Date Published:
2008
Publication Type:
Journal Article
Authors:
Secondary:
Archives of Neurology
Volume:
65
Pagination:
1096-101
URL:
https://pubmed.ncbi.nlm.nih.gov/
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:
<p>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.</p>