Influence of Cognitive Reserve on Neuropsychological Functioning in Asymptomatic Human Immunodeficiency Virus-1 Infection

Stern, Robert A.; Silva, Susan G.; Chaisson, Nicole; Evans, Dwight L.

doi:10.1001/archneur.1996.00550020052015

Cited by 150 publications

(113 citation statements)

References 28 publications

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Section: Discussionmentioning

confidence: 99%

“…Satz et al. (1993) and Stern, Silva, Chaisson, & Evans, (1996) have noted that HIV seropositive participants with low cognitive reserve perform worse on neuropsychological measures than HIV seronegative participants and HIV seropositive participants with high cognitive reserve, suggesting that low cognitive reserve puts individuals at risk for cognitive dysfunction.The present findings may serve as a heuristic for ongoing assessment of this issue. The AAHP was a community sample of African American men, and as such provided an externally valid representation of the HIV epidemic in Los Angeles.…”

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confidence: 99%

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Relationship between Alcohol Use/Abuse, HIV Infection and Neuropsychological Performance in African American Men

Durvasula

Myers

Mason

et al. 2006

Journal of Clinical and Experimental Neuropsychology

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This study examines the impact of alcohol use and HIV infection on neuropsychological performance in a sample of 497 community-resident African American men. HIV serostatus and alcohol use (during the past 12 months) exerted an interactive effect on psychomotor speed, reaction time, and motor speed, and in general, HIV infected heavy drinkers evidenced significantly poorer performance than other HIV positive subjects. Main effects for HIV serostatus were noted for reaction time, with seronegative men performing better than seropositives. This study examines a sample of men who continue to show increases in HIV infection, however, sample specific issues such as comorbid substance use, past histories of head injury, and lack of data on alcohol abuse and dependence require caution in definitively attributing the findings solely to alcohol and HIV. However, these findings suggest that relatively recent heavy alcohol use may represent a potential risk factor for more rapid or pronounced cognitive decline in HIV positive individuals, and that these patterns may be even more pronounced in persons with comorbid substance use. Relationship between Alcohol Use/Abuse, HIV Infection and Neuropsychological Performance in African American MenNumerous studies to date have investigated the synergistic effects of psychoactive drugs and HIV on disease progression and neuropsychological (NP) functioning (Bornstein et al., 1993;Concha et al., 1992, Durvasula et al., 2000Marder et al., 1992, Selnes et al., 1997. These studies, which have largely examined the independent and interactive effects of heroin and cocaine abuse on NP functioning, have yielded mixed results, and most of these studies have been conducted with injection drug users. No studies have demonstrated any interactive effects between drug use and HIV on NP performance. Some studies have reported no differences between asymptomatic injection drug users and seronegative controls Selnes et al., 1992). Bornstein et al. (1993) noted that neither recency nor severity of drug/alcohol abuse/dependence were associated with NP impairment in HIV infection - however, the drugs of abuse were not clearly specified in their study. To date, few studies have focused on whether HIV and alcohol consumption operate synergistically to produce more marked cognitive impairment in HIV infected samples. This is a noteworthy oversight given the relatively high rates of alcohol abuse and dependence among HIV positive individuals (Boscarino, Avins, Woods, Lindan, Hudes, & Clark, 1995). Alcohol Use and NP PerformanceThe adverse neuropsychological consequences of alcohol abuse and dependence are well documented. Mild to moderate NP deficits have been observed in individuals with histories of alcohol dependence (Oscar-Berman, Shagrin, Evert, & Epstein, 1997;Parsons & Nixon, 1993). Deficits are typically observed in attention, visuospatial functioning, executive functioning, and in learning and memory (Parsons & Nixon, 1993;Rourke & Loberg, 1996). There is a wide spectrum of effects as a fun...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Relationship between Alcohol Use/Abuse, HIV Infection and Neuropsychological Performance in African American Men

Durvasula

Myers

Mason

et al. 2006

Journal of Clinical and Experimental Neuropsychology

View full text Add to dashboard Cite

show abstract

“…Low education level is a risk factor for neuropsychological impairment in HIV (Satz et al, 1993;Stern et al, 1996;Da Ronchi et al, 2002). Recently, among HIV1 gay and bisexual men IQ has been found to be a superior marker of cognitive reserve compared to education (Farinpour et al, 2003), suggesting that IQ is a better indicator of native cognitive ability.…”

Section: Neuropsychological Impairment In Minorities With Hivmentioning

confidence: 99%

Neuropsychological impairment in racial/ethnic minorities with HIV infection and low literacy levels: Effects of education and reading level in participant characterization

Ryan

Baird

Mindt

et al. 2005

J. Inter. Neuropsych. Soc.

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Educational attainment is an important factor in the interpretation of cognitive test scores but years of education are not necessarily synonymous with educational quality among racial0ethnic minority populations. This study investigated the comparability of educational attainment with reading level and examined whether discrepancies in education and reading level accounted for differences in neuropsychological test performance between HIV1 racial0ethnic minority and nonminority participants. Study participants (N 5 200) were derived from the Manhattan HIV Brain Bank (MHBB) where 50% of the cohort had Յ8th grade reading level but only 5% had Յ8 years of education. Significantly lower reading ability and education was found among African Americans and Hispanics, and these participants were more likely to have discrepant reading and education levels compared to non-Hispanic Whites. Discrepancy in reading and education level was associated with worse neuropsychological performance while racial0ethnic minority status was not. As years of schooling overestimated racial0ethnic minority participants' educational quality, standard norms based on education may inflate impairment rates among racial0ethnic minorities. Identifying appropriate normative standards is and will continue to be important in the detection of cognitive impairment in racial0ethnic minorities with HIV. (JINS, 2005, 11, 889-898.)

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“…Although neither HIV infection nor alcoholism was sufficient to cause the metabolite deficits, each disease apparently carries a liability that puts affected individuals at a heightened risk of neuronal compromise when the diseases are compounded (cf Fein et al, 1998;Meyerhoff, 2001;Pfefferbaum et al, 2002). Further, the neuronal compromise suggested by the observed metabolite patterns for NAA may contribute to the visuospatial processing deficits prominent in alcoholism (for reviews see Fein et al, 1990;OscarBerman, 2000;Sullivan, 2000) and occasionally documented in HIV infection (eg Stern et al, 1996). Interpretation of decreased Cr is more problematic as it increases with age (Pfefferbaum et al, 1999b) and is in higher concentration in glia than neurons (Barker, 2005;Ernst, 2005).…”

Section: Discussionmentioning

confidence: 99%

Cortical NAA Deficits in HIV Infection without Dementia: Influence of Alcoholism Comorbidity

Pfefferbaum

Adalsteinsson

Sullivan

2005

Neuropsychopharmacol

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Alcoholism comorbidity is highly prevalent in individuals infected with human immunodeficiency virus (HIV). Each condition is known to affect brain structure, function, and metabolism, but the combined effects on the brain have only recently been considered. Single-voxel, proton MR spectroscopy (MRS) has yielded sensitive measures of early brain deterioration in the progression of HIV, but has limited coverage of neocortex, whereas MRS imaging (MRSI) can simultaneously interrogate large regions of cortex. Included were 15 men with HIV þ alcoholism, nine men with HIV alone, eight men with alcoholism alone (abstinent for 3-17 months), and 23 controls. The two HIV groups were matched in T-cell count and were not demented; the two alcoholism groups were relatively matched in lifetime alcohol consumption. We used MRSI with a variable-density spiral sequence to quantify major proton metabolitesFN-acetylaspartate (NAA), creatine (Cr), and choline (Cho)Fin the superior parietal-occipital cortex. Metabolites were expressed in absolute units and as the NAA/Cr ratio. Significant group effects were present for NAA and Cr. Only the HIV þ alcoholism group was significantly affected, exhibiting a 0.8 SD deficit in NAA and a 1.0 SD deficit in Cr. The deficits were not related to highly active antiretroviral therapy (HAART) status. Neither HIV infection nor alcoholism independently resulted in parietal-occipital cortical metabolite abnormalities, yet each disease carried a liability that put affected individuals at a heightened risk of neuronal compromise when the diseases were compounded. Further, the use of absolute measures revealed deficits in NAA and Cr that would have gone undetected if these metabolites were expressed as a ratio.

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Influence of Cognitive Reserve on Neuropsychological Functioning in Asymptomatic Human Immunodeficiency Virus-1 Infection

Cited by 150 publications

References 28 publications

Relationship between Alcohol Use/Abuse, HIV Infection and Neuropsychological Performance in African American Men

Relationship between Alcohol Use/Abuse, HIV Infection and Neuropsychological Performance in African American Men

Neuropsychological impairment in racial/ethnic minorities with HIV infection and low literacy levels: Effects of education and reading level in participant characterization

Cortical NAA Deficits in HIV Infection without Dementia: Influence of Alcoholism Comorbidity

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