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Nerological Soft Signs in HIV-associated Neurocognitive Disorder: a Clinical Marker?

Published online by Cambridge University Press:  15 April 2020

P. Toro
Affiliation:
Department of Psychiatry, Facultad de Medicina. Pontificia Universidad Católica de Chile, Santiago, Chile
M.E. Ceballos
Affiliation:
Department of Infectious Diseases, Facultad de Medicina. Pontificia Universidad Católica de Chile, Santiago, Chile
D. Valenzuela
Affiliation:
Department of Psychiatry, Facultad de Medicina. Pontificia Universidad Católica de Chile, Santiago, Chile
M.F. Inostroza
Affiliation:
Department of Psychiatry, Facultad de Medicina. Pontificia Universidad Católica de Chile, Santiago, Chile
J. Schröder
Affiliation:
Sektion for Geriatric Psychiatry, University of Heidelberg, Heidelberg, Germany

Abstract

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Introduction

With the introduction of antiretroviral treatment, the survival rates of Human Immunodeficiency virus (HIV) patients have improved significantly. However, the incidence of HIV- associated neurocognitive disorders (HAND) gained importance and represents actually a significant public health problem.

Neurological soft signs (NSS) refers to subtle neurological abnormalities in motor and sensory performance. The presence of these symptoms has been widely described in patients with mental diseases like Schizophrenia or Alzheimer’s Disease, but have not been studied in HAND despite its known subcortical physiopathology.

Objectives

To study the prevalence HAND in a Chilean cohort of HIV patients and describe its association to NSS.

Methods

HIV patients without history of head injury trauma or opportunistic infections of the CNS were recruited from the HIV clinic, underwent a thorough clinical interview and neuropsychological testing. Healthy controls were recruited from the community. All participants were assessed with the Heidelberger NSS scale. HAND was diagnosed using NIMH and NINDS criteria.

Results

Until now, 35 HIV+ patients and 18 controls completed the described assessment. 11 patients were cognitive healthy, 11 with Asymptomatic Neurocognitive Impairment (ANI) and 13 with Mild Neurocognitive Disorder (MND). NSS total score differed significantly between groups (F= 2,92 (DF=3), p<0.05), with MND and ANI patients showing the highest score. Duncan post hoc test showed group differences in NSS total scores with Controls >ANI, MND and Cognitive healthy HIV>MND.

Discussion

Our data supports the use of NSS as a marker of HAND. It should be considered in the clinical examination of HIV patients.

Type
Article: 1276
Copyright
Copyright © European Psychiatric Association 2015
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