sensitive C-Reactive Protein (hsCRP). Two years later, immediate memory and executive functioning were assessed using the 15 words task and the self ordered pointing task. Multiple linear regression analysis with bootstrapping was performed to study the association between viral infections and cognitive function, adjusting for gender, socioeconomic status, ethnicity, and cannabis use. Results Presence of HSV1 antibodies was associated with memory function ((B = −0.272, 95% CI = −0.556 to −0.016, p = 0.047)), while the association with executive functioning did not reach statistical significance (B = 0.560, 95% CI is −0.053 to 1.184, p = 0.075). The level of HSV1 antibodies was associated with both memory function (B = −0.160, 95% CI = −0.280 to −0.039, p = 0.014) and executive functioning (B = 0.296, 95% CI = 0.011 to 0.578, p = 0.046). Other herpes viruses and hsCRP were not associated with cognitive functioning. Conclusions Both presence and level of HSV1 antibodies are prospectively associated with reduced cognitive performance in a large cohort of adolescents.
    PLoS ONE 07/2014; 9(7):e101549. DOI:10.1371/journal.pone.0101549 · 3.23 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Symptoms of congenital cytomegalovirus infection remains unclear. Extremely low birth weight twins with twin-to-twin transfusion syndrome were infected with cytomegalovirus congenitally. The donor showed neuronal impairment, whereas the recipient showed hepatic dysfunction. Intrauterine hemodynamics may be important in pathophysiology of congenital cytomegalovirus infection.
    Indian pediatrics 05/2015; 52(5):429-431. DOI:10.1007/s13312-015-0650-x · 1.04 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Cytomegalovirus (CMV) is one of the most common causes of serious viral intrauterine infections. It is universally distributed among the human population with an average incidence of 0.15 to 2%. Indeed, at least half of the women in the reproductive age have evidence of prior CMV infection. Epidemiology and Pathogenicity However, it is not a usual practice to screen asymptomatic pregnant woman or neonates for CMV. Even if a mother developed a primary CMV infection during pregnancy, up to 90% of the newborns with congenital CMV will be asymptomatic at the time of birth. Only 5 to 7% of the infected babies will be acutely symptomatic, and the typical clinical presentation includes intrauterine growth restriction, microcephaly, various cutaneous manifestations (including petechiae and purpura), hematological abnormalities (particularly resistant thrombocytopenia), hepatosplenomegaly, chorioretinitis, hepatitis, etc. In contrast, acquired CMV infection is extremely unlikely to cause any serious sequelae for the infant. Cases We present a case of congenital and acquired CMV infection in twins with a focus of dissimilarity in presentation, clinical course, and outcome.
    American Journal of Perinatology 10/2015; DOI:10.1055/s-0035-1563387 · 1.91 Impact Factor

Similar Publications