The AIDS dementia complex: I. Clinical features

Abstract

Of 70 autopsied patients with the acquired immune deficiency syndrome (AIDS), 46 suffered progressive dementia that was frequently accompanied by motor and behavioral dysfunction. Impaired memory and concentration with psychomotor slowing represented the most common early presentation of this disorder, but in nearly one half of the patients either motor or behavioral changes predominated. Early motor deficits commonly included ataxia, leg weakness, tremor, and loss of fine-motor coordination, while behavioral disturbances were manifested most commonly as apathy or withdrawal, but occasionally as a frank organic psychosis. The course of the disease was steadily progressive in most patients, and at times was punctuated by an abrupt acceleration. However, in 20% of patients a more protracted indolent course was observed. In the most advanced stage of this disease, patients exhibited a stereotyped picture of severe dementia, mutism, incontinence, paraplegia, and in some cases, myoclonus. The high incidence and unique clinical presentation of this AIDS dementia complex is consistent with the emerging concept that this complication is due to direct brain infection by the retrovirus that causes AIDS.

Clinical Trials in Neurovirology: Successes, Challenges, and Pitfalls

“…Some of the conditions that emerged were characteristic opportunistic neurological infections such as toxoplasma encephalitis, cryptococcal meningitis, cytomegalovirus encephalitis, and progressive multifocal leukoencephalopathy, all emerging from chronic cellular immunodeficiency in AIDS [12]. However, it was soon apparent that HIV itself entered the CNS early, and as the disease advanced, untreated HIV commonly progressed to cause an HIV-associated dementia (HAD) that was generally fatal in less than a year from symptomatic onset [13,14].…”

HIV-1-assoziierte neurokognitive Störung

“…Daher bleibt die zerebrale Manifestation der HIV-Infektion mit der Störung von kognitiven, motorischen, Verhaltensund vegetativen Funktionen [3, 65,76,102] ein Alltagsproblem in der HIV-Medizin. Für dieses Krankheitsbild wurden verschiedene Begriffe geprägt wie HIVEnzephalopathie, AIDS-Demenz-Komplex und HIV-assoziierter kognitiv-motorischer Komplex.…”

HIV‐1 protein Tat inhibits vesicular monoamine transporter‐2 activity in rat striatum

“…HIV-1 neurodegeneration is often associated with symptoms of motor dysfunction (Navia et al, 1986). The basal ganglia, which are critical for the execution of voluntary motor tasks, may be a prominent target of HIV-1 in the brain (Nath et al, 2000).…”