Format

Send to

Choose Destination
J Neurovirol. 2016 Aug;22(4):472-8. doi: 10.1007/s13365-015-0415-2. Epub 2016 Jan 5.

International neurocognitive normative study: neurocognitive comparison data in diverse resource-limited settings: AIDS Clinical Trials Group A5271.

Author information

1
Department of Neurology, University of North Carolina, 2127 Physician Office Building, 170 Manning Drive, Chapel Hill, NC, 27599-7025, USA. kevinr@neurology.unc.edu.
2
Harvard University, Boston, MA, USA.
3
University of Washington, Seattle, WA, USA.
4
Northwestern University, Chicago, IL, USA.
5
University of Zimbabwe, Harare, Zimbabwe.
6
Johns Hopkins University, Baltimore, MD, USA.
7
Fiocruz, Rio De Janeiro, Brazil.
8
University of Colorado Denver, Aurora, CO, USA.
9
Frontier Science, Buffalo, NY, USA.
10
Queen Elizabeth, Blantyre, Malawi.
11
Chiang Mai University, Chiang Mai, Thailand.
12
NARI, Pune, India.
13
YRGCARE, Chennai, India.
14
Asociacion Civil Impacta Salud y Educacion, Lima, Peru.
15
Naval Medical Research Unit Six (NAMRU-6), Lima, Peru.
16
UNC Project, Lilongwe, Malawi.
17
University of the Witwatersrand, Johannesburg, South Africa.
18
Social Scientific Systems, Silver Springs, MD, USA.
19
University of KwaZulu-Natal, Durban, South Africa.

Abstract

Infrastructure for conducting neurological research in resource-limited settings (RLS) is limited. The lack of neurological and neuropsychological (NP) assessment and normative data needed for clinical interpretation impedes research and clinical care. Here, we report on ACTG 5271, which provided neurological training of clinical site personnel and collected neurocognitive normative comparison data in diverse settings. At ten sites in seven RLS countries, we provided training for NP assessments. We collected normative comparison data on HIV- participants from Brazil (n = 240), India (n = 480), Malawi (n = 481), Peru (n = 239), South Africa (480), Thailand (n = 240), and Zimbabwe (n = 240). Participants had a negative HIV test within 30 days before standardized NP exams were administered at baseline and 770 at 6 months. Participants were enrolled in eight strata, gender (female and male), education (<10 and ≥10 years), and age (<35 and ≥35 years). Of 2400 enrolled, 770 completed the 6-month follow-up. As expected, significant between-country differences were evident in all the neurocognitive test scores (p < 0.0001). There was variation between the age, gender, and education strata on the neurocognitive tests. Age and education were important variables for all tests; older participants had poorer performance, and those with higher education had better performance. Women had better performance on verbal learning/memory and speed of processing tests, while men performed better on motor tests. This study provides the necessary neurocognitive normative data needed to build infrastructure for future neurological and neurocognitive studies in diverse RLS. These normative data are a much-needed resource for both clinicians and researchers.

KEYWORDS:

Cognitive impairment; Neurocognitive assessment; Neuropsychological functioning; Normative comparison data; Resource limited

PMID:
26733457
PMCID:
PMC4981921
DOI:
10.1007/s13365-015-0415-2
[Indexed for MEDLINE]
Free PMC Article

Publication types, MeSH terms, Grant support

Supplemental Content

Full text links

Icon for Springer Icon for PubMed Central
Loading ...
Support Center