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Neuropsychological deficits in tests of executive function in asymptomatic and symptomatic HIV-1 seropositive men

Published online by Cambridge University Press:  09 July 2009

B. J. Sahakian ,
R. Elliott ,
N. Low ,
M. Mehta ,
R. T. Clark  and
A. L. Pozniak
B. J. Sahakian*
Affiliation:
Departments of Psychiatry and Experimental Psychology, University of Cambridge; and the Academic Unit of Genitourinary Medicine, King's College Hospital, London
R. Elliott
Affiliation:
Departments of Psychiatry and Experimental Psychology, University of Cambridge; and the Academic Unit of Genitourinary Medicine, King's College Hospital, London
N. Low
Affiliation:
Departments of Psychiatry and Experimental Psychology, University of Cambridge; and the Academic Unit of Genitourinary Medicine, King's College Hospital, London
M. Mehta
Affiliation:
Departments of Psychiatry and Experimental Psychology, University of Cambridge; and the Academic Unit of Genitourinary Medicine, King's College Hospital, London
R. T. Clark
Affiliation:
Departments of Psychiatry and Experimental Psychology, University of Cambridge; and the Academic Unit of Genitourinary Medicine, King's College Hospital, London
A. L. Pozniak
Affiliation:
Departments of Psychiatry and Experimental Psychology, University of Cambridge; and the Academic Unit of Genitourinary Medicine, King's College Hospital, London
*
1Address for correspondence: Dr Barbara J. Sahakian, Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ.
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Synopsis

There has been much debate about the exact nature and time of onset of the cognitive impairments associated with infection by the human immunodeficiency virus type 1 (HIV-1). Studies to date have not reached consistent conclusions. The present study comprised 22 asymptomatic and 18 symptomatic HIV-1 seropositive men, whose only risk factor for contraction of the virus was sexual intercourse, and 18 seronegative controls matched for age and IQ. Subjects were given computerized neuropsychological tests from the CANTAB battery, which assessed visuospatial memory, attention and executive function. Both the asymptomatic and the symptomatic HIV-1 seropositive subjects showed a selective pattern of deficits relative to the controls. In addition, the seropositive subjects were subtly but significantly impaired on tests of executive function but unimpaired on certain tests of visual memory. This finding supports an hypothesis that frontostriatal dysfunction occurs in HIV-1 infected individuals prior even to the expression of clinical symptoms.

Type
Original Articles
Information
Psychological Medicine , Volume 25 , Issue 6 , November 1995 , pp. 1233 - 1246
Copyright
Copyright © Cambridge University Press 1995

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References

REFERENCES

Aggleton, J. P., Hunt, P. R. & Rawlins, J. N. P. (1986). The effects of hippocampal lesions upon spatial and non-spatial tests of working memory. Behavioural Brain Research 19, 133–146.Google Scholar
Albert, M., Feldman, R. G. & Willis, A. L. (1974). The ‘subcortical dementia’ of progressive supranuclear palsy. Journal of Neurology, Neurosurgery and Psychiatry 37, 121–130.Google Scholar
Alexander, G. E., DeLong, M. R. & Strick, P. L. (1986). Parallel organisation of functionally segregated circuits linking basal ganglia and cortex. Annual Review of Neuroscience 9, 357–381.Google Scholar
Beats, B.C., Sahakian, B. J. & Levy, R. (1996). Cognitive performance in tests sensitive to frontal lobe dysfunction in the elderly depressed. Psychological Medicine 26, (in the press).Google Scholar
Benton, A. L. (1968). Differential behavioural effects in frontal lobe disease. Neuropsychologia 6, 53–60.CrossRefGoogle Scholar
Bornstein, R. A., Nasrallah, H. A., Para, M. F., Fass, R. J., Whitacre, C. C. & Rice, R. Jr. (1992). Neuropsychological performance in asymptomatic HIV infection. Journal of Neuropsychiatry and Clinical Neuroscience 4, 386–394.Google Scholar
CDC (1987). Revision of the CDC Surveillance Case Definition for Acquired Immunodeficiency Syndrome. MMWR 35, 334–339.Google Scholar
Cummings, J. L. (1986). Subcortical dementia: neuropsychology, neuropsychiatry and pathophysiology. British Journal of Psychiatry 149, 682–697.Google Scholar
Downes, J. J., Roberts, A. C., Sahakian, B. J., Evenden, J. L., Morris, R. G. & Robbins, T. W. (1989). Impaired extra-dimensional shift performance in medicated and unmedicated Parkinson's disease: evidence for a specific attentional dysfunction. Neuropsychologia 27, 1329–1343.CrossRefGoogle Scholar
Elliott, R., McKenna, P. J., Robbins, T. W. & Sahakian, B. J. (1995). Neuropsychological evidence for frontostriatal dysfunction in schizophrenia. Psychological Medicine 25, 619–630.Google Scholar
Funahashi, S., Bruce, C. J. & Goldman-Rakic, P. S. (1989). Mnemonic coding of visual space in the monkey's dorsolateral prefrontal cortex. Journal of Neurophysiology 61, 1–19.Google Scholar
Goldman-Rakic, P. S. (1990). Cellular and circuit basis of working memory in prefrontal cortex of non-human primates. In Progress in Brain Research, vol. 85 (ed. Uylings, H. B. M., Van Eden, C. G., De Bruin, J. P. C., Corner, M. A. and Feenstra, M. G. P.), pp. 325–336. Elsevier Science Publishers B.V.: New York.Google Scholar
Grant, I., Atkinson, J. H., Hesselink, J. R., Kennedy, C. J., Richman, D. D., Spector, S. A. & McCutchan, J. A. (1987). Evidence for early central nervous system involvement in the acquired immunodeficiency syndrome (AIDS) and other human immunodeficiency virus (HIV) infections. Annals of Internal Medicine 107, 828–836.Google Scholar
Kokkevi, A., Hatzakis, A., Maillis, A., Pittadaki, J., Zalonis, J., Samartzis, D., Touloumi, G., Mandalaki, T. & Stefanis, C. (1991). Neuropsychological assessment of HIV-seropositive haemophiliacs. AIDS 5, 1223–1229.Google Scholar
Lange, K. W., Sahakian, B. J., Quinn, N. P., Marsden, C. D. & Robbins, T. W. (1995). Comparison of executive and visuospatial memory function in Huntington's disease and dementia of the Alzheimer type matched for degree of dementia. Journal of Neurology, Neurosurgery and Psychiatry 58, 598–606.Google Scholar
Levin, H. S., Williams, D. H., Borucki, M. J., Hillman, G. R., Williams, J. B., Guinto, F. C., Amparo, E. G., Crow, W. J. & Pollard, R. B. (1990). Magnetic resonance imaging and neuropsychological findings in human immunodeficiency virus infection. Journal of Acquired Immunodeficiency Syndromes 3, 757–762.Google Scholar
Lunn, S., Skydsbjerg, M., Schulsinger, H., Parnas, J., Pedersen, C. & Mathieson, L. (1991). A preliminary report on the neuropsychologic sequelae of human immunodeficiency virus. Archives of General Psychiatry 48, 139–142.Google Scholar
McAllister, R. H., Herns, M. V., Harrison, M. J. G., Newman, S. P., Connolly, S., Fowler, C. J., Fell, M., Durrance, P., Manji, H., Kendall, B. E., Valentine, A. R., Weller, I. V. D. & Adler, M. (1992). Neurological and neuropsychological performance in HIV seropositive men without symptoms. Journal of Neurology, Neurosurgery and Psychiatry 55, 143–148.CrossRefGoogle Scholar
Marsh, N. V. & McCall, D. W. (1994). Early neuropsychological change in HIV infection. Neuropsychology 8, 44–48.CrossRefGoogle Scholar
Miller, E. N., Selnes, O. A., McArthur, J. C., Satz, P., Becker, J. T., Cohen, B. A., Sheridan, K., Machado, A. M., Van Gorp, W. G. & Visscher, B. (1990). Neuropsychological performance in HIV-1 infected homosexual men. Neurology 40, 197–203.Google Scholar
Mishkin, M. (1982). A memory system in the monkey. Philosophical Transactions of the Royal Society of London B298, 85–92.Google Scholar
Morris, R. G., Downes, J. J., Sahakian, B. J., Evenden, J. L., Heald, A. & Robbins, T. W. (1988). Planning and spatial working memory in Parkinson's disease. Journal of Neurology, Neurosurgery and Psychiatry 51, 757–766.Google Scholar
Olton, D. S. & Papas, B. C. (1979). Spatial memory and hippocampal function. Neuropsychologia 17, 669–682.Google Scholar
Owen, A. M. (1992). Fronto-striatal mechanisms in planning and attention. Ph.D. thesis. Institute of Psychiatry, University of London.Google Scholar
Owen, A. M., Downes, J. J., Sahakian, B. J., Polkey, C. E. & Robbins, T. W. (1990). Planning and spatial working memory following frontal lobe lesions in man. Neuropsychologia 28, 1021–1034.CrossRefGoogle Scholar
Owen, A. M., Roberts, A. C., Polkey, C. E., Sahakian, B. J. & Robbins, T. W. (1991). Extra-dimensional versus intra-dimension-al set shifting performance following frontal lobe excisions, temporal lobe excisions or amygdalo-hippocampectomy in Man. Neuropsychologia 10, 993–1006.CrossRefGoogle Scholar
Owen, A. M., James, M., Leigh, P. N., Summers, B. A., Marsden, C. D., Quinn, N. P., Sahakian, B. J. & Robbins, T. W. (1992). Frontostriatal cognitive deficits at different stages of Parkinson's disease. Brain 115, 1727–1751.Google Scholar
Owen, A. M., Sahakian, B. J., Hodges, J. R., Summers, B. A., Polkey, C. E. & Robbins, T. W. (1995 a). Dopamine-dependent frontostriatal planning deficits in early Parkinson's disease. Neuropsychology 9, 126–140.Google Scholar
Owen, A. M., Sahakian, B. J., Semple, J., Polkey, C. E. & Robbins, T. W. (1995 b). Visuo-spatial short term recognition memory and learning after temporal lobe excisions or amygdalo-hippocampectomy in man. Neuropsychologia 33, 1–24.Google Scholar
Passingham, R. E. (1985). Memory of monkeys (Macaca mulatta) with lesions of the prefrontal cortex. Behavioural Neuroscience 99, 3–21.Google Scholar
Price, R. W., Brew, B., Sidtis, J., Rosenblum, M., Scheck, A. C. & Cleary, P. (1988). The brain in AIDS: central nervous system HIV-1 infection and AIDS dementia complex. Science 239, 586–592.CrossRefGoogle Scholar
Price, R. W., Brew, B. J. & Rosenblum, M. (1990). The AIDS dementia complex and HIV-1 infection: a pathogenetic model of virus-immune interaction. In Immunologic Mechanisms in Neurologic and Psychiatric Disease (ed. Waksman, B. H.), pp. 269–290. Raven Press: New York.Google Scholar
Rawlins, J. N. P. & Tsaltas, E. (1983). The hippocampus, time and working memory. Behavioural Brain Research 10, 233–262.Google Scholar
Robbins, T. W. (1990). The case for frontostriatal dysfunction in schizophrenia. Schizophrenia Bulletin 16, 391–402.Google Scholar
Robbins, T. W., James, M., Lange, K. W., Owen, A. M., Quinn, N. P. & Marsden, C. D. (1992). Cognitive performance in multiple system atrophy. Brain 115, 271–291.CrossRefGoogle Scholar
Robbins, T. W., James, M., Owen, A. M., Lange, K. W., Lees, A. J., Leigh, P. N., Marsden, C. D., Quinn, N. P. & Summers, B. A. (1994 a). Cognitive deficits in progressive supranuclear palsy, Parkinson's disease, and multiple system atrophy in tests sensitive to frontal lobe dysfunction. Journal of Neurology, Neurosurgery and Psychiatry 57, 79–88.CrossRefGoogle Scholar
Robbins, T. W., James, M., Owen, A. M., Sahakian, B. J., McInnes, L. & Rabbitt, P. (1994 b). Cambridge Neuropsychological Battery (CANTAB): a factor analytic study of a large sample of normal elderly volunteers. Dementia 5, 266–281.Google Scholar
Sahakian, B. J. & Owen, A. M. (1992). Computerised assessment in neuropsychiatry using CANTAB: discussion paper. Journal of the Royal Society of Medicine 85, 399–402.Google Scholar
Sahakian, B. J., Morris, R. G., Evenden, J. L., Heald, A., Levy, R., Philpot, M. & Robbins, T. W. (1988). A comparative study of visuospatial memory and learning in Alzheimer-type dementia and Parkinson's disease. Brain 111, 695–718.Google Scholar
Sahakian, B. J., Downes, J. J., Eagger, S., Evenden, J. L., Levy, R., Philpot, M. P., Roberts, A. C. & Robbins, T. W. (1990). Sparing of attentional relative to mnemonic function in a subgroup of patients with dementia of the Alzheimer type. Neuropsychologia 28, 1197–1213.Google Scholar
Sahgal, A. & Iversen, S. D. (1978). Categorisation and retrieval after selective inferotemporal lesions in monkeys. Brain Research, Amsterdam 146, 341–350.Google Scholar
Selnes, O. A., Miller, E., McArthur, J., Gordon, B., Munoz, A., Sheridan, K., Fox, R. & Saah, A. J. (1990). HIV-1 infection: no evidence of cognitive decline during the asymptomatic stages. Neurology 40, 204–208.Google Scholar
Shallice, T. (1982). Specific impairments in planning. Philosophical Transacts of the Royal Society of London B298, 199–209.Google Scholar
Sinforiani, E., Mauri, M., Bono, G., Muratori, S., Alessi, E. & Minoli, L. (1991). Cognitive abnormalities and disease progression in a selected population of asymptomatic HIV-positive subjects. AIDS 5, 1117–1120.CrossRefGoogle Scholar
Stern, Y., Marder, K., Bell, K., Chen, J., Dooneief, G., Goldstein, G., Mindry, D., Richards, M., Sano, M., Williams, J., Gorman, J., Ehrhardt, A. & Mayeux, R. (1991). Multidisciplinary baseline assessment of homosexual men with and without human immunodeficiency virus infection. Archives of General Psychiatry 48, 131–138.Google Scholar
Van Gorp, W. G., Lamb, D. C. & Schmitt, F. A. (1993). Methodologic issues in neuropsychological research with HIV-spectrum disease. Archives of Clinical Neuropsychology 8, 17–33.CrossRefGoogle Scholar
Villa, G., Monteleone, D., Marra, C., Bartoli, A., Antinori, A., Pallavicini, F., Tamburrini, E. & Izzi, I. (1993). Neuropsychological abnormalities in AIDS and asymptomatic HIV seropositive patients. Journal of Neurology, Neurosurgery and Psychiatry 56, 878–884.Google Scholar
Weatherburn, P., Davies, P. M., Hickson, F. C. I., Hunt, A. J., McManus, T. J. & Coxon, A. P. M. (1993). No connection between alcohol use and unsafe sex among gay and bisexual men. AIDS 7, 115–119.Google Scholar
Winer, B. J. (1971). Statistical Principles in Experimental Design, 2nd edn.McGraw-Hill: New York.Google Scholar