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Sharma A, Mohanty M, Salan T, Aggarwal D, Mandell L, Jones DL, Arheart K, Sharma A, Vyas S, Singh P, Govind V, Kumar M. Sex differences in cognitive function among people with HIV-1 clade C infection in Northern India. J Neurovirol 2023; 29:614-625. [PMID: 37698788 DOI: 10.1007/s13365-023-01166-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/25/2023] [Accepted: 08/02/2023] [Indexed: 09/13/2023]
Abstract
Human immunodeficiency virus-1 (HIV-1) clade C is the most prevalent form of HIV-1 comprising nearly 46% of global infections and is the dominant subtype in India. Despite its predominance, the impact of HIV-1 clade C infection on cognitive function has been understudied in comparison with other subtypes, notably clade B, which is primarily found in Europe and North America. Few studies have assessed cognitive impairment in antiretroviral therapy (ART) naïve men and women with HIV-1 clade C infection. In this study conducted in Northern India, differences in neuropsychological functioning were compared between 109 participants (70 men, 39 women) with untreated HIV-1 clade C infection and 110 demographically matched healthy controls (74 men, 36 women). A comprehensive neuropsychological battery was used to examine depression, self-assessment of functioning, and cognitive performance in six domains of functioning. Group differences were assessed by HIV-1 status and sex, controlling for age and education. Results indicated that cognitive deficits were substantially greater among male participants with HIV-1 clade C compared to male controls in all domains of cognitive functioning; in contrast, women with HIV-1 clade C had only minor deficits compared to healthy female participants. In addition, a larger proportion of men with HIV-1 clade C exhibited high levels of depression than women with HIV-1 clade C. These findings suggest that untreated HIV-1 clade C infection in men can have debilitating effects on neuropsychological function and depression, and stress the importance of facilitating rapid access to treatment to reduce the impact of HIV-1 infection.
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Affiliation(s)
- Anchal Sharma
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education & Research, Chandigarh, Punjab, India
| | - Manju Mohanty
- Department of Neurosurgery, Postgraduate Institute of Medical Education & Research, Chandigarh, Punjab, India
| | - Teddy Salan
- Department of Radiology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Deepika Aggarwal
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education & Research, Chandigarh, Punjab, India
| | - Lissa Mandell
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Deborah L Jones
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Kristopher Arheart
- Department of Public Health, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Aman Sharma
- Clinical Immunology and Rheumatology Services, Department of Internal Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, Punjab, India
| | - Sameer Vyas
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education & Research, Chandigarh, Punjab, India
| | - Paramjeet Singh
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education & Research, Chandigarh, Punjab, India
| | - Varan Govind
- Department of Radiology, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Mahendra Kumar
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, FL, USA
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2
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Ripamonti E, Clerici M. The association of memory disorders and chronic HIV disease in the antiretroviral therapy era: a systematic literature review. HIV Med 2019; 21:9-20. [PMID: 31603624 DOI: 10.1111/hiv.12793] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2019] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Despite recent pharmacological progress, memory impairment is still frequently reported in people living with HIV. We aimed to conduct a systematic literature review investigating the presence of impairment of (sub)components of memory function in patients prescribed highly active antiretroviral therapy (ART). METHODS We adopted a cognitive neuropsychological model of memory function as the theoretical framework, distinguishing between a short-term working memory component and a long-term component of memory, along with their specific (sub)components. We systematically searched for the presence of impairment of each (sub)component in the selected papers. Careful consideration was given to study design and methods and control of covariates. RESULTS Only the central executive component of working memory has been consistently reported to be impaired in HIV infection. The other two (sub)components, namely the phonological loop and the visuospatial sketchpad, were unimpaired. Discordant results have been obtained as to verbal and visual episodic memory, as some authors reported an association with HIV infection, whereas others did not. There is little evidence for semantic memory deficit in HIV infection, while there are suggestions that the neural substrate of implicit memory may be damaged by the effects of HIV infection and inflammation. Most studies in this area have been conducted in small samples and with poor control for covariates. Thus, conclusions regarding the association of memory dysfunction with HIV infection are hampered by methodological issues such as selection bias and unmeasured confounding. CONCLUSIONS The task remains for future research to ascertain the impact of HIV infection on memory function.
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Affiliation(s)
- E Ripamonti
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - M Clerici
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.,Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy
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3
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Robbins RN, Zimmerman R, Korich R, Raymond J, Dolezal C, Choi CJ, Leu CS, Nguyen N, Malee K, Wiznia A, Abrams EJ, Mellins CA. Longitudinal trajectories of neurocognitive test performance among individuals with perinatal HIV-infection and -exposure: adolescence through young adulthood. AIDS Care 2019; 32:21-29. [PMID: 31174426 DOI: 10.1080/09540121.2019.1626343] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
There are an estimated 2.1 million youth less than 15 years of age living with HIV globally (the majority perinatally HIV-infected [PHIV]) and millions more perinatally HIV-exposed uninfected (PHEU) youth who are expected to survive through adolescence and into adulthood. Transitioning from adolescence to young adulthood requires adaptation to more demanding social interactions, academic pressures, and individual responsibilities which place distinct demands on neurocognitive functions. This study examined longitudinal trajectories of neurocognitive test performance in the domains of processing speed (PS), working memory (WM), and executive functioning (EF) among PHIV and demographically similar PHEU from adolescence through young adulthood. Data for this paper come from four time points, spanning approximately 10 years, within the Child and Adolescent Self-Awareness and Health Study (CASAH). Youth age ranged from 15 to 29 years. Longitudinal linear mixed effect models were computed for each test. Few differences in performance were found on tests of EF and WM between PHIV and PHEU youth as they aged, though PHEU youth showed significantly better PS as they aged than PHIV youth. Future research is needed to understand these vulnerable youth's neurocognitive trajectories as a function of HIV infection and -exposure, biological functions and psychosocial stressors.
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Affiliation(s)
- Reuben N Robbins
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University Medical Center, New York, NY, USA
| | - R Zimmerman
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University Medical Center, New York, NY, USA
| | - R Korich
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University Medical Center, New York, NY, USA
| | - J Raymond
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University Medical Center, New York, NY, USA
| | - C Dolezal
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University Medical Center, New York, NY, USA
| | - C J Choi
- Division of Biostatistics, New York State Psychiatric Institute, New York, NY, USA
| | - C S Leu
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University Medical Center, New York, NY, USA
| | - N Nguyen
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University Medical Center, New York, NY, USA
| | - K Malee
- Department of Psychiatry and Behavioral Science, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - A Wiznia
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA
| | - E J Abrams
- ICAP, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - C A Mellins
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University Medical Center, New York, NY, USA
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VanNostrand M, Rieger B, Baracks J, Neville C. Development and initial validation of a digital divided-attention neurocognitive test for use in concussion assessment. Brain Inj 2019; 33:941-951. [PMID: 31120799 DOI: 10.1080/02699052.2019.1619094] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Computerized neurocognitive tests are commonly used after a concussion injury. The use of reliable and valid tests that utilize a divided-attention task may improve assessment. Therefore, the purpose of this study is to test a digital divided-attention neurocognitive test for test-retest reliability, practise effects, and initial validity. Methods and procedures: One hundred ninety-two subjects (159 healthy, 33 concussed) were assessed utilizing the neurocognitive test. Group comparisons were made between subjects with concussions and matched controls to determine the initial sensitivity of the test. Results: Intraclass correlation coefficients remained high (greater than 0.50) across all time points tested, and practise effects were largest in first retest session but we correlated (single task: R2 = 0.89, divided-attention: R2 = 0.85). Subjects who had experienced concussions performed significantly worse than matched controls on both the maths computation task and shape matching task during the divided-attention test. Conclusion: The mathematical computation component of the divided-attention test yielded high reliability. Practise effects were seen between the first and second testing sessions with smaller, insignificant improvements seen thereafter. Sensitivity to injury was comparable to other digital neurocognitive tests suggesting ongoing testing is warranted.
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Affiliation(s)
- Michael VanNostrand
- a Department of PT Education , SUNY Upstate Medical University , Syracuse , NY
| | - Brian Rieger
- b Upstate Concussion Center , SUNY Upstate Medical University , Syracuse , NY
| | - Joshua Baracks
- c Bloomberg School of Public Health , Johns Hopkins University , Baltimore , MD
| | - Christopher Neville
- a Department of PT Education , SUNY Upstate Medical University , Syracuse , NY.,b Upstate Concussion Center , SUNY Upstate Medical University , Syracuse , NY
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Response Time Reduction Due to Retesting in Mental Speed Tests: A Meta-Analysis. J Intell 2018; 6:jintelligence6010006. [PMID: 31162433 PMCID: PMC6480749 DOI: 10.3390/jintelligence6010006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 02/09/2018] [Accepted: 02/23/2018] [Indexed: 01/08/2023] Open
Abstract
As retest effects in cognitive ability tests have been investigated by various primary and meta-analytic studies, most studies from this area focus on score gains as a result of retesting. To the best of our knowledge, no meta-analytic study has been reported that provides sizable estimates of response time (RT) reductions due to retesting. This multilevel meta-analysis focuses on mental speed tasks, for which outcome measures often consist of RTs. The size of RT reduction due to retesting in mental speed tasks for up to four test administrations was analyzed based on 36 studies including 49 samples and 212 outcomes for a total sample size of 21,810. Significant RT reductions were found, which increased with the number of test administrations, without reaching a plateau. Larger RT reductions were observed in more complex mental speed tasks compared to simple ones, whereas age and test-retest interval mostly did not moderate the size of the effect. Although a high heterogeneity of effects exists, retest effects were shown to occur for mental speed tasks regarding RT outcomes and should thus be more thoroughly accounted for in applied and research settings.
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