Impairments in memory and hippocampal function in HIV-positive vs HIV-negative women

Departments of Psychiatry, University of Illinois at Chicago, Chicago, IL 60612, USA.
Neurology (Impact Factor: 8.29). 06/2009; 72(19):1661-8. DOI: 10.1212/WNL.0b013e3181a55f65
Source: PubMed

ABSTRACT Neurocognitive studies of HIV typically target executive functions dependent on frontostriatal circuitry. The integrity of medial temporal systems has received considerably less attention despite high hippocampal viral load. Studies also predominately involve HIV+ men, though HIV+ women may be at increased risk for cognitive dysfunction due to the high prevalence of psychosocial/mental health problems and lower educational attainment. Our aim was to conduct a preliminary investigation of episodic memory and its neural correlates in HIV-infected and at-risk uninfected women.
Participants included 54 HIV+ and 12 HIV- women (mean age = 43 years; 86% African American) recruited from the Chicago site of the Women's Interagency HIV Study. Participants completed standardized tests of verbal and visual episodic memory, working memory, and executive function. A subset of 11 women also underwent functional MRI during a delayed verbal episodic memory task.
HIV serostatus predicted significantly lower immediate and delayed verbal episodic memory, working memory, and visual memory. Preliminary neuroimaging findings revealed group differences in bilateral hippocampal function, with HIV+ women showing decreased activation during encoding and increased activation during delayed recognition. These alterations correlated with worse episodic verbal memory.
Verbal episodic memory deficits are evident in HIV+ women and may be associated with hippocampal dysfunction at both encoding and retrieval.

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Available from: Felicia Gould, Sep 26, 2015
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    • "Interestingly, viral loads of HIV had been reported to be particularly high in the hippocampus [25]. A prior functional MRI (fMRI) study revealed that compared to HIV-women, HIV+ women showed decreased activation during encoding, and increased activation during recognition in bilateral hippocampi in a delayed verbal episodic memory task, suggesting HIV might affect the functional integrity of the medial temporal system [26]. Another fMRI study of well-educated HIV+ men demonstrated reduced signal intensity in right posterior hippocampus and right inferior frontal gyrus, during encoding of scenes [27]. "
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    ABSTRACT: Co-infection of human immunodeficiency virus (HIV) and neurosyphilis (NS) has become a rising trend, but the extent of brain damage associated with the concomitant infections remains unknown. Proton magnetic resonance spectroscopy ((1)H-MRS) can evaluate metabolic changes underlying early brain infections. 25 syphilitic patients (7 HIV-positive with NS; 6 HIV-positive without NS; 5 HIV-negative with NS; 7 non-HIV, non-NS) and 17 healthy controls (HC) underwent single-voxel (1)H-MRS in the bilateral hippocampi. Absolute concentrations of major metabolites were measured using a 3T MRI scanner. No significant structural abnormality was detected in all patients. However, metabolic changes were found in the left hippocampus of both the HIV-positive and NS subgroups, showing significantly higher choline (Cho), creatine (Cr) and myo-inositol (mI) compared to HC. In the right hippocampus, HIV-positive subgroup showed significantly higher Cr and reduced NAA, while NS subgroup only showed significantly reduced NAA compared to HC. The non-HIV, non-NS syphilitic subgroup showed no significant difference compared to HC. Substantial metabolic changes occurred in bilateral hippocampi in HIV and NS co-infections. NAA reduction might represent early neuronal damage, while mI/Cho elevation reflects gliosis/inflammatory changes. (1)H-MRS could serve as a non-invasive tool to triage patients suspected of NS for lumbar puncture in non-HIV syphilitic patients.
    American Journal of Nuclear Medicine and Molecular Imaging 01/2015; 5(1):83-94. · 3.25 Impact Factor
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    • "Although findings across the HIV literature are not entirely consistent, a number of studies show that HIV-infected patients present deficits in speed of information processing (Carey et al., 2006; Giesbrecht et al., 2014), in fine motor speed (Sacktor et al., 2002) in learning and memory (Carey et al., 2006; Maki et al., 2009), in attention (Giesbrecht et al., 2014), and in multiple domains of executive functioning such as cognitive flexibility , decision-making, and planning (Iudicello et al., 2008; Cattie et al., 2012). The issue of neurocognitive dysfunctions in HIV+ patients has both a speculative and a social relevance. "
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    ABSTRACT: The debate regarding neurocognitive functions in the early stages of HIV infection is still ongoing; different studies have reached contrasting conclusions, probably because many of them take into account different cohorts of patients. A main distinction is between HIV seropositive patients infected perinatally, and those infected postnatally. The aim of this paper is to review results on neurocognitive dysfunctions and other types of neurological involvement in a specific cohort of HIV+ patients infected postnatally: hemophilia patients. Such a review is relevant, as HIV seropositive patients infected postnatally are understudied with respect to patients infected perinatally, and as the results of the few studies aiming at comparing them are contrasting. Taken together, the 11 studies reviewed suggest the presence of both long-term neurocognitive dysfunctions and neurological alterations, such as the presence of atrophic changes and lesions in the white matter. The current review may offer new research insights into the neurocognitive dysfunctions in HIV-patients, and on the nature of such dysfunctions.
    Frontiers in Human Neuroscience 06/2014; 8. DOI:10.3389/fnhum.2014.00470 · 2.99 Impact Factor
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    • "Although episodic memory relies on the functioning of the temporal and frontal lobes (Peters and Daum, 2009; Squire et al, 2004; Turnock and Becker, 2008), the functional contributions of each cortical region can be dissociated (Ekstrom et al, 2011; Kramer et al, 2005). The hippocampus may support specific mnemonic processes that help the encoding and retrieval of episodic memories to improve memory accuracy, as has been shown directly in clinicopathological (Moore et al, 2006) and neuroimaging (Maki et al, 2009) studies in HIV. The frontal lobes may be more important for decision-making and strategic aspects of episodic memory (Kramer et al, 2005), suggesting that HIV-associated deficits in temporal order memory may relate to strategic aspects of " working with memory " (Moscovitch, 1992). "
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    ABSTRACT: To compare temporal order memory in older adults with and without human immunodeficiency virus (HIV) infection. The frontal and temporal lobes play a key role in temporal order memory for items in a sequence. HIV-associated episodic memory deficits correlate with damage to neocortical interneurons in the fronto-striato-thalamo-cortical pathway and with atypical activation of the medial temporal lobes. Therefore, temporal order memory may be sensitive to neuropathological changes in individuals with HIV. In this study, 50 HIV-seropositive individuals aged ≥ 50 years and 50 seronegative controls performed a computerized visuospatial temporal order memory task. During the sample phase of each trial, participants were shown circles presented 1 at a time in a random sequence at the end of each of the 8 arms of a radial maze. During the choice phase, they were shown the maze with a circle at the ends of 2 of the arms and asked which circle had appeared earlier than the other in the original sequence. Performance in both groups improved as a function of greater temporal separation between circle presentations. However, the HIV group had significantly worse memory impairment across all temporal separations, and the impairment was independently associated with clinical deficits in executive function and delayed retrospective memory. Our results extend prior findings that HIV is associated with deficits in strategic aspects of memory encoding and retrieval. The neural mechanisms warrant further research, as do potential impacts on everyday function, eg, adherence to antiretroviral drug regimens.
    Cognitive and behavioral neurology: official journal of the Society for Behavioral and Cognitive Neurology 12/2013; 26(4):171-80. DOI:10.1097/WNN.0000000000000013 · 0.95 Impact Factor
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