Association of Cytomegalovirus and <i>Toxoplasma gondii</i> Antibody Titers With Bipolar Disorder

Frye, Mark A.; Coombes, Brandon J.; McElroy, Susan L.; Jones‐Brando, Lorraine; Bond, David J.; Veldić, Marin; Romo‐Nava, Francisco; Bobo, William V.; Singh, Balwinder; Colby, Colin; Skime, Michelle; Biernacka, Joanna M.; Yolken, Robert H.

doi:10.1001/jamapsychiatry.2019.2499

Cited by 42 publications

(30 citation statements)

References 44 publications

(86 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Given the well-established association between MDD, stress, and inflammation [1,2], it is conceivable that HCMV may be more prone to reactivation in MDD populations. Indeed, HCMV has been associated with depression in at least 13 studies [40][41][42][43][44][45][46][47][48][49][50][51][52][53]. In our recent work, we found that HCMV infection was associated with reduced gray matter volume in participants with MDD but not healthy controls [54].…”

Section: Introductionmentioning

confidence: 67%

Replicable association between human cytomegalovirus infection and reduced white matter fractional anisotropy in major depressive disorder

Zheng

Bergamino

Ford

et al. 2021

Neuropsychopharmacol.

View full text Add to dashboard Cite

Major depressive disorder (MDD) is associated with reductions in white matter microstructural integrity as measured by fractional anisotropy (FA), an index derived from diffusion tensor imaging (DTI). The neurotropic herpesvirus, human cytomegalovirus (HCMV), is a major cause of white matter pathology in immunosuppressed populations but its relationship with FA has never been tested in MDD despite the presence of inflammation and weakened antiviral immunity in a subset of depressed patients. We tested the relationship between FA and HCMV infection in two independent samples consisting of 176 individuals with MDD and 44 healthy controls (HC) (Discovery sample) and 88 participants with MDD and 48 HCs (Replication sample). Equal numbers of HCMV positive (HCMV+) and HCMV negative (HCMV−) groups within each sample were balanced on ten different clinical/demographic variables using propensity score matching. Anti-HCMV IgG antibodies were measured using a solid-phase ELISA. In the Discovery sample, significantly lower FA was observed in the right inferior fronto-occipital fasciculus (IFOF) in HCMV+ participants with MDD compared to HCMV− participants with MDD (cluster size 1316 mm3; pFWE < 0.05, d = −0.58). This association was confirmed in the replication sample by extracting the mean FA from this exact cluster and applying the identical statistical model (p < 0.05, d = −0.45). There was no significant effect of diagnosis or interaction between diagnosis and HCMV in either sample. The effect of chronic HCMV infection on white matter integrity may—in at-risk individuals—contribute to the psychopathology of depression. These findings may provide a novel target of intervention for a subgroup of patients with MDD.

show abstract

Section: Introductionmentioning

confidence: 67%

Replicable association between human cytomegalovirus infection and reduced white matter fractional anisotropy in major depressive disorder

Zheng

Bergamino

Ford

et al. 2021

Neuropsychopharmacol.

View full text Add to dashboard Cite

show abstract

“…In addition to risky behavior, T . gondii exposure has been found to be associated with mental health [ 7 , 44 ], which may in turn influence diet-related outcomes. The above mechanisms would explain a direct or indirect causal relationship between T .…”

Section: Resultsmentioning

confidence: 99%

Cross-sectional association of Toxoplasma gondii exposure with BMI and diet in US adults

et al. 2021

View full text Add to dashboard Cite

Toxoplasmosis gondii exposure has been linked to increased impulsivity and risky behaviors, which has implications for eating behavior. Impulsivity and risk tolerance is known to be related with worse diets and a higher chance of obesity. There is little known, however, about the independent link between Toxoplasma gondii (T. gondii) exposure and diet-related outcomes. Using linear and quantile regression, we estimated the relationship between T. gondii exposure and BMI, total energy intake (kcal), and diet quality as measured by the Health Eating Index-2015 (HEI) among 9,853 adults from the 2009–2014 National Health and Nutrition Examination Survey. Previous studies have shown different behavioral responses to T. gondii infection among males and females, and socioeconomic factors are also likely to be important as both T. gondii and poor diet are more prevalent among U.S. populations in poverty. We therefore measured the associations between T. gondii and diet-related outcomes separately for men and women and for respondents in poverty. Among females <200% of the federal poverty level Toxoplasmosis gondii exposure was associated with a higher BMI by 2.0 units (95% CI [0.22, 3.83]) at median BMI and a lower HEI by 5.05 units (95% CI [-7.87, -2.24]) at the 25th percentile of HEI. Stronger associations were found at higher levels of BMI and worse diet quality among females. No associations were found among males. Through a detailed investigation of mechanisms, we were able to rule out T. gondii exposure from cat ownership, differing amounts of meat, and drinking water source as potential confounding factors; environmental exposure to T. gondii as well as changes in human behavior due to parasitic infection remain primary mechanisms.

show abstract

“…While several studies have corroborated the hypothesis, others have consistently contradicted it based on relevant samples. 37,42,45 Nevertheless, it should be noted that both of the above described studies were based on neonatal blood samples, meaning that the antibodies probably originated from the mother, rather than the newborn's exposure to the parasite. Higher quality studies are indicated by more stars in each category.…”

Section: Bipolar Disordermentioning

confidence: 99%

Association between exposure to toxoplasmosis and major psychiatric disorders: a systematic review

Fernandes

Dias

Miranda‐Scippa

2021

Braz. J. Psychiatry

View full text Add to dashboard Cite

Objective: To assess the association between exposure to toxoplasmosis and major psychiatric disorders through a systematic review of the literature. Methods: The literature review was performed in the MEDLINE, SciELO, and PsycINFO databases. To evaluate the quality of the studies included in the review, the Newcastle-Ottawa Scale was used. Results: Thirty-one studies were included, and the majority found an association between exposure to toxoplasmosis and schizophrenia or bipolar disorder (58.3 and 54.5% of the included papers, respectively), but not major depressive disorder. We found no significant difference in mean quality scores between studies that corroborated and contradicted the association hypothesis for either schizophrenia or bipolar disorder. All included papers were considered at least satisfactory according to the Newcastle-Ottawa Scale (total scores X 6 out of 9). Conclusion: Although there was no association between exposure to toxoplasmosis and major depressive disorder, the results indicate an association with both bipolar disorder and schizophrenia, despite their heterogeneity. Further studies should be performed with more specific variables so that the nature of these relationships can be elucidated.

show abstract

Association of Cytomegalovirus and Toxoplasma gondii Antibody Titers With Bipolar Disorder

Cited by 42 publications

References 44 publications

Replicable association between human cytomegalovirus infection and reduced white matter fractional anisotropy in major depressive disorder

Replicable association between human cytomegalovirus infection and reduced white matter fractional anisotropy in major depressive disorder

Cross-sectional association of Toxoplasma gondii exposure with BMI and diet in US adults

Association between exposure to toxoplasmosis and major psychiatric disorders: a systematic review

Contact Info

Product

Resources

About