Relationship between psychiatric status and frontal–subcortical systems in HIV-infected individuals

Abstract

Human immunodeficiency virus (HIV)-infected adults frequently evidence both neurocognitive and psychiatric dysfunction. It was hypothesized that apathy and irritability, but not anxiety and depression, are related to HIV effects on frontal-subcortical systems. This hypothesis was evaluated by determining the degree to which these psychiatric features are associated with neurocognitive functioning that is dependent upon frontal-subcortical circuitry and, therefore, thought to be sensitive to the central nervous system effects of HIV. Rating scales assessing irritability, apathy, depression, and anxiety and a dual-task paradigm were administered to 189 HIV-seropositive (HIV+) and 53 HIV-seronegative participants. Deficits in dual-task performance and greater anxiety, depression, apathy, and irritability were observed in HIV+ participants. Simultaneous multivariate regression and communality analyses revealed that only apathy and irritability were associated with dual-task performance in HIV+ participants. Thus, these findings suggest that apathy and irritability, but not depression and anxiety, are likely associated with the effects of HIV on frontal-subcortical circuitry.

Depression and Apathy Among People Living with HIV: Implications for Treatment of HIV Associated Neurocognitive Disorders

“…Based on extant literature, which shows a relationship between apathy and cognitive outcomes [10, 17, 18], we decided to examine whether it was moderated by age and cocaine use variables. In order to examine moderation effects, each cocaine use variable (frequency, duration, quantity, KMSK score) was centered and multiplied by centered apathy T-scores.…”

“…Additionally, apathy has been associated with different neurocognitive deficits than depression, which may indicate central nervous system (CNS) involvement, independent of depression [16]. For example, PLWH with higher levels of apathy, tend to have deficits in executive functioning, learning, and cognitive flexibility [7, 17]. Depression has been associated with deficits in all domains of cognitive functioning in PLWH, but particularly, processing speed, learning, and memory [18].…”

Psychiatric symptom burden in older people living with HIV with and without cognitive impairment: the UCSF HIV over 60 cohort study

“…While some studies suggest that depressive symptoms do not affect neuropsychological testing performance, others found an association between subtypes of depressive symptoms and cognitive deficits (Bornstein et al, 1993; Castellon et al, 2006; Cole et al, 2007; Cysique et al, 2007; Rourke, Halman, & Bassel, 1999). Our findings provided further evidence that neuropsychiatric symptoms were not associated with cognitive functioning in older PLWH.…”

Editorial NeuroAIDS review

“…In addition, there may be behavioral effects such as apathy and irritability. Psychomotor retardation (associated with damage to the frontal-striatal systems) also may occur [14,15]. The clinical severity of this process ranges from asymptomatic neurocognitive impairment (ANI), to a mild neuro-cognitive disorder (MND), to full-blown HIV-associated dementia (HAD) [16].…”