Psychomotor slowing in HIV infection: A predictor of dementia, AIDS and death

Sacktor, Ned; Bacellar, Helena; Hoover, Donald R.; Nance-Sproson, T. E.; Seines, Ola A.; Miller, Eric N.; Pan, Gerald J. Dal; Kleeberger, Cynthia A.; Brown, Amanda; Saah, A. J.; McArthur, Justin C.

doi:10.3109/13550289609146906

Cited by 128 publications

(80 citation statements)

References 28 publications

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“…Individuals in the Atypical subtype (Cluster 2) performed similarly to the Normal subtype on all neuropsychological variables except psychomotor speed. This finding is interesting as it coincides with the well-supported notion that psychomotor slowing is an early neuropsychological indicator of HIV-1 disease (e.g., Bornstein et al, 1993;Sacktor et al, 1996). The Subsyndromal subtype evidenced difficulties in psychomotor speed and some elements of problem solving (i.e., number of errors).…”

Section: Neuropsychological Performancesupporting

confidence: 52%

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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Section: Neuropsychological Performancesupporting

confidence: 52%

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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“…CNS disease in HIV infection frequently is associated with psychomotor slowing as well as impaired fine and gross motor function (12,13,16). In a study of cognitive and motor impairment in SIV-infected rhesus monkeys, motor skills were the most consistent impairment found (21,39).…”

Section: Discussionmentioning

confidence: 99%

“…One step toward unveiling such mechanisms is to analyze the temporal relationship between viral infection and the time course of specific physiological changes to identify critical periods of the disease progression. In HIV-infected individuals, multiple physiological parameters such as sleep patterns, psychomotor performance, and visual-, auditory-, and somatosensory-evoked potentials are altered (10)(11)(12)(13)(14)(15)(16). Such physiologic dysregulations can have important consequences for cognitive functions (17,18).…”

mentioning

confidence: 99%

Early physiological abnormalities after simian immunodeficiency virus infection

Horn

Huitrón‐Reséndiz

Weed

et al. 1998

Proc. Natl. Acad. Sci. U.S.A.

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Central nervous system (CNS) damage and dysfunction are devastating consequences of HIV infection. Although the CNS is one of the initial targets for HIV infection, little is known about early viral-induced abnormalities that can affect CNS function. Here we report the detection of early physiological abnormalities in simian immunodeficiency virus-infected monkeys. The acute infection caused a disruption of the circadian rhythm manifested by rises in body temperature, observed in all five individuals between 1 and 2 weeks postinoculation (p.i.), accompanied by a reduction in daily motor activity to 50% of control levels. Animals remained hyperthermic at 1 and 2 months p.i. and returned to preinoculation temperatures at 3 months after viral inoculation. Although motor activity recovered to baseline values at 1 month p.i., activity levels then decreased to approximately 50% of preinoculation values over the next 2 months. Analysis of sensory-evoked responses 1 month p.i. revealed distinct infection-induced changes in auditory-evoked potential peak latencies that persisted at 3 months after viral inoculation. These early physiological abnormalities may precede the development of observable cognitive or motor deficiencies and can provide an assay to evaluate agents to prevent or alleviate neuronal dysfunction.

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“…In the more advanced stages of the disease, around 15% of AIDS patients have HIVassociated dementia, a complex disorder consisting of psychomotor slowing, behavioral abnormalities, and Parkinsonian features such as bradykinesia and gait disturbance (McArthur et al, 2005). Decline in neurocognitive function predicts and directly contributes to mortality (Sacktor et al, 1996).…”

Section: Introductionmentioning

confidence: 99%

3D pattern of brain atrophy in HIV/AIDS visualized using tensor-based morphometry

Chiang¹,

Dutton²,

Hayashi³

et al. 2007

NeuroImage

164

152

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Abstract35% of HIV-infected patients have cognitive impairment, but the profile of HIV-induced brain damage is still not well understood. Here we used tensor-based morphometry (TBM) to visualize brain deficits and clinical/anatomical correlations in HIV/AIDS. To perform TBM, we developed a new MRI-based analysis technique that uses fluid image warping, and a new α-entropy-based information-theoretic measure of image correspondence, called the Jensen-Rényi divergence (JRD).Methods-3D T1-weighted brain MRIs of 26 AIDS patients (CDC stage C and/or 3 without HIV-associated dementia; 47.2 ± 9.8 years; 25M/1F; CD4 + T-cell count: 299.5 ± 175.7/µl; log 10 plasma viral load: 2.57 ± 1.28 RNA copies/ml) and 14 HIV-seronegative controls (37.6 ± 12.2 years; 8M/6F) were fluidly registered by applying forces throughout each deforming image to maximize the JRD between it and a target image (from a control subject). The 3D fluid registration was regularized using the linearized Cauchy-Navier operator. Fine-scale volumetric differences between diagnostic groups were mapped. Regions were identified where brain atrophy correlated with clinical measures.Results-Severe atrophy (~15-20% deficit) was detected bilaterally in the primary and association sensorimotor areas. Atrophy of these regions, particularly in the white matter, correlated with cognitive impairment (P=0.033) and CD4 + T-lymphocyte depletion (P=0.005).Conclusion-TBM facilitates 3D visualization of AIDS neuropathology in living patients scanned with MRI. Severe atrophy in frontoparietal and striatal areas may underlie early cognitive dysfunction in AIDS patients, and may signal the imminent onset of AIDS dementia complex.

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Psychomotor slowing in HIV infection: A predictor of dementia, AIDS and death

Cited by 128 publications

References 28 publications

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

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

Early physiological abnormalities after simian immunodeficiency virus infection

3D pattern of brain atrophy in HIV/AIDS visualized using tensor-based morphometry

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