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The Functional Impact of HIV-Associated Neuropsychological Decline

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HIV and the Brain

Part of the book series: Current Clinical Neurology ((CCNEU))

Abstract

Briefly, HIV infection is associated with neuropsychological deficits in attention/working memory, motor abilities, memory, and executive functioning (1–5), which are often attributed to disruptions in frontal-striatal circuitry (3, 6). These HIV-associated deficits generally worsen with infection staging (3) , and decline in psychomotor speed appears to be the most robust (5,7) . Although dementia occurs in a relatively small number of HIVinfected individuals, between 30 and 50% of those with HIV evidence milder neuropsychological deficits (3, 8). That said, the number of newly diagnosed cases of HIV, in tandem with increased life expectancies resulting from treatment with highly active antiretroviral therapy (HAART), is driving up the mean age of the HIV-infected population (9, 10); older HIV+ individuals have been shown to demonstrate disproportionately greater neuropsychological decline and are about three times more likely to develop HIV-related dementia than are their younger counterparts (11, 12) .

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Notes

  1. 1.

    Five times worse for simulations of simple driving (i.e., driving on a straight highway at a constant speed with occasional competing responses). Six times worse for simulations of evasive driving (i.e., variable speed driving requiring turns, passage of other vehicles, and avoidance of potential accidents).

  2. 2.

    Performances across the three UFOV subtests (Processing Speed, Divided Attention, and Selective Attention) are analyzed with regard to an algorithm that classifies risk level (39). Participants in Marcotte et al. (38) with a level five classification (High to Very High risk) were considered high risk.

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Author information

Authors and Affiliations

  1. Department of Psychiatry, Psychology Division, Harbor-UCLA Medical Center, David Geffen School of Medicine at UCLA, 1000 W. Canson St. D-2 Annex, #5, 495, Torrance, CA, 90509, USA

    Matthew J. Wright, Ellen Woo, Terry R. Barclay & Charles H. Hinkin

Authors
  1. Matthew J. Wright
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  2. Ellen Woo
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  3. Terry R. Barclay
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  4. Charles H. Hinkin
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Corresponding author

Correspondence to Matthew J. Wright .

Editor information

Editors and Affiliations

  1. Department of Psychology Behavioral Neuroscience, University of Missouri – St. Louis, St. Louis, U.S.A.

    Robert H. Paul PhD

  2. Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, MD, U.S.A.

    Ned Charlton Sacktor

  3. Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, U.S.A.

    Victor Valcour

  4. Memory and Aging Center Department of Neurology, UCSF, San Francisco, CA, U.S.A.

    Victor Valcour

  5. The Miriam Hospital, Alpert Medical School of Brown University, Providence, RI, U.S.A.

    Karen Tokie Tashima

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© 2009 Humana Press, a part of Springer Science+Business Media, LLC

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Wright, M.J., Woo, E., Barclay, T.R., Hinkin, C.H. (2009). The Functional Impact of HIV-Associated Neuropsychological Decline. In: Paul, R., Sacktor, N., Valcour, V., Tashima, K. (eds) HIV and the Brain. Current Clinical Neurology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59745-434-6_11

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  • DOI: https://doi.org/10.1007/978-1-59745-434-6_11

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