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Aging with HIV-1 Infection: Motor Functions, Cognition, and Attention – A Comparison with Parkinson’s Disease

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Abstract

Recent advances in highly active anti-retroviral therapy (HAART) in their various combinations have dramatically increased the life expectancies of HIV-infected persons. People diagnosed with HIV are living beyond the age of 50 but are experiencing the cumulative effects of HIV infection and aging on brain function. In HIV-infected aging individuals, the potential synergy between immunosenescence and HIV viral loads increases susceptibility to HIV-related brain injury and functional brain network degradation similar to that seen in Parkinson’s disease (PD), the second most common neurodegenerative disorder in the aging population. Although there are clear diagnostic differences in the primary pathology of both diseases, i.e., death of dopamine-generating cells in the substantia nigra in PD and neuroinflammation in HIV, neurotoxicity to dopaminergic terminals in the basal ganglia (BG) has been implied in the pathogenesis of HIV and neuroinflammation in the pathogenesis of PD. Similar to PD, HIV infection affects structures of the BG, which are part of interconnected circuits including mesocorticolimbic pathways linking brainstem nuclei to BG and cortices subserving attention, cognitive control, and motor functions. The present review discusses the combined effects of aging and neuroinflammation in HIV individuals on cognition and motor function in comparison with age-related neurodegenerative processes in PD. Despite the many challenges, some HIV patients manage to age successfully, most likely by redistribution of neural network resources to enhance function, as occurs in healthy elderly; such compensation could be curtailed by emerging PD.

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Acknowledgments

We thank Elijah DeVaughn for his critical review and comments on this manuscript. NIH Grant R01 AA023165 funded this work. The authors declare no conflict of interest.

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Authors and Affiliations

  1. Bioscience Division, Neuroscience Program, SRI International, 333 Ravenswood Ave, Menlo Park, CA, USA

    S. DeVaughn, E. M. Müller-Oehring & T. Schulte

  2. Pacific Graduate School of Psychology, Palo Alto University, Palo Alto, CA, USA

    S. DeVaughn, B. Markey & T. Schulte

  3. Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA

    E. M. Müller-Oehring

  4. Department of Neurology & Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA

    H. M. Brontë-Stewart

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  1. S. DeVaughn
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  2. E. M. Müller-Oehring
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  5. T. Schulte
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Correspondence to T. Schulte.

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DeVaughn, S., Müller-Oehring, E.M., Markey, B. et al. Aging with HIV-1 Infection: Motor Functions, Cognition, and Attention – A Comparison with Parkinson’s Disease. Neuropsychol Rev 25, 424–438 (2015). https://doi.org/10.1007/s11065-015-9305-x

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