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Estudios del líquido cefalorraquídeo en pacientes psiquiátricos seropositivos al virus de la enfermedad de Borna
Published online by Cambridge University Press: 12 May 2020
Resumen
El virus de la enfermedad de Borna (VEB) parece causar meningoencefalitis y psicosis esquizofreniforme en casos esporádicos, según experimentos anteriores de inoculación del líquido cefalorraquídeo (LCR) (Rott et ai, 1991). Sin embargo, los parámetros del LCR en pacientes psiquiátricos seropositivos al VEB resultaron casi todos normales; sólo el índice más sensible I-VEB de LCR/suero para IgG específica al VEB producida intratecalmente fue patológico en 10,5-29,0% (según diferentes límites metodológicos) de los pacientes. En una parte de los casos, se intentó aumentar la sensibilidad para detectar IgG específica en el LCR por medio de concentración. El procedimiento de concentración no aumenta significativamente el sesgo metodológico, según un análisis estadístico de los resultados. Nuestros hallazgos apoyan la hipótesis de que el VEB puede causar un patrón amplio de diagnósticos de síndromes psiquiátricos o contribuir a su patogénesis. Se espera la presencia de un espectro de diagnósticos a partir de los síntomas psiquiátricos no específicos en otras enfermedades infecciosas del cerebro y de los resultados en la enfermedad experimental de Borna (EB) en animales, en la que una mayoría de ellos mostraba síntomas bastante inespecíficos debido a una encefalitis leve, preferentemente límbica. Ligeras deficiencias a partir de una infección anterior por VEB podrían explicar el mantenimiento de los síntomas en una parte de los casos. Las recurrencias de la infección años después son muy conocidas en la EB experimental y natural en animales. Queda pendiente que este mecanismo pueda desempeñar un papel más destacado en una forma de ciclotimia «sintomática» y de esquizofrenia «sintomática», aunque los resultados de las estudios del LCR son más claros en pacientes seropositivos al VEB con psicosis mayores.
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