A prospective four-year follow-up of neuropsychological function in HIV seropositive and seronegative methadone-maintained patients

Biochemical changes in the frontal lobe of HIV-infected individuals detected by magnetic resonance spectroscopy

“…Several tests were selected from the full neuropsychological test battery for analysis. These were selected on the basis of reports in the literature, which indicate that these specific tests can detect cognitive impairment in this population (11)(12)(13)(14)(16)(17)(18). These tests included measures of psychomotor speed, attention, and verbal memory such as the Trail-Making Test A and B (31), the Finger Tapping Test (31), the Grooved Pegboard Test (32), the Digit (33), and the Rey's Auditory Verbal Learning Test (34).…”

“…Neuropsychological investigations have suggested that measures of frontal subcortical functions may be particularly sensitive measures of HIV-related cognitive decline (11)(12)(13)(14)(15). These studies have shown that neuropsychological testing can identify subtle cognitive dysfunction in early AIDS patients and perhaps even in asymptomatic HIV-positive individuals, although this last finding is somewhat controversial (16)(17)(18).…”

Comparison of Neuropsychological Performance between AIDS-Free Injecting Drug Users and Homosexual Men

“…Again, studies with larger sample sizes and prospective cohorts with strict control for age and education found no substantial differences in the cognitive perfor mance of HIV-infected and noninfected indi viduals [10,14], In those large studies where some statistically significant difference of worse performance in few cognitive tests among AIDS-free HIV-infected individuals was seen, these changes in raw scores are very small and have no apparent clinical impact on day-to-day functioning [12,29], Although a concern in the generalization of the results of the effect of HIV infection on neuropsychologic performance has been the argument that less favored populations, i.e. populations with less education, inadequate health care and malnutrition, might be more prone to early HIV cognitive effects, our results do not sup port this argument [13,[17][18][19], Additionally, our results suggest that ad justment of neuropsychologic performance by IQ scores may be a better correction for premorbid differences than years of education. One cross-sectional study, where full IQ scores of the Revised Wechsler Adult Intelli gence Scale and educational levels among asymptomatic HIV-infected and noninfected individuals were comparable, showed no dif ferences in the neuropsychologic performance between both groups [5], Riccio et al [28] had similar results at baseline and 12-month fol low-up among asymptomatic HIV-infected and noninfected individuals matched on sim ilar educational and National Adult Reading test IQ levels.…”

“…Con sistently, prospective studies and most crosssectional studies with strict adjustment for age and education have revealed no signifi cant differences between the neuropsychologic performance among AIDS-free HIVinfected and noninfected individuals [5,6,8,11,13,28]. Similar arguments and conclu sions apply with regard to the cognitive per formance among AIDS-free HIV-infected and noninfected individuals of minority groups [10,14,[16][17][18][19]29]. Again, studies with larger sample sizes and prospective cohorts with strict control for age and education found no substantial differences in the cognitive perfor mance of HIV-infected and noninfected indi viduals [10,14], In those large studies where some statistically significant difference of worse performance in few cognitive tests among AIDS-free HIV-infected individuals was seen, these changes in raw scores are very small and have no apparent clinical impact on day-to-day functioning [12,29], Although a concern in the generalization of the results of the effect of HIV infection on neuropsychologic performance has been the argument that less favored populations, i.e.…”

“…Several studies have assessed whether or not clinically significant cognitive impairment is present in otherwise healthy HIV-infected individuals, but results have been contradictory [2][3][4], Nevertheless, there is agreement among larger well-con trolled cohort and longitudinal follow-up studies of no significant increase in cognitive impairment during asymptomatic HIV infec tion [6,[8][9][10][13][14][15], The study populations in the majority of the above studies consist predominantly of white, well-educated, homosexual volunteers. However, considerable attention has been de voted to less educated and minority groups, mostly injecting drug users [10,[16][17][18][19]. It is well documented that factors such as age, edu cation and premorbid intellectual level affect performance in neuropsychologic tests [20][21][22].…”