We evaluated neurocognitive function in 149 HIV-seropositive
and 82 seronegative women enrolled in the Women's Interagency
HIV Study (WIHS), a large multi-center study of disease progression
in women living with HIV/AIDS. We evaluated the prevalence of
abnormal neuropsychological (NP) test findings in HIV-seropositive
and seronegative women and factors associated with increased
risk of abnormal NP test performance. Risk of NP impairment
was no higher for HIV positive women receiving antiretroviral
therapy at testing than for HIV-negative women (OR
= 1.00). However, the risk of abnormal NP performance increased
significantly for seropositive women not receiving antiretroviral
therapy (OR = 2.43). Further, treatment status was
a significant predictor of NP impairment in a multivariate analysis
that included viral load (OR = 1.48) and CD4 count
(OR = 1.08) which were not significant. The multivariate
analyses controlled for substance use, age, education, head
injury, ethnicity, estimated IQ, and psychological distress.
This study emphasizes the critical association of antiretroviral
therapy with the risk of neurocognitive impairment in women
living with HIV/AIDS. (JINS, 2002, 8,
781–793.)
Mesial temporal lobe epilepsy is a syndromic disorder presenting with seizures and cognitive comorbidities. The cellular mechanisms contributing to epilepsy progression are not well understood. Here we show that intelligence, verbal learning, and memory decline at a critical period when hippocampal neurogenesis becomes undetectable. Individual patient analysis revealed that the number of immature neurons, rather than total granule neurons, particularly benefit verbal learning. These results illustrate a functional role for adult human neurogenesis and reveal a therapeutic target accompanying cognitive decline.
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