Nomenclature and research case definitions for neurologic manifestations of human immunodeficiency virus‐type 1 (HIV‐1) infection

Janssen, Robert S.; Cornblath, David R.; Epstein, Leon G.; Foa, Richard P.; McArthur, Justin C.; Price, Richard W.; Asbury, Arthur K.; Beckett, Alexandra; Benson, D. Frank; Bridge, T. Peter; Leventhal, Carl M.; Satz, Paul; Saykin, Andrew J.; Sidtis, John J.; Tross, Susan; Becker, James T.; Castro, Kenneth G.; Cohen, Bruce A.; Folstein, M. F.; González‐Scarano, Francisco; Grant, Igor; Maj, Mario; McAllister, Ruth; Mesulam, Marsel; Miller, Eric N.; Oxtoby, Margaret J.; Sartorius, Norman; Selnes, Ola A.; Williams, Janet B. W.; Zaudig, Michael

doi:10.1212/wnl.41.6.778

Cited by 658 publications

(28 citation statements)

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“…The AAN and updated Frascati criteria for the neurocognitive stages of HIV share a reliance on standardized testing of cognitive and motor functions (Janssen et al, 1991; Antinori et al, 2007). This is reflected by the criteria that define impairments through domain-specific deficits.…”

Section: Discussionmentioning

confidence: 99%

“…The AIDS Task Force of the American Academy of Neurology (AAN) initially established the foundational criteria that define neurocognitive stages of HIV (Janssen et al, 1991). The AAN criteria were criticized in part for neglecting milder forms of impairment, for example how multiple impairments that individually do not breach a threshold of abnormality on clinical assessments can compound to become a notable functional deficit (Antinori et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

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Impairments of Motor Function While Multitasking in HIV

Kronemer

Mandel²,

Sacktor³

et al. 2017

Front. Hum. Neurosci.

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Human immunodeficiency virus (HIV) became a treatable illness with the introduction of combination antiretroviral therapy (CART). As a result, patients with regular access to CART are expected to live decades with HIV. Long-term HIV infection presents unique challenges, including neurocognitive impairments defined by three major stages of HIV-associated neurocognitive disorders (HAND). The current investigation aimed to study cognitive and motor impairments in HIV using a novel multitasking paradigm. Unlike current standard measures of cognitive and motor performance in HIV, multitasking increases real-world validity by mimicking the dual motor and cognitive demands that are part of daily professional and personal settings (e.g., driving, typing and writing). Moreover, multitask assessments can unmask compensatory mechanisms, normally used under single task conditions, to maintain performance. This investigation revealed that HIV+ participants were impaired on the motor component of the multitask, while cognitive performance was spared. A patient-specific positive interaction between motor performance and working memory recall was driven by poor HIV+ multitaskers. Surprisingly, HAND stage did not correspond with multitask performance and a variety of commonly used assessments indicated normal motor function among HIV+ participants with poor motor performance during the experimental task. These results support the use of multitasks to reveal otherwise hidden impairment in chronic HIV by expanding the sensitivity of clinical assessments used to determine HAND stage. Future studies should examine the capability of multitasks to predict performance in personal, professional and health-related behaviors and prognosis of patients living with chronic HIV.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Impairments of Motor Function While Multitasking in HIV

Kronemer

Mandel²,

Sacktor³

et al. 2017

Front. Hum. Neurosci.

View full text Add to dashboard Cite

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“…All subjects underwent routine clinical bedside screening for symptoms or signs of CNS opportunistic infections or other conditions that might impact CSF biomarker concentrations; individuals with CNS opportunistic infections or other conditions confounding these analyses were omitted. Most of these subjects were studied before publication of the more formal Frascati criteria [ 35 ] and were diagnosed with ADC stages 2–4 [ 71 ] and met American Academy of Neurology criteria in place at the time [ 72 ]; retrospectively, they also met the functional criteria for the Frascati diagnosis of HAD without the requisite extensive formal neuropsychological assessment, so this more contemporary term was used to encompass this group. The designation as ADC/HAD was based on clinicians’ assessment at the time of diagnostic presentation, characteristically after subacute onset and progression of cognitive and motor symptoms and signs.…”

Section: Methodsmentioning

confidence: 99%

Compartmentalization of cerebrospinal fluid inflammation across the spectrum of untreated HIV-1 infection, central nervous system injury and viral suppression

et al. 2021

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Objective To characterize the evolution of central nervous system (CNS) inflammation in HIV-1 infection applying a panel of cerebrospinal fluid (CSF) inflammatory biomarkers to grouped subjects representing a broad spectrum of systemic HIV-1 immune suppression, CNS injury and viral control. Methods This is a cross-sectional analysis of archived CSF and blood samples, assessing concentrations of 10 functionally diverse soluble inflammatory biomarkers by immunoassays in 143 HIV-1-infected subjects divided into 8 groups: untreated primary HIV-1 infection (PHI); four untreated groups defined by their blood CD4+ T lymphocyte counts; untreated patients presenting with subacute HIV-associated dementia (HAD); antiretroviral-treated subjects with ≥1 years of plasma viral suppression; and untreated elite controllers. Twenty HIV-1-uninfected controls were included for comparison. Background biomarkers included blood CD4+ and CD8+ T lymphocytes, CSF and blood HIV-1 RNA, CSF white blood cell (WBC) count, CSF/blood albumin ratio, CSF neurofilament light chain (NfL), and CSF t-tau. Findings HIV-1 infection was associated with a broad compartmentalized CSF inflammatory response that developed early in its course and changed with systemic disease progression, development of neurological injury, and viral suppression. CSF inflammation in untreated individuals without overt HAD exhibited at least two overall patterns of inflammation as blood CD4+ T lymphocytes decreased: one that peaked at 200–350 blood CD4+ T cells/μL and associated with lymphocytic CSF inflammation and HIV-1 RNA concentrations; and a second that steadily increased through the full range of CD4+ T cell decline and associated with macrophage responses and increasing CNS injury. Subacute HAD was distinguished by a third inflammatory profile with increased blood-brain barrier permeability and robust combined lymphocytic and macrophage CSF inflammation. Suppression of CSF and blood HIV-1 infections by antiretroviral treatment and elite viral control were associated with reduced CSF inflammation, though not fully to levels found in HIV-1 seronegative controls.

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“…Se conoce desde hace décadas que el deterioro de pacientes con VIH puede ser de alta gravedad, llegando a la demencia progresiva, caracterizada por cambios a nivel motor, cognitivo y conductual. Sin embargo, los pacientes también pueden presentar déficit cognitivo leve [9]. Entre las funciones principalmente afectadas en esta población, se encuentran la memoria, la velocidad psicomotora, las habilidades visoespaciales y la atención [10 -13].…”

Section: Vih Y Trastornos Neurocognitivosunclassified

Revisión Bibliográfica: Trastornos Neurocognitivos en Pacientes Infectados con el Virus de la Inmunodeficiencia Humana

et al. 2019

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El Virus de Inmunodeficiencia Humana (VIH) tiene un carácter neurotrópico, es decir afecta tanto el sistema inmunológico como el sistema nervioso de los pacientes, generando déficits conocidos como trastorno neurocognitivo asociado con el VIH (HAND por sus siglas en inglés). Los HAND se evidencian en el deterioro de las funciones ejecutivas y las funciones cognitivas de los pacientes y pueden ser clasificados en tres tipos: 1. Deterioro neurocognitivo asintomático asociado con el VIH, 2. Trastorno neurocognitivo leve asociado con el VIH, y 3. Demencia asociada al VIH. Los HAND tienen efectos perjudiciales en la calidad de vida y en las actividades cotidianas de los pacientes, pues intervienen en el rendimiento de tareas laborales, la adherencia al tratamiento o ingesta de medicamentos, conducción de vehículos y continuidad de la independencia. Para detener o prevenir la aparición de un HAND se ha estudiado la terapia antiretroviral, sin embargo, esta acción no es definitiva, por ello deben tomarse medidas adicionales como intervenciones psicológicas y neuropsicológicas pertinentes. En muchos casos la agudeza de los trastornos neurocognitivos dificulta su identificación, siendo la detección temprana de déficits en las diferentes habilidades cognitivas un factor esencial en el diagnóstico del VIH, pues al ser una afección crónica se puede esperar un mayor deterioro a futuro en caso de no ser intervenido.

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Nomenclature and research case definitions for neurologic manifestations of human immunodeficiency virus‐type 1 (HIV‐1) infection

Cited by 658 publications

References 0 publications

Impairments of Motor Function While Multitasking in HIV

Impairments of Motor Function While Multitasking in HIV

Compartmentalization of cerebrospinal fluid inflammation across the spectrum of untreated HIV-1 infection, central nervous system injury and viral suppression

Revisión Bibliográfica: Trastornos Neurocognitivos en Pacientes Infectados con el Virus de la Inmunodeficiencia Humana

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