Cognitive and motor deficits in older adults with HIV infection: Comparison with normal ageing and Parkinson’s disease

Abstract

Despite the life-extending success of antiretroviral pharmacotherapy in HIV infection (HIV), the prevalence of mild cognitive impairment in HIV remains high. Near-normal life expectancy invokes an emerging role for age-infection interaction and a potential synergy between immunosenescence and HIV-related health factors, increasing risk of cognitive and motor impairment associated with degradation in corticostriatal circuits. These neural systems are also compromised in Parkinson's disease (PD), which could help model the cognitive deficit pattern in HIV. This cross-sectional study examined three groups, age 45-79 years: 42 HIV, 41 PD, and 37 control (CTRL) participants, tested at Stanford University Medical School and SRI International. Neuropsychological tests assessed executive function (EF), information processing speed (IPS), episodic memory (MEM), visuospatial processing (VSP), and upper motor (MOT) speed and dexterity. The HIV and PD deficit profiles were similar for EF, MEM, and VSP. Although only the PD group was impaired on MOT compared with CTRL, MOT scores were related to cognitive scores in HIV but not PD. Performance was not related to depressive symptoms, socioeconomic status, or CD4 + T-cell counts. The overlap of HIV-PD cognitive deficits implicates frontostriatal disruption in both conditions. The motor-cognitive score relation in HIV provides further support for the hypothesis that these processes share similar underlying mechanisms in HIV infection possibly expressed with or exacerbated by ageing.

Sleep disturbances in HIV infection and their biological basis

“…This would be consistent with the clinical profile of Parkinson's disease (PD), the pathogenesis of which is also associated with degeneration of dopaminergic brain regions. Indeed, a study comparing cognitive and motor deficits in PLWH and adults with PD reported that HIV and PD groups presented with similar deficits in executive function, episodic memory and visual processing, with motor deficits mainly manifesting in PD and not HIV [66].…”

The effects of mood and cognition on daily functioning and quality of life in older people living with HIV and people with Parkinson’s disease.

“…Both clinical groups had lower overall current global cognitive scores (DRS-2; Jurica et al, 2004) than the CTL group ( p = .002; Table 1). The neuropsychological profile and clinical motor examination of the three study groups were previously reported in Müller-Oehring, Fama, et al (2021). In brief, both clinical groups had lower EXF and a trend for lower IPS domain scores than CTL, PLWH had lower MEM domain scores than PD and CTL groups, and the PD group performed worse than PLWH and CTL groups on the MOT domain.…”

“…The period of recruitment was from 2015 to 2018. Methodology and preliminary data from overlapping study samples were previously reported for frequency-dependent neural activity (Müller-Oehring, Hong, et al, 2021) and cognitive and motor slowing (Müller-Oehring, Fama, et al, 2021; Prabhakar et al, 2020; Sundaram et al, 2019). Written informed consent was obtained from all participants prior to undergoing any study procedures and participants were financially compensated for their time.…”

“…Furthermore, the time between infection and peripheral suppression with treatment initiation influences the extent of central nervous system (CNS) damage (Crum-Cianflone et al, 2013). In turn, many of the now aging PLWH being survivors of the AIDS epidemic before the invention of ART may be at higher risk for cognitive and motor deficits (Kamkwalala & Newhouse, 2017; Müller-Oehring, Fama, et al, 2021) and mood disturbances, as a result of neuropathology such as impaired dopaminergic connectivity, than older healthy people (Watkins & Treisman, 2012), and the pattern of deficits may be similar to those in people with PD (de la Fuente-Fernández et al, 2011; DeVaughn et al, 2015; Tierney et al, 2019).…”

Humanized Mice for Infectious and Neurodegenerative disorders

“…Moreover, this study utilized female mice, whereas most MPTP studies are performed in male mice to reduce known variability observed with females. With the advent of ART for HIV-1 treatment, individuals living with HIV have longer lives with fewer co-morbidities, yet still can exhibit motor deficits like PD [176][177][178][179][180]. Thus, a major, yet recurrent question is whether HIV infection affects the development of PD-linked neurodegeneration.…”