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Core deficits involving executive functioning in schizophrenia can greatly diminish quality of life and function and are highly variable among patients for little-understood reasons. In cross-sectional studies, herpes simplex virus type 1 (HSV-1) exposure has been associated with cognitive impairments and with low prefrontal cortex volume in schizophrenia patients. In this prospective, 1-year study of 26 drug-naive patients with first-episode schizophrenia (mean baseline age, 24) and 38 healthy controls, investigators assessed HSV-1 exposure with serum antibody assays and measured cognition and gray-matter volumes in regions associated with executive functioning. Analyses of cognition controlled for age, sex, and serologically assessed expo…