Neurobehavioral Complications of HIV Infection

Marcotte, Thomas D.; Grant, Igor; Atkinson, J. Hampton; Heaton, Robert K.

doi:10.1007/978-1-4615-1287-5_13

Cited by 6 publications

(5 citation statements)

References 120 publications

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“…However, significant differences in cognitive performance in patients with high and low levels of psychiatric symptomatology may not have been detected with the relatively small sample sizes employed in this study (i.e., 10 or 11 patients per group). Nevertheless, our findings that self-reported cognitive and psychiatric symptoms do not correspond with objective neuropsychological test performance replicate findings in samples of patients with other medical conditions, such as HIV, end-stage renal disease, and systemic lupus erythematosus (Carbotte et al, 1995;Marcotte et al, 2001;Pliskin et al, 1996).…”

Section: Discussionsupporting

confidence: 68%

“…For example, asymptomatic HIV patients have been shown to exhibit preferentially impaired attention0speed of processing and working memory Stout et al, 1995), much like the deficits observed among pre-cirrhotic HCV patients. Also, HIV patients with minor cognitive motor disorder (MCMD) demonstrate slowed informationprocessing speed, poor complex attention skills (e.g., sustained attention, divided attention), and depressed learning abilities (Marcotte et al, 2001; Working Group of the American Academy of Neurology AIDS Task Force, 1991), which is similar to the pattern of deficits found in patients with minimal type C hepatic encephalopathy (formerly known as "subclinical" hepatic encephalopathy; Ferenci et al, 2002;Hilsabeck et al, 2001;McCrea et al, 1996). Thus, the pattern and progression of neuropsychological deficits appears to be analogous to those observed among HIV patients.…”

Section: Discussionmentioning

confidence: 99%

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Cognitive functioning and psychiatric symptomatology in patients with chronic hepatitis C

Hilsabeck

Hassanein

Carlson

et al. 2003

J Int Neuropsychol Soc

190

166

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Hepatitis C virus (HCV) infection is a major public-health-care problem, with over 170 million infected worldwide. Patients with chronic HCV infection often complain of various cognitive problems as well as symptoms of depression, anxiety, and fatigue. Relatively little is known, however, about the specific cognitive deficits that are common among HCV patients, and the influence of psychiatric symptomatology on cognitive functioning. In the current study of 21 chronically infected HCV patients, we assessed subjective cognitive dysfunction, depression, anxiety, and fatigue and compared these symptom areas to cognitive tests assessing visuoconstruction, learning, memory, visual attention, psychomotor speed, and mental flexibility. Results revealed that cognitive impairment ranged from 9% of patients on a visuoconstruction task to 38% of patients on a measure of complex attention, visual scanning and tracking, and psychomotor speed, and greater HCV disease severity as indicated by liver fibrosis was associated with greater cognitive dysfunction. Objective cognitive impairment was not related to subjective cognitive complaints or psychiatric symptomatology. These findings suggest that a significant portion of patients with chronic HCV experience cognitive difficulties that may interfere with activities of daily living and quality of life. Future research using cognitive measures with HCV-infected patients may assist researchers in identifying if there is a direct effect of HCV infection on the brain and which patients may be more likely to progress to cirrhosis and hepatic encephalopathy.

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Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Cognitive functioning and psychiatric symptomatology in patients with chronic hepatitis C

Hilsabeck

Hassanein

Carlson

et al. 2003

J Int Neuropsychol Soc

190

166

View full text Add to dashboard Cite

show abstract

“…Neuropsychologists should be cognizant of the potential physiological compromises that can arise from the combination of HIV and cerebrovascular risks and should be alert to alterations and/or fluctuations in cognitive status that signal a cerebrovascular process warranting further medical evaluation (Marcotte, Grant, Atkinson, & Heaton, 2001). A clear understanding of the trajectory of neuropsychological compromise associated with HIV illness will allow neuropsychologists to examine whether existing impairments have been further exacerbated by cerebrovascular risk-related illnesses, and to help focus treatment efforts.…”

Section: Discussionmentioning

confidence: 99%

Neurocognitive functioning in HIV-1 infection: effects of cerebrovascular risk factors and age

Foley¹,

Ettenhofer²,

Wright

et al. 2010

The Clinical Neuropsychologist

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This study examined the interactive effects of cerebrovascular risks, advancing age, and HIV infection on neurocognition, and explored whether pharmacological treatment of cerebrovascular risk factors attenuated neurocognitive dysfunction. Participants included 98 HIV-seropositive adults (cerebrovascular risk: 23.5%; age >50: 27.6%). Cerebrovascular risk was associated with slower processing speed even after controlling for age effects (b = −2.071; p = .04), and the interaction of age and cerebrovascular risk was associated with poorer verbal fluency (b = 1.276, p = .002). Participants with pharmacologically untreated cerebrovascular risk demonstrated reduced processing speed, learning/memory, and executive functioning relative to those on medication. Poor cerebrovascular health confers significant risk for HIV+ individuals, and this effect may be of greater consequence than advancing age. The cognitive impact of risk appears to be more pronounced in the absence of adequate pharmacological treatment.

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“…Depending on the severity of neurocognitive disturbances, there may be a need for increased structure in daily routines and in the individual's environment. It is also important that clinicians consider patient complaints (cognitive and mood) when implementing rehabilitative efforts, since increased complaints have been noted among individuals with minor cognitive motor disorder (MCMD) (Marcotte et al, 2001). Lastly, early delineation of learning and memory profiles may have important advantages for the individual with HIV-1 infection, including appropriate referrals (i.e., assessment, counseling, medication), compensatory lifestyle changes, and identification of at-risk individuals who may have difficulties carrying out daily tasks.…”

Section: Discussionmentioning

confidence: 99%

Theoretically derived CVLT subtypes in HIV-1 infection: Internal and external validation

Murji

Rourke

Donders

et al. 2003

J Int Neuropsychol Soc

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The present study sought to delineate empirically derived memory subtypes using the California Verbal Learning Test (CVLT; Delis et al., 1987) in a sample of adults with HIV-1 infection (N 5 154). Confirmatory factor analysis was used to evaluate eight models of the CVLT structure suggested by Wiegner and Donders (1999). A four-factor model, consisting of Attention Span, Learning Efficiency, Delayed Recall, and Inaccurate Recall appeared to be the best fitting model. Variables with the highest factor loadings from the model were entered in a two-stage cluster analysis. Four reliable CVLT clusters or subtypes were identified: Normal, Atypical, Subsyndromal, and Frontal-striatal. Internal and external validation of subtypes demonstrated that clusters were stable and clinically interpretable. Subtypes were meaningfully related to neuropsychological functioning, and to some extent, depressive symptomatology. Subtypes did not differ significantly with respect to subjective neurocognitive complaints and markers of HIV-1 disease. The present findings highlight the heterogeneity of memory profiles in HIV-1 infection and support a frontal-striatal conceptualization of verbal memory performance. The identification of robust HIV-1 memory subtypes may have important implications for the clinical management of adults infected with HIV-1 infection. (JINS, 2003, 9, 1-16.)

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Neurobehavioral Complications of HIV Infection

Cited by 6 publications

References 120 publications

Cognitive functioning and psychiatric symptomatology in patients with chronic hepatitis C

Cognitive functioning and psychiatric symptomatology in patients with chronic hepatitis C

Neurocognitive functioning in HIV-1 infection: effects of cerebrovascular risk factors and age

Theoretically derived CVLT subtypes in HIV-1 infection: Internal and external validation

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