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A longitudinal study of the neuropsychiatric consequences of HIV-1 infection in gay men. I Neuropsychological performance and neurological status at baseline and at 12-month follow-up

Published online by Cambridge University Press:  09 July 2009

A. P. Burgess*
Affiliation:
Academic Department of Psychiatry, Charing Cross and Westminster Medical School, Chelsea and Westminster Hospital, Department of Genito-Urinary Medicine, St Stephen's Clinic, London; Department of Psychiatry, Royal South Hants Hospital, Southampton
M. Riccio
Affiliation:
Academic Department of Psychiatry, Charing Cross and Westminster Medical School, Chelsea and Westminster Hospital, Department of Genito-Urinary Medicine, St Stephen's Clinic, London; Department of Psychiatry, Royal South Hants Hospital, Southampton
D. Jadresic
Affiliation:
Academic Department of Psychiatry, Charing Cross and Westminster Medical School, Chelsea and Westminster Hospital, Department of Genito-Urinary Medicine, St Stephen's Clinic, London; Department of Psychiatry, Royal South Hants Hospital, Southampton
K. Pugh
Affiliation:
Academic Department of Psychiatry, Charing Cross and Westminster Medical School, Chelsea and Westminster Hospital, Department of Genito-Urinary Medicine, St Stephen's Clinic, London; Department of Psychiatry, Royal South Hants Hospital, Southampton
J. Catalan
Affiliation:
Academic Department of Psychiatry, Charing Cross and Westminster Medical School, Chelsea and Westminster Hospital, Department of Genito-Urinary Medicine, St Stephen's Clinic, London; Department of Psychiatry, Royal South Hants Hospital, Southampton
D. A. Hawkins
Affiliation:
Academic Department of Psychiatry, Charing Cross and Westminster Medical School, Chelsea and Westminster Hospital, Department of Genito-Urinary Medicine, St Stephen's Clinic, London; Department of Psychiatry, Royal South Hants Hospital, Southampton
T. Baldeweg
Affiliation:
Academic Department of Psychiatry, Charing Cross and Westminster Medical School, Chelsea and Westminster Hospital, Department of Genito-Urinary Medicine, St Stephen's Clinic, London; Department of Psychiatry, Royal South Hants Hospital, Southampton
E. Lovett
Affiliation:
Academic Department of Psychiatry, Charing Cross and Westminster Medical School, Chelsea and Westminster Hospital, Department of Genito-Urinary Medicine, St Stephen's Clinic, London; Department of Psychiatry, Royal South Hants Hospital, Southampton
J Gruzelier
Affiliation:
Academic Department of Psychiatry, Charing Cross and Westminster Medical School, Chelsea and Westminster Hospital, Department of Genito-Urinary Medicine, St Stephen's Clinic, London; Department of Psychiatry, Royal South Hants Hospital, Southampton
C. Thompson
Affiliation:
Academic Department of Psychiatry, Charing Cross and Westminster Medical School, Chelsea and Westminster Hospital, Department of Genito-Urinary Medicine, St Stephen's Clinic, London; Department of Psychiatry, Royal South Hants Hospital, Southampton
*
1Address for correspondence: Mr A. P. Burgess, Academic Department of Psychiatry, Charing Cross and Westminster Medical School, Chelsea & Westminster Hospital, 369 Fulham Road, London SW10 9NG

Synopsis

The aim of this study was to determine whether HIV infection is associated with neurological or neuropsychological impairment in the asymptomatic and early symptomatic stages of disease. Subjects included 61 gay men (41 HIV −, 20 HIV +) who were assessed at the time of requesting their first HIV test and again 12 months later. The assessments at baseline were conducted double-blind to HIV serostatus. Measures included a neuropsychological battery, neurological examination and full psychiatric assessment. There were no differences between the asymptomatic HIV + and HIV − groups at baseline or at follow-up in terms of mean scores on neuropsychological tests. Mean scores were within the normal range for all neuropsychological tests for both groups. Multiple regression analysis was used to predict each individual's performance at follow-up on the basis of their baseline performance, psychiatric state, neurological history and drug use for each of the neuropsychological tests. HIV + subjects were more likely than control subjects to perform at a significantly lower level at follow-up on one or more tests than predicted on the basis of their baseline performance.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1994

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References

Baddeley, A. (1981). The cognitive psychology of everyday life, British Journal of Experimental Psychology 72, 257269.CrossRefGoogle Scholar
Benton, A. & Hamsher, K. (1976). Multi-lingual Aphasia Examination. University of Iowa: Iowa City.Google Scholar
Burgess, A. P. & Riccio, M. (1992). Cognitive impairment and dementia in HIV infection. In Balliere's Clinical Neurology (ed Rudge, P.), pp. 155174. Balliere Tindall: London.Google Scholar
Grant, I., Atkinson, J., Hesselink, J., Kennedy, C., Richman, D., Spector, S. & McCutchan, J. (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, 828836.CrossRefGoogle ScholarPubMed
Grassi, M., Clerici, F., Perin, C., Mezzenzana, M., Dedivitis, G., Cargnel, A. & Mangoni, A. (1991). Evaluation of cognitive functions in HIV-positive intravenous drug users.VIIth International Conference on AIDS,Florence,16–21 June, 1991, Published Abstract MB2085.Google Scholar
Janssen, R., Saykin, A., Cannon, L., Campbell, J., Pinsky, P., Hessol, N., O'Malley, P., Lifson, A., Doll, L., Rutherford, G. & Kaplan, J. (1989). Neurological and neuropsychological manifestations of HIV-1 infection: association with AIDS-related complex but not asymptomatic HIV-1 infection. Annals of Neurology 26, 592600.CrossRefGoogle Scholar
Klimes, I., Elcombe, S., Hodges, S., Catalan, J., Day, A., Garrod, A., Bond, A. & Rizza, C. (1991). Neuropsychological status of men with haemophilia and HIV infection: a controlled investigation – one year follow-up.VIIth International Conference on AIDS,Florence,16–21 June, 1991, Published Abstract MB2089.Google Scholar
Lunn, S., Skydsbjerg, M., Schulsinger, H., Parnas, J., Pederson, C. & Mathiesen, L. (1991). A preliminary report on the neuropsychologic sequelae of human immuno-deficiency virus. Archives of General Psychiatry 48, 139142.CrossRefGoogle Scholar
McArthur, J., Cohen, B., Selnes, O., Kumar, A., Cooper, K., McArthur, J. H., Soucy, G., Cornblath, D., Chmiel, J., Wanmg, M., Starkey, D., Ginzburg, H., Ostrow, D., Johnson, R., Phair, J. & Polk, B. (1989). Low prevalence of neurological and neuropsychological abnormalities in otherwise healthy HIV-1 infected individuals: results from the Multicenter AIDS Cohort Study. Annals of Neurology 26, 601611.CrossRefGoogle ScholarPubMed
Matthews, C. & Klove, H. (1964). Instruction Manual for the Adult Neuropsychology Test Battery. University of Wisconsin Medical School Madison, Wisconsin.Google Scholar
Miller, E., Seines, O., McArthur, J., Satz, P., Becker, J., Cohen, B., Sheridan, K., Machado, A., Van Gorp, W. & Visscher, B. (1990). Neuropsychological performance in HIV-1-infected homosexual men: the Multicenter AIDS Cohort Study (MACS). Neurology 40, 197203.CrossRefGoogle ScholarPubMed
Milner, B. (1971). Interhemispheric differences in the localisation of psychological processes in man. British Medical Bulletin 27, 272277.CrossRefGoogle ScholarPubMed
Mortimer, P., Parry, J. & Mortimer, J. (1985). Which anti-HTLV assays for screening and confirmation testing. Lancet ii, 873877.CrossRefGoogle Scholar
Navia, B., Jordan, B. & Price, R., (1986 a). The AIDS dementia complex: I Clinical features. Annals of Neurology 19, 517524.CrossRefGoogle ScholarPubMed
Navia, B., Cho, E., Petito, C. & Price, R. (1986 b). The AIDS dementia complex: II Neuropathology. Annals of Neurology 19, 525535.CrossRefGoogle ScholarPubMed
Nelson, H. (1976). A modified Card Sorting Test sensitive to frontal lobe defects. Cortex 12, 313324.CrossRefGoogle ScholarPubMed
Nelson, H. (1982). The National Adult Reading Test, NFER-Nelson: Windsor.Google Scholar
Norusis, M. (1988). Statistical Package for Social Scientists (SPSS PC+). SPSS INC: Chicago.Google Scholar
Pugh, K., Riccio, M., Jadresic, D., Burgess, A. P., Baldeweg, T., Catalan, J., Lovett, E., Hawkins, D. A., Gruzelier, J. & Thompson, C. (1994). A longitudinal study of the neuropsychiatric consequences of HIV-1 infection in gay men. II Psychosocial and health status at baseline and at 12-month follow-up. Psychological Medicine 24, 897904.CrossRefGoogle Scholar
Reitan, R. (1958). Validity of the Trail Making Test as an indication of organic brain damage. Perceptual and Motor Skills 8, 271276.CrossRefGoogle Scholar
Riccio, M., Pugh, K., Jadresic, D., Catalán, J.Burgess, A. P., Thompson, C., Wilson, B. A., Lovett, E., Baldeweg, T. & Hawkins, D. (1993). Neuropsychiatric aspects of HIV-1 infection in gay men: a controlled investigation of psychiatric, neuropsychological and neurological status. Journal of Psychosomatic Research 37, 819830.CrossRefGoogle Scholar
Satz, P., Morgernstern, H., Miller, E., Selnes, O., McArthur, J., Cohen, B., Wesch, J., Becker, J., Jacobson, L., D'Elia, L., van Gorp, W. & Visscher, B. (1993). Low education as a possible risk factor for cognitive abnormalities in HIV-1: findings from the Multicenter AIDS Cohort Study (MACS). Journal of Acquired Immune Deficiency Syndromes 6, 503511.CrossRefGoogle ScholarPubMed
Saykin, A., Janssen, R., Sprehn, G., Kaplan, J., Spira, T. & O'Connor, B. (1992). Longitudinal evaluation of neuropsychological function in homosexual men with HIV infection: 18-month follow-up. Journal of Neuropsychiatry and Clinical Neurosciences 3, 286298.Google Scholar
Seines, O., Miller, E., McArthur, J., Gordon, B., Muñoz, A., Sheridan, K., Fox, R., Saah, A. J. & the Multicentre AIDS Cohort Study. (1990). HIV-1 Infection: no evidence of cognitive decline during the asymptomatic stages. Neurology 40, 204208.Google Scholar
Selnes, O., McArthur, J., Royal, W, Updike, M. L., Nance-Spronson, T., Concha, M., Gordon, B., Soloman, L. & Vlahov, D. (1992). HIV-1 infection and intravenous drug use: longitudinal neuropsychological evaluation of asymptomatic subjects. Neurology 42, 19241929.CrossRefGoogle ScholarPubMed
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, 11171120.CrossRefGoogle Scholar
Stern, Y., Marder, K., Bell, K., Chen, J., Doonief, G., Goldstein, S., 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 immuno-deficiency virus infection. III Neurologic and neuropsychological findings. Archives of General Psychiatry 48, 131138.CrossRefGoogle Scholar
Tross, S., Price, R., Navia, B., Thaler, H., Gold, J., Hirsch, D. & Sidtis, J. (1988). Neuropsychological characterisation of the AIDS dementia complex: a preliminary report. AIDS 2, 8188.CrossRefGoogle ScholarPubMed
Warrington, E. & Taylor, A. (1973). The contribution of the right parietal lobe to object recognition. Cortex 9, 152164.CrossRefGoogle ScholarPubMed
Wechsler, D. (1945). A standardised memory scale for clinical use. Journal of Psychology 19, 8795.CrossRefGoogle Scholar
Wechsler, D. (1981). The Wechsler Adult Intelligence Scale – Revised. The Psychological Corporation: New York.Google Scholar
Wilkie, F., Eisdorfer, C., Morgan, R., Loewenstein, D. & Szapocznik, J. (1990). Cognition in early human immunodeficiency virus infection. Archives of Neurology 47, 433440.CrossRefGoogle ScholarPubMed
Wilkins, J., Robertson, K., van der Horst, C., Robertson, W., Fryer, J. & Hall, C. (1990). The importance of confounding factors in the evaluation of neuropsychological changes in patients infected with human immunodeficiency virus. Journal of Acquired Immune Deficiency Syndromes 3, 938942.Google ScholarPubMed
Wilson, B., Cockburn, J. & Baddeley, A. (1985). Rivermead Behavioural Memory Test. Thames Valley Test Company: Reading.Google Scholar
Wing, J., Cooper, J. & Sartorius, N. (1974). The Measurement and Classification of Psychiatric Symptoms. Cambridge University Press: Cambridge.Google Scholar
World Health Organization (1990). Report of the Second Consultation on the Neuropsychiatric Aspects of HIV-1 Infection. 11–13 01 1990, Geneva.Google Scholar
Zigmond, A. & Snaith, R. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavia 67, 361370.CrossRefGoogle ScholarPubMed