Motor function and human immunodeficiency virus-associated cognitive impairment in a highly active antiretroviral therapy-era cohort
Title | Motor function and human immunodeficiency virus-associated cognitive impairment in a highly active antiretroviral therapy-era cohort |
Publication Type | Journal Article |
Year of Publication | 2008 |
Authors | Robinson-Papp, JS, Byrd, D, Mindt, MRivera, Oden, NL, Simpson, DM, Morgello, S |
Journal | Archives of Neurology |
Volume | 65 |
Pagination | 1096-101 |
Date Published | 2008 |
Keywords | Adult, AIDS Dementia Complex, Antiretroviral Therapy, Cognition Disorders, Cohort Studies, Female, Highly Active, HIV, HIV Infections, Humans, Internal, Longitudinal Studies, Male, Middle Aged, Motor Skills, Motor Skills Disorders, Neuropsychological Test |
Abstract | BACKGROUND: Cognitive impairment has long been recognized as a manifestation of human immunodeficiency virus (HIV) infection. However, highly active antiretroviral therapy (HAART) has altered the neurologic manifestations of HIV. OBJECTIVES: To develop a measure to quantify the motor abnormalities included in the original descriptions of HIV-associated dementia (HAD); to determine whether motor, affective, and behavioral dysfunction predict cognitive impairment; and to determine whether quantitative motor testing is a helpful adjunct in the diagnosis of HAD in a complex population from the HAART era. DESIGN: Neurologic and neuropsychological data were collected from the Manhattan HIV Brain Bank, a longitudinal cohort study of patients with advanced HIV. The HIV-Dementia Motor Scale (HDMS) was developed and validated and cognitive and affective or behavioral function was quantified using global neuropsychological T scores, the Beck Depression Inventory (BDI), and an independent assessment of apathy. Relationships among cognitive, motor, affective, and behavioral performance were examined using correlation, linear regression, and analyses of variance. SETTING: An urban AIDS research center. PARTICIPANTS: A total of 260 HIV-positive, predominantly minority patients. MAIN OUTCOME MEASURES: The HDMS scores and global neuropsychological T scores. RESULTS: The HDMS and BDI scores were independent predictors of cognitive impairment. Significant cognitive impairment was found in patients with motor dysfunction. Patients diagnosed as having HAD had a greater degree of motor impairment than those with other neurocognitive diagnoses. CONCLUSIONS: Motor, affective, and behavioral abnormalities predict cognitive impairment in HIV-positive patients in this HAART-era cohort. The HDMS may be useful in the assignment of HIV-associated neurocognitive impairment in HIV populations in which normative data or neuropsychological test design is not optimal. |
URL | http://www.ncbi.nlm.nih.gov/pubmed/18695060 |