Skip to main content Accessibility help
×
Home
Hostname: page-component-544b6db54f-2p87r Total loading time: 0.327 Render date: 2021-10-24T10:55:18.687Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

Cognitive Effects of HIV-1 Infection

Published online by Cambridge University Press:  07 November 2014

Abstract

The major neurological complication of human immunodeficiency virus type 1 (HIV-1) infection is cognitive impairment, which can range in severity from a mild subclinical cognitive inefficiency to a severe dementing illness. Mild to moderate cognitive impairment is identified primarily by neuropsychological tests. The prevalence and severity of cognitive impairment associated with HIV-1 infection increases as the disease progresses. Deficits in attention, information processing speed, memory, and motor abilities can occur early in the course of HIV-1 infection, with deficits in abstraction and executive functions observed in later stages of infection. The nature of the cognitive impairment observed is thought to reflect the effects of HIV-1 infection on the integrity of subcortical or frontostriatal brain systems. Issues related to the detection of subclinical to severe cognitive impairment are discussed, along with the clinical significance of mild cognitive impairment as a significant risk factor for mortality in HIV-1 infection. The need to control for possible confounding factors that can influence test performance is also reviewed.

Type
Feature Articles
Copyright
Copyright © Cambridge University Press 2000

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Palmer, DL, Hjelle, BL, Wiley, CA, et al.HIV-1 infection despite immediate combination antiviral therapy after infusion of contaminated white cells. Am J Med. 1994;97:289295.CrossRefGoogle ScholarPubMed
2.American Academy of Neurology AIDS Task Force (Working Group). Nomenclature and research case definition for neurologic manifestations of human immunodeficiency virus-type 1 (HIV-1) infection. Neurology. 1991;41:778785.CrossRefGoogle Scholar
3.Goodkin, K, Wilkie, FL, Concha, M, et al.Subtle neuropsychological impairment and minor cognitive-motor disorder in HIV-1 infection: neuroradiological, neuro-physiological, neuroimmunological, and virological correlates. Neuroimaging Clin N Am. 1997;7(3):561579.Google Scholar
4.Concha, M, Rabinstein, A. Central nervous system opportunistic infections in HIV-1 infection. CNS Spectrums. 2000;5:4360.CrossRefGoogle ScholarPubMed
5.Wilkie, FL, Eisdorfer, C, Morgan, R, Loewenstein, DA, Szapocznik, J. Cognition in early human immunodeficiency virus infection. Arch Neurol. 1990;47:433440.CrossRefGoogle ScholarPubMed
6.White, DA, Heaton, RK, Monsch, AU, et al.Neuropsychological studies of asymptomatic human immunodeficiency virus type 1 infected individuals. J Int Neuropsychol Soc. 1995;1:304315.CrossRefGoogle ScholarPubMed
7.Heaton, RK, Grant, I, Butters, N, et al.The HNRC 500: neuropsychology of HIV infection at different disease stages. J Int Neuropsychol Soc. 1995;1:231251.CrossRefGoogle ScholarPubMed
8.McArthur, JC, Hoover, DR, Bacellar, H, et al.Dementia in AIDS patients: incidence and risk factors. Neurology. 1993;43:22452252.CrossRefGoogle ScholarPubMed
9. The Dana Consortium on Therapy for HIV Dementia and Related Cognitive Disorders. Clinical confirmation of the American Academy of Neurology algorithm for HIV-1-associated cognitive/motor disorder. Neurology. 1996;47:12471253.CrossRefGoogle Scholar
10.Grant, I, Heaton, RK, Ellis, RO, et al. Neurocognitive complications in HIV [abstract]. In: 12th World AIDS Conference. Geneva, June28-July 3, 1998. Bridging the Gap Conference Record. Int Con. AIDS. 1998:12:562. Abstract 32208.Google Scholar
11.Navia, BA, Cho, E-S, Petito, CK, et al.The AIDS dementia complex: I. clinical features. Ann Neurol. 1986;91:517524.CrossRefGoogle Scholar
12.Martin, A. HIV, cognition, and the basal ganglia. In: Grant, I, Martin, A, eds. Neuropsychology of HIV Infection. New York, NY: Oxford University Press; 1994:234.Google Scholar
13.Grant, I, Atkinson, JH, Hesselink, JR, et al.Evidence for early central nervous system involvement in the acquired immunodeficiency syndrome (AIDS) and other human immunodeficiency virus (HIV) infections: studies with neuropsychologic testing and magnetic resonance imaging. Ann Intern Med. 1987;107:828836.CrossRefGoogle ScholarPubMed
14.Harrison, MIJ, Newman, SP, Hall-Craggs, MA, et al.Evidence of CNS impairment in HIV infection: clinical, neuropsychological, EEG, and MRI/MRS study. J Neurol Neurosurg Psychiatry. 1998;5(3):301307.CrossRefGoogle Scholar
15.Bornstein, RA. Methodological and conceptual issues in the study of cognitive change in HIV infection. In: Grant, I, Martin, A, eds. Neuropsychology and HIV Infection. New York, NY: Oxford University Press; 1994:146160.Google Scholar
16.Wilkie, FL, Goodkin, K. Cognitive function in HIV-1 infection. In: Goodkin, K, Visser, AP, eds. Psychoneuroimmunology: Stress, Mental Disorders and Health. Washington, DC: American Psychiatric Press; 2000:195242.Google Scholar
17.Becker, JT, Caldararo, R, Lopez, OL, et al.Qualitative features of the memory deficit associated with HIV infection and AIDS: cross-validation of a discriminant function classification scheme. J Clin Exp Neuropsychol. 1995;17:134142.CrossRefGoogle ScholarPubMed
18.Peavy, G, Jacobs, D, Salmon, DP, et al.Verbal memory performance of patients with human immunodeficiency virus infection: evidence of subcortical dysfunction. J Clin Exp Neuropsychol. 1994;16:508523.CrossRefGoogle ScholarPubMed
19.Heindel, WC, Butters, N, Salmon, DP. Impaired learning of a motor skill in patients with Huntington's disease. Behav Neurosci. 1998;102:141147.CrossRefGoogle Scholar
20.Strub, RL, Black, FW. The mental status exam. In: Feinberg, YE, Farah, MJ, eds. Behavioral Neurology and Neuropsychology. New York, NY: McGraw Hill; 1997:2542.Google Scholar
21.Tross, S, Price, RW, Navia, B, et al.Neuropsychological performance in HIV-1 immunocompromised patients: a preliminary report. AIDS. 1988;2:8188.CrossRefGoogle Scholar
22.Stern, Y, Marder, K, Bell, K, et al.Multidisciplinary baseline assessment of homosexual men with and without human immunodeficiency virus infection: III. neurologic and neuropsychologic findings. Arch Gen Psychiatry. 1991;48:131138.CrossRefGoogle Scholar
23.Lunn, S, Skydsberg M, Schulsinger, et al.A preliminary report of the neuropsychological sequelae of human immunodeficiency virus. Arch Gen Psychiatry. 1991;48:139142.CrossRefGoogle ScholarPubMed
24.Miller, EN, Selnes, OA, McArthur, JC, et al.Neuropsychological performance in HIV-1 infected homosexual men: the Multicenter AIDS Cohort Study (MACS). Neurology. 1990;40:197203.CrossRefGoogle Scholar
25.Martin, EM, Robertson, LC, Edelstein, HE, et al.Performance of patients with HIV-1 infection on the Stroop task. J Clin Exp Neuropsychol. 1992;14:840851.CrossRefGoogle ScholarPubMed
26.Martin, EM, Robertson, LC, Sorensen, D, et al.Speed of memory scanning is not affected in early HIV-1 infection. J Clin Exp Neuropsychol. 1993;15:311320.CrossRefGoogle Scholar
27.Law, WA, Martin, A, Mapou, RL, et al.Working memory in individuals with HIV infection. J Clin Exp Neuropsychol. 1994;16:173182.CrossRefGoogle ScholarPubMed
28.Law, WA, Mapou, RL, Roller, TL, et al.Reaction time slowing in HIV-1 infected individuals: role of the preparatory interval. J Clin Exp Neuropsychol. 1995;17:122133.CrossRefGoogle ScholarPubMed
29.Martin, A, Heyes, MP, Salazar, AM, et al.Progressive slowing of reaction time and increasing cerebrospinal fluid concentrations of quinolinic acid in HIV-infected individuals. J Neuropsychiatry Clin Neurosci. 1992;4:270279.Google ScholarPubMed
30.Martin, EM, Sorensen, DJ, Edelstein, HE, Robertson, LC. Decision making speed in HIV-1 infection: a preliminary report. AIDS. 1992;6:109113.CrossRefGoogle ScholarPubMed
31.Miller, EN, Satz, P, Visscher, BV. Computerized and conventional neuropsychological assessment of HIV-1 infected homosexual men. Neurology. 1991;41:16081616.CrossRefGoogle ScholarPubMed
32.Miller, EN, Wilkie, FL. Computerized testing to assess cognition in HIV-positive individuals. In: Grant, I, Martin, A, eds. Neuropsychology of HIV Infection. New York, NY: Oxford University Press; 1994:161175.Google Scholar
33.Wilkie, FL, Morgan, R, Fletcher, MA, et al.Cognition and immune function in HIV-1 infection. AIDS. 1992;6:977981.CrossRefGoogle ScholarPubMed
34.Llorente, AM, Miller, EN, D'Elia, LF, et al.Slowed information processing in HIV-1 disease. The Multicenter AIDS Cohort Study (MACS). J Clin Exp Neuropsychol. 1998;20:6072.CrossRefGoogle Scholar
35.van Gorp, WG, Satz, P, Hinkin, C, et al.Metacognition in HIV-1 seropositive asymptomatic individuals: self ratings versus objective neuropsychological performance. Multicenter AIDS Cohort Study (MACS). J Clin Exp Neuropsychol. 1991;13:812819.CrossRefGoogle Scholar
36.Cummings, JL. Frontal-subcortical circuits and human behavior. Arch Neurol. 1993;50:873880.CrossRefGoogle ScholarPubMed
37.Joffe, R, Rubinow, D, Squillac, K, et al.Neuropsychiatric manifestations of the acquired immune deficiency syndrome (AIDS). Psychopharmacol Bull. 1986;22(3):684688.Google Scholar
38.Silberstein, CH, McKegney, FP, O'Dowd, MA, et al.A prospective longitudinal study of the neuropsychological and psychosocial factors in asymptomatic individuals at risk for HTLV-III/LAV infection in a methadone program: preliminary findings. Int J Neurosci. 1987;32:669676.CrossRefGoogle Scholar
39.van Gorp, WG, Miller, EN, Satz, P, Visscher, B. Neuropsychological performance in HIV-1 immunocompromised patients: a preliminary report. J Clin Exp Neuropsychol. 1989;11(5):763773.CrossRefGoogle ScholarPubMed
40.Butters, N, Grant, I, Haxby, J, et al.Special presentation: assessment of AIDS-related cognitive changes: recommendations of the NIMH Workshop on Neuropsychological Assessment Approaches. J Clin Exp Neuropsychol. 1990;12:963978.CrossRefGoogle Scholar
41.Folstein, MF, Folstein, SE, McHugh, PR. Mini Mental State: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189198.CrossRefGoogle ScholarPubMed
42.Power, C, Selnes, OA, Grim, JA, et al.HIV dementia scale: a rapid screening test. J Acquir Immune Defic Syndr Hum Retrovirol. 1995;8:273278.CrossRefGoogle ScholarPubMed
43.Skolasky, RL, Esposito, DR, Selnes, OA, Power, C, McArthur, JC. Modified HIV dementia scale: accurate stage of HIV-associated dementia [abstract]. Journal of Neurovirology. 1998;4(3):366.Google Scholar
44.Bornstein, RA, Nasrallah, HA, Para, MF, et al.Neuropsychological performance in symptomatic and asymptomatic HIV infection. AIDS. 1993;7:519524.CrossRefGoogle ScholarPubMed
45.Cohen, J, Goodkin, K, Wilkie, FL, et al. Association of cognitive function/disorder with functional status in HIV-1 seropositive homosexual men and women. Poster presentation at: 7th Annual Conference of Neuroimmune Circuits and Infectious Disease; October 7–9, 1999; NIH Clinical Center, Bethesda, Md.Google Scholar
46.Loewenstein, DA, Amigo, E, Duara, R, et al.A new scale for the assessment of functional status in Alzheimer's disease and related disorders. J Gerontol. 1989;44:114121.CrossRefGoogle ScholarPubMed
47.Albert, SM, Marder, K, Dooneief, G, et al.Neuropsychological impairment in early HIV infection: a risk factor for work disability. Arch Neurol. 1995;52:525530.CrossRefGoogle Scholar
48.Heaton, RK, Velin, RA, McCutchan, JA, et al.Neuropsychological impairment in HIV-infection: implications for employment. Psychosom Med. 1994;56:817.CrossRefGoogle ScholarPubMed
49.Mayeux, R, Stern, Y, Tang, M-X, et al.Mortality risks in gay men with human immunodeficiency virus infection and cognitive impairment. Neurology. 1993;43:176182.CrossRefGoogle ScholarPubMed
50.Wilkie, FL, Goodkin, K, Eisdorfer, C, et al.Mild cognitive impairment and risk of mortality in HIV-1 infection. J Neuropsychiatry Clin Neurosci. 1998;10:125132.CrossRefGoogle ScholarPubMed
51.Salthouse, TA. Theoretical Perspectives on Cognitive Aging. Hillsdale, NJ: Lawrence Erlbaum Associates; 1991.Google Scholar
52.Goodkin, K. Psychiatric disorders in HIV-spectrum illness. Tex Med. 1988;84:5561.Google ScholarPubMed
53.Goodkin, K, Shapshak, P, Metsch, L, et al.Cocaine abuse and HIV-1: epidemiology and neuropathogenesis. J Neuroimmunol. 1998;83:88101.CrossRefGoogle ScholarPubMed
54.Maj, M, Satz, P, Janssen, R, et al.WHO neuropsychiatric AIDS study, cross-sectional phase: II. neuropsychological and neurological findings. Arch Gen Psychiatry. 1994;51:5161.CrossRefGoogle ScholarPubMed
55.Bornstein, RA, Pace, P, Rosenberger, P, et al.Depression and neuropsychological performance in asymptomatic HIV infection. Am J Psychiatry. 1993b;150:922927.Google Scholar
56.Hinklin, CH, van Gorp, WG, Satz, P, et al.Depressed mood and its relationship to neuropsychological test performance in HIV-1 seropositive individuals. J Clin Exp Neuropsychol. 1992;14:289297.CrossRefGoogle Scholar
57.Mapou, RL, Law, WA, Martin, A, et al.Neuropsychological performance, mood, and complaints of cognitive and motor difficulties in individuals infected with the human immunodeficiency virus. J Neuropsychiatry Clin Neurosci. 1993;5:8693.Google ScholarPubMed
18
Cited by

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Cognitive Effects of HIV-1 Infection
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Cognitive Effects of HIV-1 Infection
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Cognitive Effects of HIV-1 Infection
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *