An exploratory study of long-term neurocognitive outcomes following recovery from opportunistic brain infections in HIV+ adults

Los Angeles-National Neurological AIDS Bank, University of California, Los Angeles, CA 90025, USA.
Journal of Clinical and Experimental Neuropsychology (Impact Factor: 2.08). 03/2008; 30(7):836-43. DOI: 10.1080/13803390701819036
Source: PubMed


Central nervous system opportunistic infections (CNS-OI) are a significant cause of morbidity and mortality in AIDS. While current interventions are increasingly successful in treating CNS-OI, little information exists regarding long-term behavioral outcomes among survivors. In this exploratory study we examined neurocognitive data among three groups of adults with different AIDS-related CNS-OI: 15 with past cryptococcal meningitis (CM), 8 with toxoplasmosis encephalitis (TE), and 8 with progressive multifocal leukoencephalopathy (PML). A group of 61 individuals with AIDS, but without CNS-OI, was used as a comparison group. A battery of standardized neuropsychological tests assessing a variety of cognitive domains was administered upon entry. Results indicate that individuals with a history of CNS-OI were most impaired on measures of cognitive and psychomotor speed relative to the HIV+ comparison group. Among the CNS-OI groups, individuals with history of TE had the most severe and varied deficits. The results are discussed in relation to what is known about the neuropathological consequences of the various CNS-OIs. While this is the first systematic group study of residual CNS-OI effects on neurocognitive function, future studies employing more participants, perhaps focusing on specific CNS-OIs, will further characterize the long-term outcomes in AIDS-related CNS-OI.

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    • "Less often, multifocal/confluent regions of hyperintensity in a patient with suspected dementia may result from a number of other conditions, including infections, inflammatory demyelinating diseases, leukodystrophies or leukoencephalopathies.19 34 Infective processes may need consideration in immunocompromised patients at risk of opportunistic infections, including cerebral toxoplasmosis.35 "
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    Journal of neurology, neurosurgery, and psychiatry 10/2013; 85(6). DOI:10.1136/jnnp-2013-306285 · 6.81 Impact Factor
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    • "Written consent to autopsy was also obtained. Neurocognitive functioning was reflected by a composite measure derived from a comprehensive neuropsychological battery assessing speed of information processing, attention/working memory, learning, recall memory, verbal fluency, abstract/executive functioning, and motor/psychomotor speed, with statistical correction for demographic variables (i.e., age, sex, ethnicity, and education), as described previously (Levine et al. 2008). Both the number and severity of deficits across the neuropsychological battery were considered. "
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    • "Persistent neuropsychological deficits are evident in many survivors of TE. Examining the long term neurocognitive outcomes of individuals who survived AIDS CNS-OIs, Levine et al (2008) found that those with past TE performed worse on all but one neuropsychological domain than those with history of other AIDS CNS OI, including PML and CM {137}. "
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