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Performances on the CogState and Standard Neuropsychological Batteries Among HIV Patients Without Dementia

Abstract

HIV-associated neurocognitive disorders remain prevalent but challenging to diagnose particularly among non-demented individuals. To determine whether a brief computerized battery correlates with formal neurocognitive testing, we identified 46 HIV-infected persons who had undergone both formal neurocognitive testing and a brief computerized battery. Simple detection tests correlated best with formal neuropsychological testing. By multivariable regression model, 53% of the variance in the composite Global Deficit Score was accounted for by elements from the brief computerized tool (P < 0.01). These data confirm previous correlation data with the computerized battery. Using the five significant parameters from the regression model in a Receiver Operating Characteristic curve, 90% of persons were accurately classified as being cognitively impaired or not. The test battery requires additional evaluation, specifically for identifying persons with mild impairment, a state upon which interventions may be effective.

Resumen

Los trastornos neurocognitivos asociados con el virus de inmunodeficiencia humana (VIH) son altamente prevalentes pero difíciles de diagnosticar, particularmente entre individuos que no presentan signos de demencia en el momento del examen clínico. Para determinar si una breve batería de pruebas computarizada correlaciona con resultados de pruebas neurocognitivas, identificamos a 46 individuos infectados con VIH que se habían sometido a pruebas neurocognitivas así como a esta prueba computarizada. Los resultados preliminares indicaron que las pruebas de detección simples mostraron la mejor correlación con los exámenes neurocognitivos. Mediante el uso de un modelo de regresión multivariable fuimos capaces de explicar el 53% de la varianza del Global Deficit Score (GDS, puntuación compuesta del déficit global) con componentes de la breve batería computarizada (P < 0.01). Estos datos confirman estudios anteriores que analizaron la correlación entre el GDS y la batería computarizada. Utilizando los cinco parámetros significativos del modelo de regresión en una curva del Receiver Operating Characteristic (ROC), el 90% de las personas fueron clasificadas correctamente como individios que presentaban deterioro cognitivo o no. Se necesitan estudios adicionales de esta batería de pruebas, en particular para identificar a personas con un deterioro leve, el cual podría ser especialmente interesante debido a que intervenciones clínicas, psicológicas o farmacéuticas podrían ser eficaces.

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Acknowledgments

The authors would like to express our appreciation to all the SUN study and CHARTER participants. The CNS HIV Anti-Retroviral Therapy Effects Research (CHARTER) is supported by award N01 MH22005 from the National Institutes of Health.

Conflicts of interest

No authors have conflicts of interest regarding this research.

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Correspondence to Edgar Turner Overton.

Appendix

Appendix

The SUN Study Investigators are: John T. Brooks, Pragna Patel, Lois Conley, and Tim Bush, Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, Georgia; Kathleen Wood, Rose Baker, and Cheryl Akridge, Cerner Corporation, Vienna, Virginia; John Hammer, Tara Kennedy, Barbara Widick and Billie Thomas, Denver Infectious Disease Consultants, Inc., Denver, Colorado; Ken Lichtenstein and Cheryl Stewart, National Jewish Medical and Research Center, Denver, Colorado; Keith Henry, Jason Baker, Rachel Prosser, Edie Gunderson, Miki Olson, and John Hall, Hennepin County Medical Center, Minneapolis, Minnesota; Frank Rhame, Mark Olson, and Eve Austad, Abbott-Northwestern Hospital, Minneapolis, Minnesota; Hal Martin, Meaghan Morton, and Cheri Murch, Park-Nicollet Institute, Minneapolis, Minnesota; Charles Carpenter, Susan Cu-Uvin, Kenneth Mayer, Erna Milunka Kojic, Jennifer Florczyk, Sara Metzler, and Patricia D’Aiello, The Miriam Hospital, Providence, Rhode Island; and E. Turner Overton, Don Connor, Lisa Kessels, Mariea Snell, Sara Hubert, Dorothea Dedeaux-Turner, and Dave Coughlan, Washington University School of Medicine, St. Louis, Missouri.

The CNS HIV Anti-Retroviral Therapy Effects Research (CHARTER) group is affiliated with the Johns Hopkins University, Mount Sinai School of Medicine, University of California, San Diego, University of Texas, Galveston, University of Washington, Seattle, Washington University, St. Louis and is headquartered at the University of California, San Diego and includes: Director: Igor Grant, M.D.; Co-Directors: J. Allen McCutchan, M.D., Ronald J. Ellis, M.D., Ph.D., Thomas D. Marcotte, Ph.D.; Center Manager: Donald Franklin, Jr.; Neuromedical Component: Ronald J. Ellis, M.D., Ph.D. (P.I.), J. Allen McCutchan, M.D., Terry Alexander, R.N.; Laboratory, Pharmacology and Immunology Component: Scott Letendre, M.D. (P.I.), Edmund Capparelli, Pharm.D.; Neurobehavioral Component: Robert K. Heaton, Ph.D. (P.I.), J. Hampton Atkinson, M.D., Steven Paul Woods, Psy.D., Matthew Dawson; Virology Component: Joseph K. Wong, M.D. (P.I.); Imaging Component: Christine Fennema-Notestine, Ph.D. (Co-P.I.), Michael J. Taylor, Ph.D. (Co-P.I.), Rebecca Theilmann, Ph.D.; Data Management Unit: Anthony C. Gamst, Ph.D. (P.I.), Clint Cushman,; Statistics Unit: Ian Abramson, Ph.D. (P.I.), Florin Vaida, Ph.D.; Protocol Coordinating Component: Thomas D. Marcotte, Ph.D. (P.I.), Rodney von Jaeger, M.P.H.; Johns Hopkins University Site: Justin McArthur (P.I.), Mary Smith; Mount Sinai School of Medicine Site: Susan Morgello, M.D. (Co-P.I.) and David Simpson, M.D. (Co-P.I.), Letty Mintz, N.P.; University of California, San Diego Site: J. Allen McCutchan, M.D. (P.I.), Will Toperoff, N.P.; University of Washington, Seattle Site: Ann Collier, M.D. (Co-P.I.) and Christina Marra, M.D. (Co-P.I.), Trudy Jones, M.N., A.R.N.P.; University of Texas, Galveston Site: Benjamin Gelman, M.D., Ph.D. (P.I.), Eleanor Head, R.N., B.S.N.; and Washington University, St. Louis Site: David Clifford, M.D. (P.I.), Muhammad Al-Lozi, M.D., Mengesha Teshome, M.D.

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Overton, E.T., Kauwe, J.S.K., Paul, R. et al. Performances on the CogState and Standard Neuropsychological Batteries Among HIV Patients Without Dementia. AIDS Behav 15, 1902–1909 (2011). https://doi.org/10.1007/s10461-011-0033-9

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Keyword

  • HIV infection
  • neurocognitive function
  • HIV-associated dementia
  • CogState
  • SUN study