Verbal and spatial working memory among drug-using HIV-infected men and women

Abstract

Working memory (WM) is a critical component of many neurocognitive functions. The literature has demonstrated consistently that WM impairment is more frequent and severe among substance-dependent individuals (SDIs) infected with HIV compared with uninfected SDIs; however, the SDIs who participated in these previous studies were primarily male. There are few published data on WM performance among HIV+ women with or without substance use disorders, and essentially no direct comparisons of WM performance between HIV+ men and women, regardless of substance use. We investigated potential sex and serostatus effects on WM among a sample of 360 SDIs (114 with HIV; 66% female) verified abstinent from alcohol and drugs of abuse at testing and generally comparable on substance use and comorbid characteristics. Participants were tested with the n-back task, a well-established WM measure that is sensitive to HIV-associated cognitive impairment. HIV+ men and women performed spatial and verbal versions of the n-back significantly less accurately compared with HIV- participants. Women showed slower response times compared with men on both versions, regardless of HIV serostatus. Individuals dependent on cocaine showed faster RTs compared with non-dependent users, but this effect was not apparent among opioid- or alcohol-dependent groups. Findings on n-back accuracy are consistent with our previous proposal that WM impairment represents a signature deficit among HIV+ SDIs; however, WM impairment appears less common among HIV+ women without a substance use history. The pattern of sex differences in response speed but serostatus effects on response accuracy is comparable to a recent report by our group of sex differences in learning speed but serostatus effects on delayed recall.

A candidate gene study of intermediate histopathological phenotypes in HIV-associated neurocognitive disorders

“…To test potential causal pathways involving histopathological markers, we used a multi-stage linear regression-based mediation analysis approach (MacKinnon, 2008;Tingley et al, 2014). The evidence for a particular pathway was provided by the proportion of the effect of a predictor that could be explained by the effect of a mediator (the proportion mediated).…”

Opioid and neuroHIV Comorbidity – Current and Future Perspectives

“…However, with the introduction of cART, the clinical picture has significantly changed with a 50% decline in the rate of death from AIDS, reduced incidence of opportunistic infections and HIVE, and a 40-50% decrease in the incidence of HIV-associated dementia (HAD), the most severe form of HIV-associated neurocognitive disorders (HAND) (Maschke et al 2000;McArthur et al 2010;Saylor et al 2016). Nevertheless, chronic opiate exposure (which almost always is confounded by the use of other illicit and legal drugs) in PWH can worsen neuroHIV (Anthony et al 2005;Bell et al 2006;Anthony et al 2008) and cognitive impairment (Rodriguez Salgado et al 2006;Martin-Thormeyer and Paul 2009;Byrd et al 2011;Smith et al 2014;Martin et al 2018;Rubin et al 2018) despite cART, even though some studies fail to show that opioids worsen neuroHIV (Royal et al 1991;Applebaum et al 2010) or HAND (Martin et al 2019). Opiate exposure in cARTtreated PWH worsens CD4 counts and viral loads (Ryan et al 2004), neuropathology (including increased tauopathy; Smith et al 2014), CNS inflammation (Anthony et al 2005(Anthony et al , 2008Smith et al 2014), and neurocognition (Applebaum et al 2009;Byrd et al 2011;Meyer et al 2013) including deficits in memory and working memory (Byrd et al 2011).…”

Effects of Hiv Infection and Former Cocaine Dependence on Neuroanatomical Measures and Neurocognitive Performance

“…Both groups show alterations in executive function, verbal memory, and working memory (Madoz-Gúrpide et al, 2011; Walker and Brown, 2018), although data suggest that cocaine-related NCI is attenuated following abstinence (Vonmoos et al, 2014). However, preliminary evidence indicates persistent, compounded NCI in HIV+ individuals with a history of substance dependence despite current abstinence (Martin et al, 2018), suggesting that the substance dependence in HIV+ patients can cause long-lasting neurocognitive changes which do not ameliorate along the typical abstinence-related recovery trajectory.…”