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Arch Neurol. 2008 Aug;65(8):1096-101. doi: 10.1001/archneur.65.8.1096.

Motor function and human immunodeficiency virus-associated cognitive impairment in a highly active antiretroviral therapy-era cohort.

Author information

  • 1Departments of Pathology, Mount Sinai Medical Center, Box 1052, One Gustave L Levy Place, New York, NY 10029, USA. jessica.robinson-papp@mssm.edu

Abstract

BACKGROUND:

Cognitive impairment has long been recognized as a manifestation of human immunodeficiency virus (HIV) infection. However, highly active antiretroviral therapy (HAART) has altered the neurologic manifestations of HIV.

OBJECTIVES:

To develop a measure to quantify the motor abnormalities included in the original descriptions of HIV-associated dementia (HAD); to determine whether motor, affective, and behavioral dysfunction predict cognitive impairment; and to determine whether quantitative motor testing is a helpful adjunct in the diagnosis of HAD in a complex population from the HAART era.

DESIGN:

Neurologic and neuropsychological data were collected from the Manhattan HIV Brain Bank, a longitudinal cohort study of patients with advanced HIV. The HIV-Dementia Motor Scale (HDMS) was developed and validated and cognitive and affective or behavioral function was quantified using global neuropsychological T scores, the Beck Depression Inventory (BDI), and an independent assessment of apathy. Relationships among cognitive, motor, affective, and behavioral performance were examined using correlation, linear regression, and analyses of variance.

SETTING:

An urban AIDS research center.

PARTICIPANTS:

A total of 260 HIV-positive, predominantly minority patients.

MAIN OUTCOME MEASURES:

The HDMS scores and global neuropsychological T scores.

RESULTS:

The HDMS and BDI scores were independent predictors of cognitive impairment. Significant cognitive impairment was found in patients with motor dysfunction. Patients diagnosed as having HAD had a greater degree of motor impairment than those with other neurocognitive diagnoses.

CONCLUSIONS:

Motor, affective, and behavioral abnormalities predict cognitive impairment in HIV-positive patients in this HAART-era cohort. The HDMS may be useful in the assignment of HIV-associated neurocognitive impairment in HIV populations in which normative data or neuropsychological test design is not optimal.

PMID:
18695060
[PubMed - indexed for MEDLINE]
PMCID:
PMC2696223
Free PMC Article

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