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However, evidence so far is inconsistent. We, therefore, analyzed the seroprevalence and titer levels of IgG antibodies against several herpesviruses and Toxoplasma gondii <jats:italic>(T. gondii)<\/jats:italic> in plasma of 760 patients with a bipolar disorder, 144 first-degree matched relatives and 132 controls of the Dutch Bipolar (DB) Cohort using ELISA. In addition, we performed a literature-based meta-analysis on the seroprevalence of IgG antibodies against these pathogens (<jats:italic>n<\/jats:italic>\u2009=\u200914). Our results in the DB Cohort and subsequent meta-analysis (<jats:italic>n<\/jats:italic>\u2009=\u20092364 BD patients, <jats:italic>n<\/jats:italic>\u2009=\u20095101 controls) show no association between exposure to herpesviruses and bipolar disorder (HSV-1 [adjusted OR 0.842, 95% CI 0.567\u20131.230], HSV-2 [adjusted OR 0.877, 95% CI 0.437\u20131.761], CMV [adjusted OR 0.884 95% CI 0.603\u20131.295], EBV [adjusted OR 0.968 95% CI 0.658\u20131.423]). In the DB Cohort, we did not find an association between bipolar disorder and <jats:italic>T. gondii<\/jats:italic> titer or seroprevalence either [adjusted OR 1.018, 95% CI 0.672\u20131.542]. The overall OR was not significant for <jats:italic>T. gondii<\/jats:italic> [OR: 1.4, 95% CI 0.95\u20131.90, <jats:italic>p<\/jats:italic>\u2009=\u20090.09), but subgroup analyses in age groups below 40 years showed a significantly increased seroprevalence of <jats:italic>T. gondii<\/jats:italic> IgGs in BD [OR: 1.8 (95% CI 1.10\u20132.89, <jats:italic>p<\/jats:italic>\u2009=\u20090.021]. Our meta-analysis indicates that <jats:italic>T. gondii<\/jats:italic> exposure may be a risk factor for BD in certain subpopulations.<\/jats:p>","DOI":"10.1038\/s41398-019-0636-x","type":"journal-article","created":{"date-parts":[[2019,11,20]],"date-time":"2019-11-20T14:03:23Z","timestamp":1574258603000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["The association between antibodies to neurotropic pathogens and bipolar disorder"],"prefix":"10.1038","volume":"9","author":[{"given":"Gijsje J. L. 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