Skip to main content Accessibility help

Neuropsychological studies of asymptomatic Human Immunodeficiency Virus-Type-1 infected individuals

  • Desirée A. White (a1), Robert K. Heaton (a1), Andreas U. Monsch (a1) (a2) and The HNRC (a1) (a2) (a3)


The current review was conducted to address the ongoing debate regarding the presence or absence of neuropsychological impairment in asymptomatic HIV-Type 1 (HIV-1) seropositive individuals. Results were summarized from 57 studies that compared the performances of seropositive asymptomatic and seronegative individuals. Overall, the differences observed between median rates of impairment for asymptomatic (35%) and seronegative (12%) groups provided the clearest indication of deficits in asymptomatics. In addition, five variables were examined as possible contributors to inconsistencies found in the literature: mode of infection, test battery type, test battery size, sample size, and method of data analysis. Of these variables, only mode of infection and test battery size appeared to substantially influence the outcome of the studies reviewed with regard to identifying neuropsychological impairment in asymptomatics. (JINS, 1995, I, 304–315.)



Hide All
Ayhvard, E.H., Hendcrcr, J.D., McArthur, J.C., Brettschneider, P.D., Harris, G.J., Barta, P.E., & Pearlson, G.D. (1993). Reduced basal ganglia volume in HIV-1-associated dementia: Results from quantitative neuroimaging. Neurology,43, 20992104.
Belsky-Barr, D., Barr, W.B., Jacobsberg, L., & Perry, S. (1990). An error analysis of mental control deficits in asymptomatic HIV seropositive males. Journal of Clinical and Experimental Neuropsychology, 12, 7273.
Boccellari, A.A., Dilley, J.W., Chambers, D.B., Yingling, C.D., Tauber, M.A., Moss, A.R., & Osmond, D.H. (1993). Immune function and neuropsychological performance in HIV-1-infected homosexual men. Journal of Acquired Immune Deficiency Syndromes, 6, 592601.
Bornstein, R.A., Nasrallah, H.A., Para, M.F., Whitacre, C.C., Rosenbergcr, P., Fass, R.J., & Rice, R. (1992). Neuropsychological performance in asymptomatic HIV infection. The Journal ofNeuropsychiatry and Clinical Neuroscienccs, 4(4), 386394.
Butters, N., Grant, I., Haxby, J., Judd., L.L., Martin, A., McClelland, J., Pequegnat, W., Schactcr, D., & Stover, E. (1990). Assessment of AIDS-rcIated cognitive changes: Recommendations of the NIMH workshop on ncuropsychological assessment approaches. Journal of Clinical and Experimental Neuropsychology, 12, 963978.
Centers for Disease Control. (1986). Classification system for human T-lymphotropic virus type III/lymphadenopathy-associated virus infections. Morbidity and Mortality Weekly Report, 35(20), 334339.
Centers for Disease Control. (1994). Update: Impact of the Expanded AIDS surveillance case definition of adolescents and adults on case reporting-United States, 1993. Morbidity and Mortality Weekly Report, 43(9), 160170.
Clifford, D.B., Jacoby, R.G., Miller, J.P., Scyfricd, W.R., & Glicksman, M. (1990). Neuropsychometric performance of asymptomatic HIV-infected subjects. AIDS, 4, 767774.
Collier, A.C., Marra, C., Coombs, R.W., Claypoole, K., Cohen, W., Longstreth, W.T., Townes, B.D., Maravilla, K.R., Critchlow, C., Murphy, V.L., & Handsfield, H.H. (1992). Central nervous system manifestations in human immunodeficiency virus infection without AIDS. Journal of Acquired Immune Deficiency Syndrome, 5, 229241.
Dunlop, O., Bjorklund, R.A., Abdelnoor, M., & Myrvang, B. (1992). Five different tests of reaction time evaluated in HIV seropositive men. Acta Neurologica Scandinavica, 86, 260266.
Egan, V. (1992). Neuropsychological aspects of HIV infection. AIDS Care, 4, 310.
Egan, V.G., Crawford, J.R., Bretlle, R.P., & Goodwin, G.M. (1990). The Edinburgh cohort of HIV-positive drug users: Current intellectual function is impaired, but not due to early AIDS dementia complex. AIDS, 4, 651656.
Field, M., Kunze, H.Tatc, J., & Frazcr, I.H. (1989). Cerebral dysfunction with evidence of cerebral HIV infection amongst asymptomatic HIV seropositivc subjects. Australian and New Zealand Journal of Medicine, 19, 694699.
Folstein, M.F., Folstein, S.E., & McHugh, P.R. (1975). “Mini-Mental State”: A practical method for grading cognitive state of patients for the clinicians. Journal of Psychiatric Research, 12, 189198.
Franzblau, A., Letz, R., Hershman, D., Mason, P., Wallace, J.I., & Bckesi, J.G. (1991). Quantitative neurologic and neurobehavioral testing of persons infected with human immunodeficiency virus type 1. Archives of Neurology, 48, 263268.
Gibbs, A., Andrewes, D.G., Szmukler, G., Mulhall, B., & Bowden, S.C. (1990). Early HIV-related neuropsychological impairment: Relationship to stage of viral infection. Journal of Clinical and Experimental Neuropsychology, 12(5), 766780.
Goethe, K.E., Mitchell, J.E., Marshall, D.W., Brey, R.L., Cahill, W.T., Leger, D., Hoy, L.J., & Boswell, R.N. (1989). Neuropsychological and neurological function of human immunodeficiency virus scropositive asymptomatic individuals. Archives of Neurology, 46, 129133.
Grant, I., Atkinson, J.H., Hessclink, J.R., Kennedy, C.J., Richman, D.D., Spector, S.A., &. McCutchan, J.A. (1987). Evidence for early central nervous system involvement in the acquired immunodeficiency syndrome (AIDS) and other human immunodeficiency virus (HIV) infections. Annals of Internal Medicine, 107, 828836.
Grant, I., Caun, K., Kingsley, D.P.E., Winer, J., Trimble, M.R., & Pinching, A.J. (1992). Neuropsychological and NMR abnormalities in HIV infection. Neuropsychiatry Neuropsychology, and Behavioral Neurology, 5(3), 185193.
Grant, I. & Hcaton, R.K. (1990). Human Immunodeficiency Virus-Type I (HIV-1) and the brain. Journal of Consulting and Clinical Psychology, 55(1), 2230.
Handelsman, L., Aronson, M., Maurer, G., Wiener, J., Jacobson, J., Bernstein, D., Ness, R., Herman, S., Losonezy, M., Sook, Song I.. Holloway, K., Horvath, T., Donnelly, N., Hirschowitz, J., & Rowan, A.J. (1992). Neuropsychological and neurological manifestations of HIV-1 dementia in drug users. The Journal of Neuropsychiatry and Clinical Neuroscienccs, 4, 2128.
Heaton, R.K., Kirson, D., Velin, R.A., Grant, I., & the HNRC Group. (1994). The utility of clinical ratings for detecting early cognitive change in HIV infection. In I. Grant & Martin, A. (Eds.), Neuropsychology of HIVinfection, (pp. 188206). New York: Oxford University Press.
Ingraham, L.J., Bridge, T.P., Janssen, R., Stover, E., & Mirsky, A.F. (1990). Neuropsychological effects of early HIV-1 infection: Assessment and methodology. Journal of Neuropsychiatry, 2(2), 174182.
Janssen, R.S., Saykin, A.J., Cannon, L., Campbell, J., Pinsky, P.F., Hessol, N.A., O'Mallcy, P.M., Lifson, A.R., Doll, L.S., Rutherford, G.W., & Kaplan, J.E. (1989). Neurological and neuropsychological manifestations of HIV-1 infection: Association with AIDS-related complex but not asymptomatic HIV-1 infection. Annals of Neurology, 26, 592600.
Janssen, R.S., Saykin, A.J., Kaplan, J.E., Spira, T.J., Pinsky, P.F., Sprehn, G.C., Hoffman, J.C., Mayer, W.B., & Schonbcrgcr, L.B. (1988). Neurological complications of human immunodeficiency virus infection in patients with lymphadcnopathy syndrome. Annals of Neurology, 23, 4955.
Karlsen, N.R., Reinvang, I., & Froland, S.S. (1992). Slowed reaction time in asymptomatic HIV-positive patients. Acta Neurologica Scandinavian, 86, 242246.
Klusman, L.E., Moulton, J.M., Hornbostel, L.K., Picano, J.J., & Beattie, M.T. (1991). Neuropsychological abnormalities in asymptomatic HIV seropositive military personnel. The Journal of Neuropsychiatry and Clinical Neurosciences, 3, 422428.
Kokkevi, A., Hatzakis, A., Maillis, A., Pittadaki, J., Zalonis, J., Samartzis, D., Touloumi, G., Mandalaki, T., & Stefanis, C. (1991). Neuropsychological assessment of HlV-seropositive haemophiliacs. AIDS, 5, 12231229.
Koralnik, I.J., Beaumanoir, A., Hausler, R., Kohler, A., Safran, A.B., Delacoux, R., Vibert, D., Mayer, E., Burkhard, P., Nahory, A., Magistris, M.R., Sanchez, J., Myers, P., Paccolat, F., Quoex, F., Gabriel, V., Perrin, L., Mermil-Iod, B., Gauthier, G., Waldvogel, F.A., & Hirschel, B. (1990). A controlled study of early neurologic abnormalities in men with asymptomatic human immunodeficiency virus infection. New England Journal of Medicine, 323, 864870.
Krikorian, R. & Wrobel, A.J. (1991). Cognitive impairment in HIV infection. AIDS, 5, 15011507.
Levin, H.S., Williams, D.H., Borucki, M.J., Hillman, G.R., Williams, J.B., Guinto, F.C., Amparo, E.G., Crow, W.N., & Pollard, R.B. (1990). Magnetic resonance imaging and neuropsychological findings in human immunodeficiency virus infection. Journal of Acquired Immune Deficiency Syndromes, 3(8), 757762.
Lunn, S., Skydsbjerg, M., Schulsinger, H., Parnas, J., Pedersen, C., & Mathiesen, L. (1991). A preliminary report on the neuropsychologic sequelae of human immunodeficiency virus. Archives of General Psychiatry, 48, 139142.
Maj, M., Satz, P., Janssen, R., Zaudig, M., Starace, F., D'Elia, L., Sughondhabirom, B., Mussa, M., Naber, D., Ndetei, D., Schulte, G., & Sartorius, N. (1994). WHO neuropsychiatric AIDS study, cross-sectional phase II: Neuropsychological and neurological findings. Archives of General Psychiatry, 51, 5162.
Marotta, R. & Perry, S. (1989). Early neuropsychological dysfunction caused by Human Immunodeficiency Virus. Journal of Neuropsychiatry, 1(3), 225235.
Marsh, N.V. & McCall, D.W. (1994). Early neuropsychological change in HIV infection. Neuropsychology, 8(1), 4448.
Martin, A., Heyes, M.P., Salazar, A.M., Kampen, D.L., Williams, J., Law, W.A., Coats, M.E., & Markey, S.P. (1992). Progressive slowing of reaction time and increasing cerebrospinal fluid concentrations of quinolinic acid in HIV-infected individuals. The Journal of Neuropsychiatry and Clinical Neurosciences, 4, 270279.
Martin, E.M., Robertson, L.C., Edelstein, H.E., Jagust, W.J., Sorensen, D.J., Giovanni, D.S., & Chirurgi, V.A. (1992a). Performance of patients with early HIV-1 infection on the Stroop task. Journal of Clinical and Experimental Neuropsychology, 14(5), 857868.
Martin, E.M., Robertson, L.C., Sorensen, D.J., Jagust, W.J., Mallon, K.F., & Chirurgi, V.A. (1993). Speed of memory scanning is not affected in early HIV-1 infection. Journal of Clinical and Experimental Neuropsychology, 15, 311320.
Martin, E.M., Sorensen, D.J., Robertson, L.C., Edelstein, H.E., & Chirurgi, V.A. (1992b). Spatial attention in HIV-1 infection: A preliminary report. Journal of Neuropsychiatry and Clinical Neurosciences, 4, 288293.
McAllister, R.H., Herns, M.V., Harrison, M.J.G., Newman, S.P., Connolly, S., Fowler, C.J., Fell, M., Durrance, P., Manji, H., Kendall, B.E., Valentine, A.R., Weller, I.V.D., & Adler, M. (1992). Neurological and neuropsychological performance in HIV seropositive men without symptoms. Journal of Neurology, Neurosurgery, and Psychiatry, 55, 143148.
McArthur, J.C., Cohen, B.A., Seines, O.A., Kumar, A.J., Cooper, K., McArthur, J.H., Soucy, G., Cornblath, D.R., Chmiel, J.S., Wang, M., Starkey, D.L., Ginzburg, H., Ostrovv, D.G., Johnson, R.T., Phair, J.P., & Polk, B.F. (1989). Low prevalence of neurological and neuropsychological ab-normalities in otherwise healthy HI V-1-infected individuals: Results from the multicenter AIDS cohort study. Annals of Neurology, 26, 601611.
McKegney, F.P., O'Dowd, M.A., Feiner, C., Selwyn, P., Drucker, E., & Friedland, G.H. (1990). A prospective comparison of neuropsychologic function in HIV-seropositive and seronegative methadone-maintained patients. AIDS, 4, 565569.
Miller, E.N., Seines, O.A., McArthur, J.C., Satz, P., Becker, J.T., Cohen, B.A., Sheridan, K., Machado, A.M., van Gorp, W.G., & Visscher, B. (1990). Neuropsychological performance in HI V-1-infected homosexual men: The Multicenter AIDS Cohort Study. Neurology, 40, 197203.
Miller, E.N., Satz, P., & Visscher, B. (1991). Computerized and conventional neuropsychological assessment of HIV-1- infected homosexual men. Neurology, 41, 16081616.
Naber, D., Perro, C., Schick, U., Schmauss, M., Erfurth, A., Bove, D., Goebel, F.D., & Hippius, H. (1990). Psychiatric symptoms and neuropsychological deficits in HIV infection. Neuropsychopharmacology, 745755.
Navia, B.A., Cho, E., Petito, C.K., & Price, R.W. (1986a). The AIDS dementia complex: II. Neuropathology. Annals of Neurology, 19, 525535.
Navia, B.A., Jordan, B.D., & Price, R.W. (1986b). The AIDS dementia complex: I. Clinical features. Annals of Neurology, 19, 517524.
Olio, C., Johnson, R., & Grafman, J. (1991). Signs of cognitive change in HIV disease: An event-related brain potential study. Neurology, 41, 209215.
Olio, C., Litman, R., Rubinow, D., Bridge, T.P., & Pickar, D. (1990). Neuropsychological correlates of smooth pursuit eyemovements in HIV disease. Journal of Clinical and Experimental Neuropsychology, 12(1), 73.
Perdices, M. & Cooper, D.A. (1989). Simple and choice reaction time in patients with human immunodeficiency virus infection. Annals of Neurology, 25, 460467.
Perry, S., Belsky-Barr, D., Barr, W.B., & Jacobsberg, L. (1989). Neuropsychological function in physically asymptomatic, HIV-seropositive men. Journal of Neuropsychiatry, 1(3), 296302.
Poutiainen, E., Elovaara, I., Raininko, R., Hokkanen, L., Valle, S-L., Lahdevirta, J., & Iivanainen, M. (1993). Cognitive performance in HIV-1 infection: Relationship to severity of disease and brain atrophy. Ada Neurologica Scandinavica, 87, 8894.
Redfield, R.R., Wright, D.C., &Tramont, E.C. (1986). The Walter Reed staging classification for HTLV-III/LAV infection. New England Journal of Medicine, 314, 131132.
Reinvang, I., Froland, S.S., & Skripeland, V. (1991). Prevalence of neuropsychological deficit in HIV infection. Incipient signs of AIDS dementia complex in patients with AIDS. Acta Neurologica Scandinavica, 83, 289293.
Reitan, R. & Wolfson, D. (1985). The Halstead-Reitan Neuropsychological Test Battery: Theory and clinical interpretation. Tucson, AZ: Neuropsychological Press.
Riedel, R.R., Helmstaedter, C., Bulau, P., Durwen, H.F., Brackmann, H., Fimmers, R., Clarenbach, P., Miller, E.N., & Bottcher, M. (1992). Early signs of cognitive deficits among human immunodeficiency virus-positive hemophiliacs. Acta Psychiatrica Scandinavica, 85, 321326.
Royal, W., Updike, M., Seines, O.A., Proctor, T.V., Nance-Sproson, L., Solomon, L., Vlahov, D., Cornblath, D.R., & McArthur, J.C. (1991). HIV-1 infection and nervous system abnormalities among a cohort of intravenous drug users. Neurology, 41, 19051910.
Rubinow, D.R., Berrettini, C.H., Brouwers, P., & Lane, H.C. (1988). Neuropsychiatric consequences of AIDS. Annals of Neurology, 25(suppl), 2426.
Satz, P., Morgenstern, H., Miller, E.N., Seines, O.A., McArthur, J.C., Cohen, B.A., Wesch, J., Becker, J.T., Jacobson, L., D'Elia, L.F., van Gorp, W., & Visscher, B. (1993). Low education as a possible risk factor for cognitive abnormalities in HIV-1: Findings from the Multicenter AIDS Cohort Study (MACS). Journal of Acquired Immune Deficiency Syndromes, 6, 503511.
Saykin, A.J., Janssen, R.S., Sprehn, G.C., Kaplan, J.E., Spira, T.J., & Weller, P. (1988). Neuropsychological dysfunction in HIV-infection: Characterization in a lymphadenopathy cohort.International Journal of Clinical Neuropsychology, 10(2), 8195.
Silberstein, C.H., McKegney, F.P., O'Dowd, M.A., Selwyn, P.A., Schoenbaum, E., Drucker, E., Feiner, C., Cox, C.P., & Friedland, G. (1987). A prospective longitudinal study of neuropsychological and psychosocial factors in asymptomatic individuals at risk for HTLV/LAV infection in a methadone program: Preliminary findings. International Journal of Neuroscience, 32, 669676.
Sinforiani, E., Mauri, M., Bono, G., Muratori, S., Alessi, E., & Minoli, L. (1991). Cognitive abnormalities and disease progression in a selected population of asymptomatic HIVpositive subjects. AIDS, 5, 11171120.
Skoraszewski, M.J., Ball, J.D., & Mikulka, P. (1991). Neuropsychological functioning of HIV-infected males. Journal of Clinical and Experimental Neuropsychology, 13(2), 278290.
Stern, R.A., Singer, N.G., Silva, S.G., Rogers, H.J., Perkins, D.O., Hall, C.D., van der Horst, C.M., & Evans, D.L. (1992). Neurobehavioral functioning in a nonconfounded group of asymptomatic HIV-seropositive homosexual men. American Journal of Psychiatry, 149, 10991102.
Stern, Y., Marder, K., Bell, K., Chen, J., Dooneief, G., Goldstein, S., Mindry, D., Richards, M., Sano, M., Williams, J., Gorman, J., Ehrhardt, A., & Mayeux, R. (1991). Multidisciplinary baseline assessment of homosexual men with and without human immunodeficiency virus infection. Archives of General Psychiatry, 48, 131138.
Tross, S., Price, R.W., Navia, B., Thaler, H.T., Gold, J., Hirsch, D.A., & Sidtis, J.J. (1988). Neuropsychological characterization of the AIDS dementia complex: A preliminary report. AIDS, 2, 8188.
Turnbull, O., Saling, M.M., Kaplan-Solms, K., Cohn, R., & Schoub, B. (1991). Neuropsychological deficit in haemophiliacs with human immunodeficiency virus. Journal of Neurology, Neurosurgery, and Psychiatry, 54, 175177.
van Gorp, W.G., Lamb, D.G., & Schmitt, F.A. (1993). Methodologic issues in neuropsychological research with HIVspectrum disease. Archives of Clinical Neuropsychology, 8, 1733.
van Gorp, W.G., Satz, P., Hinkin, C., Seines, O., Miller, E.N., McArthur, J., Cohen, B., Paz, D., & the Multicenter AIDS Cohort Study. (1991). Metacognition in HIV-1 seropositive asymptomatic individuals: Self-ratings versus objective neuropsychological performance. Journal of Clinical and Experimental Neuropsychology, 13(5), 812819.
Wechsler, D.A. (1981). Manual for the Wechsler Adult Intelligence Scale-Revised. San Antonio, TX: The Psychological Corporation.
Wechsler, D.A. (1987). Manual for the Wechsler Memory Scale-Revised. San Antonio, TX: The Psychological Corporation.
Wellman, M.C. (1992). Neuropsychological impairment among intravenous drug users in pre-AIDS stages of HIV infection. InternationalJournalof Neuroscience, 64, 183194.
Wilkie, F.L., Eisdorfer, C., Morgan, R., Loewenstein, D.A., & Szapocznik, J. (1990). Cognition in early human immunodeficiency virus infection. Archives of Neurology, 47,433440.
Wilkins, J.W., Robertson, K.R., Snyder, C.R., Robertson, W.K., van der Horst, C., & Hall, C.D. (1991). Implications of self-reported cognitive and motor dysfunction in HIVpositive patients. American Journal of Psychiatry, 148, 641643.


Neuropsychological studies of asymptomatic Human Immunodeficiency Virus-Type-1 infected individuals

  • Desirée A. White (a1), Robert K. Heaton (a1), Andreas U. Monsch (a1) (a2) and The HNRC (a1) (a2) (a3)


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed