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A Novel Approach to the Determination and Characterization of HIV Dementia

Published online by Cambridge University Press:  18 September 2015

P. Brouwers ,
E. Mohr ,
K. Hildebrand ,
M. Hendricks ,
J.J. Claus ,
I.S. Baron ,
M. Young  and
P. Pierce
P. Brouwers*
Affiliation:
Pediatric Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
E. Mohr
Affiliation:
University of Ottawa/Faculty of Medicine, Ottawa
K. Hildebrand
Affiliation:
University of Ottawa/Faculty of Medicine, Ottawa
M. Hendricks
Affiliation:
Pediatric Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
J.J. Claus
Affiliation:
National Instutute of Neurologic Disorders & Stroke, National Institutes of Health, Bethesda, Maryland
I.S. Baron
Affiliation:
Georgetown University Medical Center, Washington, DC
M. Young
Affiliation:
Georgetown University Medical Center, Washington, DC
P. Pierce
Affiliation:
Georgetown University Medical Center, Washington, DC
*
Pediatric Branch, National Cancer Institute, NIH Clinical Center, Bldg 10, Rm 13N240, Bethesda, Maryland 20892 U.S.A
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Abstract:

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Background: Neuropsychological studies of the pattern and extent of cognitive impairment in HIV-infected patients have mostly used deviations from control values and/or cut-off scores as criteria for classification of dementia. There is, however, no agreement as to how to define impairment, and classification is imprecise. Method: The current study used a dementia classification matrix, developed with a step-wise linear discriminant analysis of neuropsychological data from patients with primary neurodegenerative dementias, to classify symptomatic HIV patients as demented or non-demented, and further to differentiate cortical and subcortical dementia patterns. Thirty-two male and 2 female patients (mean age 39 ± 2) with symptomatic HIV disease (mean absolute CD4 count 195 ±41) participated in the study. Results: Thirty-five per cent of patients were classified as demented. Of these, 83% showed a subcortical pattern and 17% a cortical profile of deficits. Significant differences between patients classified as subcortically demented and those categorized as normal on neuropsychological measures associated with subcortical integrity further validated the classification. Measures of psychiatric status between subgroups were similar. Conclusion: Since certain treatments may delay or reverse cognitive deficits, the use of an objective classification method based on discriminant analysis may help to identify patients who may benefit from therapy.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 23 , Issue 2 , February 1996 , pp. 104 - 109
Copyright
Copyright © Canadian Neurological Sciences Federation 1996

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