Sensorimotor Dysfunction in HIV/AIDS: Effects of Antiretroviral Treatment and Comorbid Psychiatric Disorders

Bauer, Lance O.; Ceballos, Natalie A.; Shanley, John D.; Wolfson, Leslie

doi:10.1097/01.aids.0000162338.66180.0b

Cited by 38 publications

(50 citation statements)

References 34 publications

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“…Substances included were alcohol, cocaine and opiates. Analysis of variance revealed no significant effects of substance use--whether drug status was formerly dependent or currently dependent--on sensorimotor functioning [84] . An early study examined neuropsychological functioning in 500 individuals (389 seropositives).…”

Section: Injecting Drug Usementioning

confidence: 82%

Neuropsychological Complications of HIV Disease and Substances of Abuse

Norman¹,

Kumar²

2006

American J. of Infectious Diseases

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Section: Injecting Drug Usementioning

confidence: 82%

Neuropsychological Complications of HIV Disease and Substances of Abuse

Norman¹,

Kumar²

2006

American J. of Infectious Diseases

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“…Gait and balance problems can be related to, or exacerbated by, HIV-related neuropathy of the peripheral nervous system (cf., Goodkin et al 2001; Richardson and Hurvitz 1995), but concurrent lower limb neuropathy does not necessarily account for postural instability (Bauer et al 2005). Indeed, pathology in the central nervous system, the cerebellum and pons in particular, is known to be involved in HIV infection (Abe et al 1996; Anders et al 1993; Kinzel et al 2004; Kuchelmeister et al 1993; Ruiz et al 1997; Tagliati et al 1998).…”

Section: Discussionmentioning

confidence: 99%

Pontocerebellar contribution to postural instability and psychomotor slowing in HIV infection without dementia

Sullivan

Rosenbloom

Rohlfing

et al. 2010

Brain Imaging and Behavior

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Postural instability occurs in HIV infection, but quantitative balance tests in conjunction with neuroimaging are lacking. We examined whether infratentorial brain tissue volume would be deficient in nondemented HIV-infected individuals and whether selective tissue deficits would be related to postural stability and psychomotor speed performance. The 123 participants included 28 men and 12 women with HIV infection without dementia or alcohol use disorders, and 40 men and 43 women without medical or psychiatric conditions. Participants completed quantitative balance testing, Digit Symbol test, and a test of finger movement speed and dexterity. An infratentorial brain region, supratentorial ventricular system, and corpus callosum were quantified with MRI-derived atlas-based parcellation, and together with archival DTI-derived fiber tracking of pontocerebellar and internal and external capsule fiber systems, brain measures were correlated with test performance. The tissue ratio of the infratentorium was ~3% smaller in the HIV than control group. The HIV group exhibited performance deficits in balancing on one foot, walking toe-to-heel, Digit Symbol substitution task, and time to complete all Digit Symbol grid boxes. Total infratentorial tissue ratio was a significant predictor of balance and Digit Symbol scores. Balance scores did not correlate significantly with ventricular volumes, callosal size, or internal or external capsule fiber integrity but did so with indices of pontocerebellar tract integrity. HIV-infected individuals specifically recruited to be without complications from alcohol use disorders had pontocerebellar tissue volume deficits with functional ramifications. Postural stability and psychomotor speed were impaired and attributable, at least in part, to compromised infratentorial brain systems.

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“…Revelation of markers such as impairment on spatial and verbal working memory, apathy, auditory defects, sensori-motor loss and odour disturbances 7813–15…”

Section: Discussionmentioning

confidence: 99%

Neurocognitive deficits in HIV-positive patients-two case reports: Revising current AANTF guidelines in view of recent revelation of new neurocognitive symptoms

Vahia

Bhojraj

Creado

2006

Indian J Psychiatry

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Certain organic antecedents such as fever, weight loss, diarrhoea and systemic infections often present with neurocognitive deficits (NCDs). However, routine HIV screening is not done in such cases. HIV can present with psychiatric and neurocognitive symptoms as highlighted in the two cases given below.Case 1, a housewife, had been exhibiting altered behaviour following a low-grade fever over the past 3 weeks, associated with muttering to self, talking irrelevantly, would wander away from home, had decreased sleep, loss of appetite, and neglected self-care. She had displayed impulsivity by jumping into a well. On admission, the patient was mute, lethargic and the cerebrospinal fluid (CSF) tested positive for cryptococcus. Her human immunodeficiency virus (HIV) status was positive.Case 2, a housewife, presented with one-month history of muttering to self, increased irritability, aggressive on minimal provocation, decreased sleep, loss of appetite, and suspiciousness towards family members. On provisional diagnosis of schizophrenia, the patient was started on low-dose antipsychotic drugs, which showed minimal improvement. There was a distinct slowness in her movements and she progressively lost weight. Routine investigations were normal but her HIV status was positive.It has recently come to light that HIV infection also presents with subtle manifestations of the central nervous system (CNS), which are distinct from NCD and, if harnessed, could enhance diagnostic sensitivity and reduce the ‘asymptomatic period’. Hence HIV testing is recommended in such cases.

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Sensorimotor Dysfunction in HIV/AIDS: Effects of Antiretroviral Treatment and Comorbid Psychiatric Disorders

Abstract: HIV/AIDS is associated with reliable decrements in balance and peripheral sensory function which are variably sensitive to antiretroviral treatment. The implications of these findings for mobility, and workplace or operator safety, should be contemplated.

Cited by 38 publications

References 34 publications

Neuropsychological Complications of HIV Disease and Substances of Abuse

Neuropsychological Complications of HIV Disease and Substances of Abuse

Pontocerebellar contribution to postural instability and psychomotor slowing in HIV infection without dementia

Neurocognitive deficits in HIV-positive patients-two case reports: Revising current AANTF guidelines in view of recent revelation of new neurocognitive symptoms

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