精神分裂症病患及其家屬之單純疱疹病毒血清抗體與持續注意力之相關研究

Relations Between Serum Antibodies to Herpes Simplex Viruses and Sustained Attention in Schizophrenic Patients and Their Families

馮琦芳(Chi-Fang Feng)

指導教授 ： 陳為堅

國立臺灣大學/公共衛生學院/流行病學研究所/碩士(2004年)

https://doi.org/10.6342/NTU.2004.02092

摘要

目的： 探討精神分裂症病患家族成員及對照組家族成員之單純疱疹病毒第一型(herpes simplex virus type 1, HSV-1)、第二型(HSV-2)血清學特徵與持續注意力之相關性。
方法： 自2002年至2004年收集三類研究對象，包括：117位精神分裂症指標個案及其257位一等親屬、44位對照家族指標個案及其44位母親、以及317位無血緣關係之對照個案。針對所有研究個案提供之血液檢體，利用固相酵素免疫分析(solid-phase enzyme immunoassay)進行HSV-1及HSV-2血清抗體G型免疫球蛋白之效價檢驗。部分的家族成員另外施予連續操作測驗(continuous performance test)以測量其持續注意力。統計分析方面，分別比較精神分裂症病患家族成員及對照組家族成員之單純疱疹病毒血清學特徵與持續注意力。家族內成員的共同感染情形，藉由合適的相關係數指標予以量化：類別性的感染狀態之相關程度以tetrachoric correlation呈現，而連續性的抗體效價則以intraclass correlation coefficient呈現。
結果： 血清學特徵的比較中，發現精神分裂症病患及其母親比起對照指標個案及其母親有顯著較高的HSV-2抗體效價，而HSV-1之效價則未發現有顯著差異。以精神分裂症病患的病毒抗體效價平均值作為切點，將精神分裂症指標個案及其各類一等親屬分為高效價組與低效價組，比較結果發現僅在精神分裂症病患中HSV-1高效價組呈現顯著較差的持續注意力，一等親屬中則皆未見此差異。於是進一步利用持續注意力分數將精神分裂症病患分成三等分並分析HSV-1抗體效價之分佈，結果得到隨注意力分數越高其抗體效價越低的線性趨勢。關於家族內成員HSV-1感染狀態的相關，精神分裂症指標個案及其無病手足之間相關程度很高，而精神分裂症指標個案及其母親之間則呈現中等的相關程度。
結論： 精神分裂症病患之HSV-1血清抗體與持續注意力有所相關，且此HSV-1感染可能源於家族內的共同感染。

關鍵字

單純疱單純疱疹病毒第二型 ； 精神分裂症 ； 持續注意力 ； 疹病毒第一型 ； 連續操作測驗

並列摘要

Objective: To evaluate the relations between the serological characteristics to herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) and sustained attention deficits in subjects of schizophrenic families and those of control families.
Methods: We recruited 117 schizophrenic probands and their 257 first-degree relatives, 44 control probands and their 44 mothers, and 317 unrelated population controls during the period of 2002 to 2004. Each participant’s serum immunoglobulin G class antibody titers to HSV-1 and HSV-2 were detected by means of solid-phase enzyme immunoassay with type-specific antigens, whereas part of the participants further undertook two sessions of the Continuous Performance Test (CPT). Members of the two types of families were compared for both HSV serological characteristics and CPT performance, and familial correlation in HSV infection was examined in tetrachoric correlation for categorical serostatus and in intraclass correlation coefficient for continuous antibody titers.
Results: Schizophrenic probands and their mothers had higher HSV-2 antibody titers than their counterparts in the control families, whereas no difference was found for HSV-1. When the mean antibody level of schizophrenic patients was used as the cut-off for the dichotomization of schizophrenic probands and their first-degree relatives, only patients with high HSV-1 titers were found to have poorer scores on the degraded CPT whereas other family members did not exhibit such differences. A linearly decreasing trend in HSV-1 antibody titers was further demonstrated when schizophrenic patients were trichotomized in terms of CPT scores. Prominent familial correlation in HSV-1 serostatus existed between schizophrenic probands and siblings, while moderate correlation between schizophrenic probands and mothers.
Conclusion: Our results indicate that the antibody titers to HSV-1 is associated with sustained attention deficits in schizophrenia and the infection is likely to be family-originated.

並列關鍵字

herpes simplex virus type 2 (HSV-2) ； sustained attention ； continuous performance test (CPT) ； schizophrenia ； herpes simplex virus type 1 (HSV-1)

參考文獻

1. Lewis DA, Levitt P. Schizophrenia as a disorder of neurodevelopment. Annu Rev Neurosci. 2002;25:409-432.

2. Tsuang MT, Stone WS, Faraone SV. Genes, environment and schizophrenia. Br J Psychiatry. 2001;178:s18-s24.

3. Torrey EF, Miller J, Rawlings R, Yolken RH. Seasonality of births in schizophrenia and bipolar disorder: a review of the literature. Schizophr Res. 1997;28:1-38.

4. Pedersen CB, Mortensen PB. Evidence of a dose-response relationship between urbanicity during upbringing and schizophrenia risk. Arch Gen Psychiatry. 2001;58:1039-1046.

5. Torrey EF, Yolken RH. At issue: is household crowding a risk factor for schizophrenia and bipolar disorder? Schizophr Bull. 1998;24:321-324.