Preliminary study of a novel cognitive assessment device for the evaluation of HIV-associated neurocognitive impairment

J Neurovirol. 2016 Dec;22(6):816-822. doi: 10.1007/s13365-016-0458-z. Epub 2016 May 31.

Abstract

Given the high prevalence of HIV-associated neurocognitive disorders (HAND), we examined the performance of a novel computerized cognitive assessment device (NCAD) for the evaluation of neurocognitive impairment in the setting of HIV. In addition to a standard 8-test neuropsychological battery, each participant underwent testing with the NCAD, which requires approximately 20 min and has been shown to accurately measure neurocognition in elderly individuals. The NCAD yields seven subtest scores in addition to an overall predictive score that is calculated based on subtest results. Thirty-nine HIV-infected participants were included in this study; the majority of which (71.8 %) had undetectable plasma HIV RNA levels and a history of significant immunocompromise (median nadir CD4+ count 34 cells/μl). The mean composite neuropsychological score (NPT-8) was 46.07, and mean global deficit score (GDS) was 0.59. NCAD total subtest accuracy correlated significantly with NPT-8 (Pearson correlation r = 0.59, p < 0.0001) as well as GDS (Spearman's rho = -0.36, p = 0.02). NCAD predictive score also correlated significantly with NPT-8 (Spearman's rho = -0.5601, p = 0.0016) and GDS (Spearman's rho = 0.45, p = 0.0144). When using the most recent nosology of HAND criteria for neurocognitive impairment, the area under the curve (AUC) for NCAD total subtest accuracy was 0.7562 (p = 0.012), while the AUC for the HIV dementia scale was 0.508 (p = 0.930). While not as comprehensive as a full neuropsychological battery, the NCAD shows promise as a rapid screening tool for HIV-infected individuals, and additional research of this device is indicated.

Keywords: AIDS; AIDS dementia complex; Cognition; HIV; Memory.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Area Under Curve
  • Brain-Computer Interfaces*
  • CD4 Lymphocyte Count
  • Cognitive Dysfunction / complications
  • Cognitive Dysfunction / diagnosis*
  • Cognitive Dysfunction / physiopathology
  • Cognitive Dysfunction / psychology
  • Equipment Design
  • Female
  • Georgia
  • HIV Infections / complications
  • HIV Infections / diagnosis*
  • HIV Infections / physiopathology
  • HIV Infections / psychology
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests*
  • RNA, Viral / blood
  • Sensitivity and Specificity
  • Severity of Illness Index

Substances

  • RNA, Viral