Auditory neurophysiology reveals central nervous system dysfunction in HIV-infected individuals

White-Schwoch, Travis; Magohe, Albert; Fellows, Abigail; Rieke, Catherine C.; Vilarello, Brandon; Nicol, Trent; Massawe, Enica Richard; Moshi, Ndeserua; Kraus, Nina; Buckey, Jay C.

doi:10.1016/j.clinph.2020.04.165

Cited by 14 publications

(28 citation statements)

References 40 publications

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“…Results from this study suggest that CATs may be a useful way to provide surveillance for the development of neurocognitive problems in people with HIV. Previous studies have suggested that HIV-positive individuals develop signs of central auditory processing deficits [ 8 , 33 , 53 , 54 ]. These deficits could reflect CNS damage from HIV infection or treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Neuroimaging research has confirmed age differences in brain activity related to processing speed, particularly in areas of the prefrontal cortex [ 72 ], as well as hearing-related differences in patterns of brain activation [ 73 ]. The exact links remain to be determined, but such structural and functional changes provide a mechanism for linking sensory and cognitive changes with age and HIV [ 54 ]. Finally, a more difficult central auditory task may be more sensitive to detecting HIV-related neurocognitive disorders with age.…”

Section: Discussionmentioning

confidence: 99%

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Central Auditory Tests to Track Cognitive Function in People With HIV: Longitudinal Cohort Study

Niemczak¹,

Fellows²,

Lichtenstein³

et al. 2021

JMIR Form Res

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Background The development of neurocognitive deficits in people infected with HIV is a significant public health problem. Previous cross-sectional studies have shown that performance on central auditory tests (CATs) correlates with cognitive test results in those with HIV, but no longitudinal data exist for confirmation. We have been performing longitudinal assessments of central auditory and cognitive function on a cohort of HIV-positive and HIV-negative individuals in Dar es Salaam, Tanzania to understand how the central auditory system could be used to study and track the progress of central nervous system dysfunction. Objective The goal of the project was to determine if CATs can track the trajectory of cognitive function over time in people diagnosed with HIV. Methods Tests of peripheral and central auditory function as well as cognitive performance were performed on 382 individuals over the course of 3.5 years. Visits were scheduled every 6 months. CATs included tests of auditory temporal processing (gap detection) and speech perception in noise (Hearing in Noise Test and Triple Digit Test). Cognitive tests included the Montreal Cognitive Assessment (MoCA), Test of Variables of Attention (TOVA), and subtests from the Cogstate battery. HIV-positive subjects were divided into groups based on their CAT results at their final visit (bottom 20%, top 20%, middle 60%). Primary analyses focused on the comparison between HIV-positive individuals that performed worse on CATs (bottom 20%) and the overall HIV-positive group (middle 60%). Data were analyzed using linear mixed-effect models with time as the main fixed effect. Results The group with the worst (bottom 20%) CAT performance showed a difference in trajectory for the MoCA (P=.003), TOVA (P<.048), and Cogstate (P<.046) over the course of the study period compared to the overall HIV-positive group. A battery of three CATs showed a significant difference in cognitive trajectory over a relatively short study period of 3.5 years independent of age (bottom 20% vs HIV-positive group). Conclusions The results of this study support the ability for CATs to track cognitive function over time, suggesting that central auditory processing can provide a window into central nervous system performance. CATs can be simple to perform, and are relatively insensitive to education and socioeconomic status because they only require repeating sentences, numbers, or detecting gaps in noise. These tests could potentially provide a time-efficient, low-cost method to screen for and monitor cognitive decline in patients with HIV, making them a useful surveillance tool for this major public health problem.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Central Auditory Tests to Track Cognitive Function in People With HIV: Longitudinal Cohort Study

Niemczak¹,

Fellows²,

Lichtenstein³

et al. 2021

JMIR Form Res

Self Cite

View full text Add to dashboard Cite

show abstract

“…Neuroimaging research has confirmed age differences in brain activity related to processing speed, particularly in areas of the prefrontal cortex [72], as well as hearing-related differences in patterns of brain activation [73]. The exact links remain to be determined, but such structural and functional changes provide a mechanism for linking sensory and cognitive changes with age and HIV [54]. Finally, a more difficult central auditory task may be more sensitive to detecting HIV-related neurocognitive disorders with age.…”

Section: Principal Resultsmentioning

confidence: 95%

“…Results from this study suggest that CATs may be a useful way to provide surveillance for the development of neurocognitive problems in people with HIV. Previous studies have suggested that HIV-positive individuals develop signs of central auditory processing deficits [8,33,53,54]. These deficits could reflect CNS damage from HIV infection or treatment.…”

Section: Principal Resultsmentioning

confidence: 99%

Central Auditory Tests to Track Cognitive Function in People With HIV: Longitudinal Cohort Study (Preprint)

Niemczak¹,

Fellows²,

Lichtenstein³

et al. 2020

Preprint

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BACKGROUND The development of neurocognitive deficits in those infected with human immunodeficiency virus (HIV) is a significant public health problem. Previous cross-sectional studies show that performance on central auditory tests (CATs) correlates with cognitive test results in those with HIV, but no longitudinal data exist. We have been performing longitudinal assessments of central auditory and cognitive function on a cohort of HIV+ and HIV- individuals in Dar es Salaam, Tanzania to understand how the central auditory system could be used to study and track the progress of central nervous system dysfunction. OBJECTIVE The goal of the project was to determine if CATs can track the trajectory of cognitive function over time in those diagnosed with HIV. METHODS Tests of peripheral and central auditory function, as well as cognitive performance, were performed on 382 individuals over the course of 3.5 years. Visits were scheduled every 6 months. CATs included tests of auditory temporal processing (gap detection) and speech perception in noise (Hearing in Noise Test and Triple Digit Test). Cognitive tests included the Montreal Cognitive Assessment (MoCA), Test of Variables of Attention (TOVA), and subtests from the Cogstate battery. HIV+ subjects were divided into groups based on their CAT results at their final visit (bottom 20%, top 20%, middle 60%). Primary analyses focused on the comparison between HIV+ individuals that performed worse on CATs (bottom 20%) and the overall HIV+ group (middle 60%). Data were analyzed using linear mixed-effect models with time as the main fixed effect. RESULTS The group with the worst (bottom 20%) CAT performance showed a difference in trajectory for MoCA (p=.003), TOVA (p ≤.048), and Cogstate (p≤.046) over the course of the study period compared to the overall HIV+ group. A battery of three central auditory tests showed a significant difference in cognitive trajectory over a relatively short study period of 3.5 years independent of age (bottom 20% vs. HIV+, p<0.05). CONCLUSIONS Results were consistent with CATs tracking cognitive function over time, suggesting that central auditory processing can provide a window into CNS performance. CATs can be simple to perform and are relatively insensitive to education and socioeconomic status because they only require repeating sentences, numbers, or detecting gaps in noise. These tests could potentially provide a time-efficient, low-cost way to screen for and monitor cognitive decline in patients with HIV making them a useful surveillance tool for this major public health problem.

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“…Central auditory function, reflected in tests of speech perception in background noise, correlates with cognition (Watson, 1991;Hallgren et al, 2001;Anderson and Kraus, 2010;Hoover et al, 2017;Panza et al, 2018;Danielsson et al, 2019;Humes, 2020Humes, , 2021, including cognitive dysfunction due to mild cognitive impairment (MCI), Alzheimer's disease (Gates et al, 1996;Idrizbegovic et al, 2011), and HIV (Zhan et al, 2017b;Buckey et al, 2019;White-Schwoch et al, 2020;Niemczak et al, 2021). This suggests central auditory tests might be useful for tracking cognitive dysfunction in populations with disordered neuro-cognitive processing.…”

Section: Introductionmentioning

confidence: 99%

The Relationship Between Central Auditory Tests and Neurocognitive Domains in Adults Living With HIV

et al. 2021

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Objective: Tests requiring central auditory processing, such as speech perception-in-noise, are simple, time efficient, and correlate with cognitive processing. These tests may be useful for tracking brain function. Doing this effectively requires information on which tests correlate with overall cognitive function and specific cognitive domains. This study evaluated the relationship between selected central auditory focused tests and cognitive domains in a cohort of normal hearing adults living with HIV and HIV– controls. The long-term aim is determining the relationships between auditory processing and neurocognitive domains and applying this to analyzing cognitive function in HIV and other neurocognitive disorders longitudinally.Method: Subjects were recruited from an ongoing study in Dar es Salaam, Tanzania. Central auditory measures included the Gap Detection Test (Gap), Hearing in Noise Test (HINT), and Triple Digit Test (TDT). Cognitive measures included variables from the Test of Variables of Attention (TOVA), Cogstate neurocognitive battery, and Kiswahili Montreal Cognitive Assessment (MoCA). The measures represented three cognitive domains: processing speed, learning, and working memory. Bootstrap resampling was used to calculate the mean and standard deviation of the proportion of variance explained by the individual central auditory tests for each cognitive measure. The association of cognitive measures with central auditory variables taking HIV status and age into account was determined using regression models.Results: Hearing in Noise Tests and TDT were significantly associated with Cogstate learning and working memory tests. Gap was not significantly associated with any cognitive measure with age in the model. TDT explained the largest mean proportion of variance and had the strongest relationship to the MoCA and Cogstate tasks. With age in the model, HIV status did not affect the relationship between central auditory tests and cognitive measures. Age was strongly associated with multiple cognitive tests.Conclusion: Central auditory tests were associated with measures of learning and working memory. Compared to the other central auditory tests, TDT was most strongly related to cognitive function. These findings expand on the association between auditory processing and cognitive domains seen in other studies and support evaluating these tests for tracking brain health in HIV and other neurocognitive disorders.

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Auditory neurophysiology reveals central nervous system dysfunction in HIV-infected individuals

Cited by 14 publications

References 40 publications

Central Auditory Tests to Track Cognitive Function in People With HIV: Longitudinal Cohort Study

Central Auditory Tests to Track Cognitive Function in People With HIV: Longitudinal Cohort Study

Central Auditory Tests to Track Cognitive Function in People With HIV: Longitudinal Cohort Study (Preprint)

The Relationship Between Central Auditory Tests and Neurocognitive Domains in Adults Living With HIV

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