Self-reported executive functioning in adults with congenital cytomegalovirus infection

Congenital Cytomegalovirus (cCMV) is the most common prenatal infection and the main infectious cause of neurodevelopmental abnormalities in developed countries. Long-term neuropsychological outcome of cCMV infection is yet not well understood, and follow-up studies on adults screened for CMV at birth are few. The aim of this study was to investigate self-reported executive functioning (EF) in adults with cCMV infection in relation to uninfected controls. All individuals from a universal newborn CMV screening study conducted in Southern Sweden and sampled 1977–85, was invited to participate in a follow-up study. 45/71 individuals (63%) with cCMV infection and 25/46 controls (54%) were enrolled. Participants were aged 34–43 years. Neurological symptoms and neuropsychiatric disabilities were documented through written reports from the original study and a semi-structured study protocol. Executive functioning was evaluated with BRIEF-A (questionnaire). No statistically significant differences were found between groups in self-reported executive functioning, although greater variability in outcomes was observed in the cCMV group. Everyday executive functioning might not be affected at the group level in adults with cCMV infection or may not be adequately captured through self-reports alone. The variability in executive functioning results suggests that individuals with cCMV infection represent a more heterogeneous group compared to the controls. In this unique population-based cohort of adults with cCMV infection, identified through a newborn screening study in Sweden during the1970s–1980s, no signs of impaired self-reported everyday executive functioning were observed at the group level. This suggests that self-reported everyday executive functioning is not significantly affected at the group level in adults with cCMV infection or may not be fully captured through self-reports alone.

先天性巨细胞病毒（Congenital Cytomegalovirus, cCMV）是发达国家最常见的产前感染性疾病，亦是引发神经发育异常的首要感染性病因。目前学界对cCMV感染患者的长期神经心理结局尚未完全阐明，且针对出生时接受巨细胞病毒筛查的成年人开展的随访研究仍较为匮乏。本研究旨在探讨先天性巨细胞病毒感染成年人的自我报告执行功能（Executive Functioning, EF），并与未感染对照组进行对比分析。本研究邀请了瑞典南部1977至1985年开展的新生儿巨细胞病毒普筛研究中的全部受试者参与本次随访，最终71例cCMV感染受试者中的45例（占比63%）与46例对照受试者中的25例（占比54%）成功入组，所有入组受试者年龄介于34至43岁之间。研究通过原始研究的书面报告及半结构化研究方案，收集了受试者的神经系统症状与神经精神残疾相关数据，执行功能采用BRIEF-A问卷进行评估。结果显示，两组受试者的自我报告执行功能未发现统计学显著性差异，但cCMV感染组的结局变异度显著更高。这提示，在群体水平上，cCMV感染成年人的日常执行功能可能未受影响，或仅通过自我报告难以充分捕捉其执行功能损伤情况。执行功能评估结果的变异度提示，与对照组相比，cCMV感染受试者构成了异质性更强的队列。在这项独特的基于人群的队列研究中，受试者为20世纪70至80年代通过瑞典新生儿筛查项目识别的cCMV感染成年人，群体水平未观察到自我报告的日常执行功能受损迹象。这进一步表明，cCMV感染成年人的自我报告日常执行功能在群体水平未受显著影响，或仅通过自我报告难以完全覆盖其真实的执行功能状态。