Stout JC, Taylor MJ, Kirson D, Peavy G, Butters N, Salmon DP, Heaton R, Chandler JL, Atkinson H, Grant I; International Conference on AIDS.
Int Conf AIDS. 1992 Jul 19-24; 8: 137 (abstract no. PuB 7530).
HIV Neurobehavioral Research Center, University of California, San Diego.
BACKGROUND: Neuropsychological defects in HIV+ symptomatic individuals have been repeatedly demonstrated, however, the neurocognitive status of HIV+ asymptomatic individuals is a matter of controversy. We investigated whether more subtle declines in cognitive function, which may be associated with asymptomatic HIV infection, would be detected using a sensitive, demanding test of working memory, the Reading Span Test (Daneman & Carpenter [1983]. Journal of Exp. Psychol, 9, 561) SUBJECTS: HIV+ symptomatic (n = 19), HIV+ asymptomatic (n = 93), and seronegative (HIV-) males (n = 42) from the HIV Neurobehavioral Research Center (HNRC) received evaluations in medicine, virology, neurology, neuropsychology, psychiatry, and brain imaging, and were matched for age and education. Scores for the HIV+ symptomatic group were lower on the Dementia Rating Scale, and higher on the Beck Depression Inventory than the other two groups, but did not indicate clinically significant levels of dementia or depression. PART A: For the Reading Span Test, subjects were instructed to read aloud 2-5 sentences, each presented on a white card, and then recall the final word of all the sentences in that group. The reading span score was the number of sentences in a group that a subject could read, and correctly recall final words; total number of correct trials (of the 5 per level) was also recorded. Results of ANOVA and post-hoc comparisons indicated that both symptomatic and asymptomatic HIV+ groups had poorer performances than did HIV- controls on reading span and number of correct trials; these differences were not accounted for by levels of depression. Thus, the Reading Span Test appears to be sensitive enough to detect a decline in cognitive functioning in asymptomatic as well as symptomatic HIV+ subjects. PART B: HIV+ asymptomatic subjects (from Part A) were assigned clinical ratings from the HNRC neuropsychological evaluation, in seven cognitive ability areas (global, attention, verbal, abstraction, learning, sensory, and motor) by an neuropsychologist who was unaware of subjects' performance on the Reading Span Test. For each ability area, the groups rated clinically as "impaired" and "unimpaired" were compared (t-tests) on Reading Span Test scores. Groups "impaired" on global cognitive functioning, and on attention, verbal, and abstraction, performed more poorly on the Reading Span Test. Ratings of learning, sensory, and motor impairment were not associated with group differences in Reading Span scores. CONCLUSIONS: Both symptomatic and asymptomatic HIV+ subjects performed more poorly on the Reading Span Test, a task that burdens working memory and requires divided attention. The consistency of this finding in asymptomatic HIV+ subjects with the clinical ratings of impairments in global, attention, verbal, and abstraction abilities, provides consensual validation that performance on the Reading Span Test declines in some HIV+ asymptomatic individuals. As deterioration of attentional abilities is a prominent feature of subcortical dementias, these findings support the hypothesis that early declines in cognitive functions of HIV+ individuals may be of subcortical origin.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Aptitude
- Attention
- Case-Control Studies
- HIV Infections
- HIV Seropositivity
- Humans
- Male
- Memory, Short-Term
- Mental Recall
- Reading
- Research Design
Other ID:
UI: 102201306
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