{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T18:06:01Z","timestamp":1775844361346,"version":"3.50.1"},"reference-count":60,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,4]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    Spinal cord (SC) narrowing has been documented in patients with human T cell lymphotropic virus type 1 (HTLV-1)-associated myelopathy (HAM). However, it remains uncertain whether individuals who present with lower urinary tract symptoms (LUTSs) without motor disability (probable HAM) exhibit damage to the central nervous system. These patients typically experience nocturia, urgency, incontinence, and, less frequently, an arreflexic bladder, which requires intermittent catheterization for voiding. The aim for the present study was to investigate the effectiveness of magnetic resonance imaging with tractography in detecting abnormalities in HTLV-1-infected individuals with LUTS. The study participants included those with probable HAM (\n                    <jats:italic>n<\/jats:italic>\n                    = 39), HTLV-1 carriers (HCs;\n                    <jats:italic>n<\/jats:italic>\n                    = 41), and seronegative (SN) controls (\n                    <jats:italic>n<\/jats:italic>\n                    = 12). Magnetic resonance imaging with diffusion tensor imaging and tractography was performed, with two regions of interest positioned side-by-side at T5 and T12-L1. Measurements included the SC area, mean diffusivity, and fractional anisotropy (FA). No significant differences were found between groups regarding age or sex (\n                    <jats:italic>P<\/jats:italic>\n                    &gt;0.05). The medians and interquartile ranges for the thoracic SC area were 0.41 (0.39\u20130.45), 0.36 (0.30\u20130.40), and 0.33 (0.27\u20130.36) in SN controls, HCs, and those with probable HAM, respectively (\n                    <jats:italic>P<\/jats:italic>\n                    &lt;0.05). The lumbar SC area was smaller in patients with probable HAM compared with HCs and SN controls. Furthermore, the median FA in the lumbar region was significantly lower in patients with probable HAM (\n                    <jats:italic>P<\/jats:italic>\n                    &lt;0.05). Urinary dysfunction is the most common manifestation in probable HAM, and the present study reveals SC narrowing in these patients, despite the absence of motor disability.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.25-0126","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T15:32:20Z","timestamp":1764689540000},"page":"328-333","source":"Crossref","is-referenced-by-count":0,"title":["Evidence of Spinal Cord Damage in Human T Cell Lymphotropic Virus Type 1-Infected Subjects Without Motor Disability"],"prefix":"10.4269","volume":"114","author":[{"given":"Jos\u00e9 Abra\u00e3o Carneiro","family":"Neto","sequence":"first","affiliation":[{"name":"Immunology Service, Federal University of Bahia Post-Graduate Program in Health Sciences, Professor Edgard Santos University Hospital, Salvador, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheila Nunes","family":"Ferraz","sequence":"additional","affiliation":[{"name":"Immunology Service, Federal University of Bahia Post-Graduate Program in Health Sciences, Professor Edgard Santos University Hospital, Salvador, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanna","family":"Ladeia-Rocha","sequence":"additional","affiliation":[{"name":"Image Memorial\/DASA, Salvador, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cassius Jos\u00e9 V\u00edtor","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"Immunology Service, Federal University of Bahia Post-Graduate Program in Health Sciences, Professor Edgard Santos University Hospital, Salvador, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L\u00facia","family":"Passos","sequence":"additional","affiliation":[{"name":"Immunology Service, Federal University of Bahia Post-Graduate Program in Health Sciences, Professor Edgard Santos University Hospital, Salvador, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renata Gl\u00f3ria","family":"S\u00e1","sequence":"additional","affiliation":[{"name":"Immunology Service, Federal University of Bahia Post-Graduate Program in Health Sciences, Professor Edgard Santos University Hospital, Salvador, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N\u00e9viton","family":"Castro","sequence":"additional","affiliation":[{"name":"Urology Service, Professor Edgard Santos University Hospital, Salvador, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucas Teixeira","family":"Batista","sequence":"additional","affiliation":[{"name":"Urology Service, Professor Edgard Santos University Hospital, Salvador, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C\u00e9sar Ara\u00fajo","family":"Neto","sequence":"additional","affiliation":[{"name":"Image Memorial\/DASA, Salvador, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamary","family":"Oliveira-Filho","sequence":"additional","affiliation":[{"name":"Neurology Service, Professor Edgard Santos University Hospital, Salvador, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edgar M.","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Immunology Service, Federal University of Bahia Post-Graduate Program in Health Sciences, Professor Edgard Santos University Hospital, Salvador, Brazil;"},{"name":"Gon\u00e7alo Moniz Institute, Fiocruz, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Lancet Neurol","first-page":"1068","article-title":"The HTLV-1 neurological complex","volume":"5","author":"Araujo","year":"2006"},{"key":"b2","series-title":"Front Med","first-page":"1","article-title":"Human T-cell lymphotropic virus type 1 and Strongyloides stercoralis co-infection: A systematic review and meta-analysis","volume":"9","author":"Ye","year":"2022"},{"key":"b3","series-title":"Front Med (Lausanne)","first-page":"812016","article-title":"HTLV-1 and co-infections","volume":"9","author":"Rosadas","year":"2022"},{"key":"b4","series-title":"AIDS Res Hum Retroviruses","first-page":"365","article-title":"Clinical manifestations associated with HTLV type I infection: A cross-sectional study","volume":"23","author":"Caskey","year":"2007"},{"key":"b5","series-title":"Urology","first-page":"813","article-title":"Urinary symptoms associated with human T-cell lymphotropic virus type I infection: Evidence of urinary manifestations in large group of HTLV-I carriers","volume":"69","author":"Castro","year":"2007"},{"key":"b6","series-title":"AIDS Res Hum Retroviruses","first-page":"931","article-title":"Proposal for diagnostic criteria of tropical spastic paraparesis\/HTLV-I-associated myelopathy (TSP\/HAM)","volume":"22","author":"De Castro-Costa","year":"2006"},{"key":"b7","series-title":"Neurourol Urodyn","first-page":"449","article-title":"Retrospective clinic and urodynamic study in the neurogenic bladder dysfunction caused by human T cell lymphotrophic virus type 1 associated myelopathy\/tropical spastic paraparesis (HAM\/TSP)","volume":"36","author":"Troisgros","year":"2017"},{"key":"b8","series-title":"PLoS Negl Trop Dis","first-page":"e0009772","article-title":"Bladder dysfunction in human T cell lymphotropic virus infection: A prospective cohort study","volume":"16","author":"Neto","year":"2022"},{"key":"b9","series-title":"Eur J Obstet Gynecol Reprod Biol","first-page":"230","article-title":"Impact of HTLV-I in quality of life and urogynecologic parameters of women with urinary incontinence","volume":"147","author":"Diniz","year":"2009"},{"key":"b10","series-title":"J Neurovirol","first-page":"583","article-title":"Atrophy, focal spinal cord lesions and alterations of diffusion tensor imaging (DTI) parameters in asymptomatic virus carriers and patients suffering from human T-lymphotrophic virus type 1 (HTLV-1)-associated myelopathy\/tropical spastic paraparesis (HAM\/TSP)","volume":"20","author":"Vilchez","year":"2014"},{"key":"b11","series-title":"Ann Clin Transl Neurol","first-page":"488","article-title":"Diffusion tensor imaging metrics in diagnosis of HTLV-1-associated myelopathy","volume":"9","author":"Liberato de Matos","year":"2022"},{"key":"b12","series-title":"Neurology","first-page":"1444","article-title":"Rating neurologic impairment in multiple sclerosis: An expanded disability status scale (EDSS)","volume":"33","author":"Kurtzke","year":"1983"},{"key":"b13","series-title":"Neurourol Urodyn","first-page":"287","article-title":"Reviewing the ICS 2002 terminology report: The ongoing debate","volume":"28","author":"Abrams","year":"2009"},{"key":"b14","series-title":"Urology","first-page":"60","article-title":"Assessment of overactive bladder symptoms: Comparison of 3-day bladder diary and the overactive bladder symptoms score","volume":"77","author":"Homma","year":"2011"},{"key":"b15","series-title":"Pathogens","first-page":"492","article-title":"HAM\/TSP pathogenesis: The transmigration activity of HTLV-1-infected T cells into tissues","volume":"12","author":"Nakamura","year":"2023"},{"key":"b16","series-title":"J Med Virol","first-page":"1809","article-title":"Immunological and viral features in patients with overactive bladder associated with human T-cell lymphotropic virus type 1 infection","volume":"84","author":"Santos","year":"2012"},{"key":"b17","series-title":"Clin Infect Dis","first-page":"49","article-title":"Neurological manifestations in human T-cell lymphotropic virus type 1 (HTLV-1)-infected individuals without HTLV-1-associated myelopathy\/tropical spastic paraparesis: A longitudinal cohort study","volume":"61","author":"Tanajura","year":"2015"},{"key":"b18","series-title":"Case Rep Med","first-page":"289389","article-title":"Detrusor arreflexia as an end stage of neurogenic bladder in HAM\/TSP?","volume":"2011","author":"Tannus","year":"2011"},{"key":"b19","series-title":"N Engl J Med","first-page":"529","article-title":"Mogamulizumab (Anti-CCR4) in HTLV-1-associated myelopathy","volume":"378","author":"Sato","year":"2018"},{"key":"b20","series-title":"Viruses","first-page":"136","article-title":"Efficacy of corticosteroid therapy for HTLV-1-associated myelopathy: A randomized controlled trial (HAMLET-P)","volume":"14","author":"Yamauchi","year":"2022"},{"key":"b21","series-title":"Lancet","first-page":"1938","article-title":"Effect of epidural stimulation of the lumbosacral spinal cord on voluntary movement, standing, and assisted stepping after motor complete paraplegia: A case study","volume":"377","author":"Harkema","year":"2011"},{"key":"b22","series-title":"J Epidemiol","first-page":"254","article-title":"Profile of Nagasaki Islands Study (NaIS): A population-based prospective cohort study on 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study","volume":"12","author":"Gharaylou","year":"2021"},{"key":"b27","series-title":"J Neurol","first-page":"1808","article-title":"Subtyping relapsing-remitting multiple sclerosis using structural MRI","volume":"268","author":"Zhuo","year":"2021"},{"key":"b28","series-title":"Surg Neurol Int","first-page":"S705","article-title":"Diagnostic potential of the diffusion tensor tractography with fractional anisotropy in the diagnosis and treatment of cervical spondylotic and posttraumatic myelopathy","volume":"7","author":"Landi","year":"2016"},{"key":"b29","series-title":"Arq Neuropsiquiatr","first-page":"280","article-title":"Muscular weakness represents the main limiting factor of walk, functional independence and quality of life of myelopathy patients associated to HTLV-1","volume":"74","author":"Caiafa","year":"2016"},{"key":"b30","series-title":"J Neurosurg","first-page":"759","article-title":"A preliminary study of the clinical application of optic pathway diffusion tensor 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study","volume":"23","author":"Caskey","year":"2007"},{"key":"b5","series-title":"Urology","first-page":"813","article-title":"Urinary symptoms associated with human T-cell lymphotropic virus type I infection: Evidence of urinary manifestations in large group of HTLV-I carriers","volume":"69","author":"Castro","year":"2007"},{"key":"b6","series-title":"AIDS Res Hum Retroviruses","first-page":"931","article-title":"Proposal for diagnostic criteria of tropical spastic paraparesis\/HTLV-I-associated myelopathy (TSP\/HAM)","volume":"22","author":"De Castro-Costa","year":"2006"},{"key":"b7","series-title":"Neurourol Urodyn","first-page":"449","article-title":"Retrospective clinic and urodynamic study in the neurogenic bladder dysfunction caused by human T cell lymphotrophic virus type 1 associated myelopathy\/tropical spastic paraparesis (HAM\/TSP)","volume":"36","author":"Troisgros","year":"2017"},{"key":"b8","series-title":"PLoS Negl Trop Dis","first-page":"e0009772","article-title":"Bladder dysfunction in human T cell lymphotropic virus infection: A prospective cohort study","volume":"16","author":"Neto","year":"2022"},{"key":"b9","series-title":"Eur J Obstet Gynecol Reprod Biol","first-page":"230","article-title":"Impact of HTLV-I in quality of life and urogynecologic parameters of women with urinary incontinence","volume":"147","author":"Diniz","year":"2009"},{"key":"b10","series-title":"J Neurovirol","first-page":"583","article-title":"Atrophy, focal spinal cord lesions and alterations of diffusion tensor imaging (DTI) parameters in asymptomatic virus carriers and patients suffering from human T-lymphotrophic virus type 1 (HTLV-1)-associated myelopathy\/tropical spastic paraparesis (HAM\/TSP)","volume":"20","author":"Vilchez","year":"2014"},{"key":"b11","series-title":"Ann Clin Transl Neurol","first-page":"488","article-title":"Diffusion tensor imaging metrics in diagnosis of HTLV-1-associated myelopathy","volume":"9","author":"Liberato de Matos","year":"2022"},{"key":"b12","series-title":"Neurology","first-page":"1444","article-title":"Rating neurologic impairment in multiple sclerosis: An expanded disability status scale (EDSS)","volume":"33","author":"Kurtzke","year":"1983"},{"key":"b13","series-title":"Neurourol Urodyn","first-page":"287","article-title":"Reviewing the ICS 2002 terminology report: The ongoing debate","volume":"28","author":"Abrams","year":"2009"},{"key":"b14","series-title":"Urology","first-page":"60","article-title":"Assessment of overactive bladder symptoms: Comparison of 3-day bladder diary and the overactive bladder symptoms score","volume":"77","author":"Homma","year":"2011"},{"key":"b15","series-title":"Pathogens","first-page":"492","article-title":"HAM\/TSP pathogenesis: The transmigration activity of HTLV-1-infected T cells into tissues","volume":"12","author":"Nakamura","year":"2023"},{"key":"b16","series-title":"J Med Virol","first-page":"1809","article-title":"Immunological and viral features in patients with overactive bladder associated with human T-cell lymphotropic virus type 1 infection","volume":"84","author":"Santos","year":"2012"},{"key":"b17","series-title":"Clin Infect Dis","first-page":"49","article-title":"Neurological manifestations in human T-cell lymphotropic virus type 1 (HTLV-1)-infected individuals without HTLV-1-associated myelopathy\/tropical spastic paraparesis: A longitudinal cohort study","volume":"61","author":"Tanajura","year":"2015"},{"key":"b18","series-title":"Case Rep Med","first-page":"289389","article-title":"Detrusor arreflexia as an end stage of neurogenic bladder in HAM\/TSP?","volume":"2011","author":"Tannus","year":"2011"},{"key":"b19","series-title":"N Engl J Med","first-page":"529","article-title":"Mogamulizumab (Anti-CCR4) in HTLV-1-associated 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