Qualitative features of the memory deficit associated with hiv infection and AIDS: Cross-validation of a discriminant function classification scheme

Abstract

The neuropsychological defects associated with late stage HIV infection and AIDS have been characterized as being similar to those seen in patients with dementia syndromes of subcortical etiologies. The purpose of this paper is to report on the cross-center replication of the classification of HIV-infected subjects' neuropsychological status based on a discriminant function generated from other HIV-related and unrelated cognitively impaired subjects. Of the HIV-control subjects, 42/46 (91.3%) were classified as "Normal", with only two subjects in each of two "dementia" groups: subcortical and cortical. However, similar to other HIV+ samples, a large proportion (36%) of our HIV-infected subjects were classified as "Subcortical", with 61% classified as "Normal", and one (3%) in the "Cortical" group. These data demonstrate that not only does the cognitive performance of some HIV+ subjects have distinct features relative to that of HIV-control subjects, but that the features are consistent with previous suggestions that such patients have a "Subcortical" pattern of impairment.

Retrograde Amnesia in Dementia: Comparison of HIV-Associated Dementia, Alzheimer's Disease, and Huntington's Disease.

“…The similarity between HIV-D and HD in benefits from retrieval cues suggests that the remote memory impairment involved is due in part to a retrieval deficit and, furthermore, that remote memory impairment in HIV-D may be largely mediated by subcortical pathology (Navia et al, 1986), as appears to be the case in HD (Becker et al, 1997;Peavy et al, 1994;White et al, 1997). However, the inability of the HIV-D and HD groups to benefit from cuing to the same degree as the YHC group suggests that another factor, such as loss of remote memory, may also contribute to the RA pattern.…”

“…The relatively mild, non-temporally graded RA associated with HIV-D and HD may be indicative of a general retrieval deficit that equally affects recall of information from any past time period. Such a retrieval deficit has been postulated as a contributory factor in the anterograde memory deficit observed with HIV-D or HD (Becker et al, 1997;Butters, Wolfe, Martone, Granholm, & Cermak, 1985;White et al, 1997; for a review, see Paulsen & Robinson, 2001) and has been attributed to the frontostriatal dysfunction that characterizes these disorders. In contrast, the severe and temporally graded RA associated with AD may reflect the interruption of a long-term consolidation process that is dependent on medial temporal lobe structures such as the hippocampus.…”

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

“…Previous research in HIV-1 infection may be limited due to shortcomings associated with the characterization of memory profiles in terms of a strict "subcortical" versus "cortical" distinction (Becker et al, 1995;Delis et al, 1995;Peavy et al, 1994;White et al, 1997). There is evidence in the literature to support the existence of multiple memory systems linking frontal and subcortical regions (Crosson, 1992;Cummings, 1993a;Lichter & Cummings, 2001).…”

“…Investigations of CVLT profiles of individuals with HIV-1 infection have reported that the pattern of verbal memory performance is characteristic of predominant subcortical dysfunction (Becker et al, 1995;Delis et al, 1995;Peavy et al, 1994;White et al, 1997). Specifically, CVLT profiles (impaired learning and recall, intact retention, ability to benefit from recognition testing relative to recall) are thought to be indicative of a retrieval deficit in a subgroup of individuals with HIV-1 infection0AIDS.…”

“…The CVLT is regarded as a useful tool for characterizing memory profiles associated with different neuropsychological disturbances, including Alzheimer's disease (AD), Huntington's disease (HD), and Korsakoff 's syndrome (e.g., Delis et al, 1991), HIV-1 infection (Becker et al, 1995;Delis et al, 1995;Peavy et al, 1994;White et al, 1997), depression (Massman et al, 1992), and schizophrenia (Paulsen et al, 1995). The scoring system of the CVLT allows quantification of several indices including style of learning (e.g., semantic categorization of related words), consistency of item recall across learning trials, retention of information over short and longer delays, vulnerability to interference, recall errors (e.g., intrusions), and discriminability (ability to detect target words from distracters on recognition testing).…”