Motor function declines over time in human immunodeficiency virus and is associated with cerebrovascular disease, while HIV-associated neurocognitive disorder remains stable

Elicer, Isabel; Byrd, Desiree; Clark, Uraina S.; Morgello, Susan; Robinson‐Papp, Jessica

doi:10.1007/s13365-018-0640-6

Cited by 34 publications

(33 citation statements)

References 25 publications

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“…Our findings support this suggestion, and are consistent with prior studies in HIV demonstrating an association between neuropsychiatric abnormality and frailty status [9,10]. Although the underlying mechanism of this association cannot be determined in our study, prior studies have demonstrated an association between motor abnormality (and with particular relevance to frailty, abnormal gait) and cognitive impairment, both in PLWH and HIV-negative populations [19][20][21]. In turn, motor and cognitive abnormalities may be correlated with cerebral white matter disease on neuroimaging [22][23][24].…”

Section: Discussionsupporting

confidence: 92%

Frailty in medically complex individuals with chronic HIV

Morgello

Sherman

Ellis

et al. 2019

Aids

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Sueiras i , for the NNTC Objectives: Multimorbidity and frailty are consequences of aging with HIV, yet not everyone with medical disease is frail. Our objective was to identify factors associated with frailty in a multimorbid HIV-infected cohort. Design: Analysis of a prospective, observational, longitudinal cohort. Methods: Three hundred and thirty-two participants in the medically advanced NNTC were categorized as frail, prefrail, or robust with the Fried Frailty Index. A series of logistic regression analyses (first univariate, then multivariable) were conducted to determine whether medical comorbidities, immunologic and virologic parameters, and/or neuropsychiatric variables predicted increased odds of frailty. Results: The mean number of medical comorbidities per participant was 2.7, mean CD4 þ T-cell count was 530 cells/ml, and 77% had undetectable HIV RNA in blood. Twenty-two percent were frail, 55% prefrail, and 23% robust. Significant predictors of frailty in multivariable analysis were cognitive diagnosis rendered by Frascati criteria, depressive symptoms, diabetes mellitus, chronic obstructive pulmonary disease (COPD), and sex. Men were less likely to be frail than women. Higher odds of frailty were seen with: symptomatic, but not asymptomatic, cognitive impairment (compared with cognitive normals); more depressive symptoms; diabetes mellitus; and COPD. Conclusion: Neuropsychiatric illness increased odds of being frail on a predominantly physical/motoric measure, but only when symptomatic. Lack of association with asymptomatic impairment may reflect the importance of functional limitation to frailty, or possibly a unique resilience phenotype. Understanding why sex and symptomatic neuropsychiatric illness are associated with frailty will be important in managing HIVassociated morbidity in aging populations.

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Section: Discussionsupporting

confidence: 92%

Frailty in medically complex individuals with chronic HIV

Morgello

Sherman

Ellis

et al. 2019

Aids

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“…These results suggest that gross upper limb motor impairments may be an overlooked effect of HIV and that the BBT can be used to identify these impairments as an alternative to the GP. This approach could be useful when examining patients with both HIV and stroke in particular, when motor impairments may be more prevalent [44].…”

Section: Discussionmentioning

confidence: 99%

Robot-based assessment of HIV-related motor and cognitive impairment for neurorehabilitation

Bui

Wamsley²,

Shofer

et al. 2020

Preprint

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There is a pressing need for strategies to slow or treat the progression of functional decline in people living with HIV. This paper explores a novel rehabilitation robotics approach to measuring cognitive and motor impairment in adults living with HIV, including a subset with stroke. We conducted a cross-sectional study with 21 subjects exhibiting varying levels of cognitive and motor impairment. We developed three robot-based tasks - trajectory tracking, N-back, and spatial span - to assess if metrics derived from these tasks were sensitive to differences in subjects with varying levels of executive function and upper limb motor impairments. We also examined if these metrics could estimate clinical cognitive and motor scores. The results showed that the average sequence length on the robot-based spatial span task was the most sensitive to differences between subjects' cognitive and motor impairment levels. We observed strong correlations between robot-based measures and clinical cognitive and motor assessments relevant to the HIV population, such as the Color Trails 1 (rho = 0.83), Color Trails 2 (rho = 0.71), Digit Symbol - Coding (rho = 0.81), Montreal Cognitive Assessment - Executive Function subscore (rho = 0.70), and Box and Block Test (rho = 0.74). Importantly, our results highlight that gross motor impairment may be overlooked in the assessment of HIV-related disability. This study shows that rehabilitation robotics can be expanded to new populations beyond stroke, namely to people living with HIV and those with cognitive impairments.

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“…These results suggest that gross upper limb motor impairments may be an overlooked effect of chronic HIV and that the BBT can be used to identify these impairments as an alternative to the GP. This approach could be useful when examining patients with both HIV and stroke in particular, when motor impairments may be more prevalent [44].…”

Section: A Gross Motor Impairments Are Prevalent In Plwhmentioning

confidence: 99%

Robot-Based Assessment of HIV-Related Motor and Cognitive Impairment for Neurorehabilitation

Bui

Wamsley

Shofer

et al. 2021

IEEE Trans. Neural Syst. Rehabil. Eng.

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There is a pressing need for strategies to slow or treat the progression of functional decline in people living with HIV. This paper explores a novel rehabilitation robotics approach to measuring cognitive and motor impairment in adults living with HIV, including a subset with stroke. We conducted a crosssectional study with 21 subjects exhibiting varying levels of cognitive and motor impairment. We tested three robot-based taskstrajectory tracking, N-back, and spatial span -to assess if metrics derived from these tasks were sensitive to differences in subjects with varying levels of executive function and upper limb motor impairments. We also examined how well these metrics could estimate clinical cognitive and motor scores. The results showed that the average sequence length on the robot-based spatial span task was the most sensitive to differences between various cognitive and motor impairment levels. We observed strong correlations between robot-based measures and clinical cognitive and motor assessments relevant to the HIV population, such as the Color Trails 1 (rho = 0.83), Color Trails 2 (rho = 0.71), Digit Symbol -Coding (rho = 0.81), Montreal Cognitive Assessment -Executive Function subscore (rho = 0.70), and Box and Block Test (rho = 0.74). Importantly, our results highlight that gross motor impairment may be overlooked in the assessment of HIV-related disability. This study shows that rehabilitation robotics can be expanded to new populations beyond stroke, namely to people living with HIV and those with cognitive impairments.

show abstract

Motor function declines over time in human immunodeficiency virus and is associated with cerebrovascular disease, while HIV-associated neurocognitive disorder remains stable

Cited by 34 publications

References 25 publications

Frailty in medically complex individuals with chronic HIV

Frailty in medically complex individuals with chronic HIV

Robot-based assessment of HIV-related motor and cognitive impairment for neurorehabilitation

Robot-Based Assessment of HIV-Related Motor and Cognitive Impairment for Neurorehabilitation

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