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ABSTRACT: To investigate the independent and interactive effects of opiate addiction and HIV on neuroinflammation, we measured microglial/macrophage activation and astrogliosis in multiple regions of human brain. Samples of thalamus, frontal gray matter, and frontal white matter were obtained from 46 individuals categorized as: HIV negatives, HIV-negative opiate addicts, HIV positives, HIV-positive opiate addicts, HIV encephalitis (HIVE), and HIVE opiate addicts. Activated brain microglia/macrophages and astrocytosis were quantified by morphometric analysis of immunohistochemical stains for CD68, HLA-D, CD163, and GFAP. The effects of HIV grouping, opiate addiction, and their interaction on expression of the markers were examined in a series of two-way ANOVAs. In opiate addicts, there was generally higher baseline expression of CD68 and HLA-D in HIV negatives, and lower expression in HIV and HIVE, compared to individuals without opiate abuse. Thus, for these markers, and for GFAP in frontal gray, opiates were associated with attenuated HIV effect. In contrast, for CD163, opiates did not significantly alter responses to HIV, and HIV effects were variably absent in individuals without opiate abuse. The divergent impact that opiate addiction displays on these markers may suggest a generally immunosuppressive role in the CNS, with decreased HIV-associated activation of markers CD68 and HLA-D that potentially reflect neurotoxic pathways, and preservation of CD163, thought to be an indicator of neuroprotective scavenger systems. These results suggest a complex impact of opiates on neuroinflammation in baseline and virally stimulated states.
Journal of NeuroVirology 07/2012; 18(5):364-73. · 2.31 Impact Factor
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Alyssa Arentoft, Desiree Byrd,
Reuben N Robbins,
Jennifer Monzones,
Caitlin Miranda,
Ana Rosario,
Kelly Coulehan,
Armando Fuentes,
Kaori Kubo Germano,
Erica D'Aquila,
Jacob Sheynin,
Felicia Fraser,
Susan Morgello,
Monica Rivera Mindt
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ABSTRACT: Acculturation has been linked to neuropsychological performance in several ethnic groups. However, research among Latina/o samples has examined primarily Mexicans/Mexican Americans and has not examined Latina/o clinical populations of Caribbean descent. This study examined associations between a multidimensional acculturation measure and neuropsychological performance among 82 HIV+ Caribbean Latina/o adults. Multivariate results showed that US acculturation significantly predicted 11-14% of the variance in global neuropsychological functioning, verbal fluency, and processing speed, whereas Latina/o acculturation predicted 6-8% of the variance in motor and executive function (trend level associations). Both linguistic and nonlinguistic cultural factors had distinct effects on neuropsychological performance.
Journal of Clinical and Experimental Neuropsychology 05/2012; 34(8):814-25. · 2.13 Impact Factor
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ABSTRACT: Adherence to antiretroviral therapy (ART) is integral to the successful treatment of HIV infection. Research has indicated that HIV-infected Latinos may have difficulty adhering to ART. While studies have demonstrated strong relationships between numerous psychosocial factors and ART adherence, no research has examined if cultural factors are also involved in ART adherence among Latinos. Our study examined the relationship between acculturation to mainstream U.S. culture, bicultural self-efficacy, and ART adherence among HIV-infected Puerto Rican adults living in the United States. Participants with ≥ 95% adherence scored higher on U.S.- and Latino-involvement acculturation scales and on a measure of bicultural self-efficacy compared to those with suboptimal adherence. Among bicultural HIV-infected Puerto Ricans, both acculturation and self-efficacy to navigate between cultures were positively related to adherence. Understanding the role of an individual's sociocultural experience may help elucidate why HIV-infected Latinos have difficulties achieving optimal ART adherence and improve ART adherence interventions.
The Journal of the Association of Nurses in AIDS Care: JANAC 04/2012; 23(6):531-8. · 0.96 Impact Factor
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ABSTRACT: The 2008 Diversity Summit recognized the many advantages of increasing the number of neuropsychologists from ethnically diverse backgrounds. The Summit addressed the aspiration of creating a more ethnically diverse body of neuropsychologists by increasing the recruitment of ethnic minority students to neuropsychology training programs. Challenges to successful recruitment and retention of ethnic minority students were discussion points at the Summit. This paper summarizes and expands these points and also suggests solutions to these challenges with the aim of stimulating innovative approaches to increasing the representation of ethnic minorities in neuropsychology.
The Clinical Neuropsychologist 11/2010; 24(8):1279-91. · 2.12 Impact Factor
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ABSTRACT: US demographic and sociopolitical shifts have resulted in a rapidly growing need for culturally competent neuropsychological services. However, clinical neuropsychology as a field has not kept pace with the needs of ethnic minority clients. In this discussion we review: historical precedents and the limits of universalism in neuropsychology; ethical/professional guidelines pertinent to neuropsychological practice with ethnic minority clients; critical cultural considerations in neuropsychology; current disparities germane to practice; and challenges to the provision of services to racial/ethnic minority clients. We provide a call to action for neuropsychologists and related organizations to advance multiculturalism and diversity within the field by increasing multicultural awareness and knowledge, multicultural education and training, multicultural neuropsychological research, and the provision of culturally competent neuropsychological services to racial/ethnic minority clients. Lastly, we discuss strategies for increasing the provision of culturally competent neuropsychological services, and offer several resources to meet these goals.
The Clinical Neuropsychologist 04/2010; 24(3):429-53. · 2.12 Impact Factor
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ABSTRACT: Reports an error in "Characterization and sociocultural predictors of neuropsychological test performance in HIV+ Hispanic individuals" by Monica Rivera Mindt, Desiree Byrd, Elizabeth L. Ryan, Reuben Robbins, Jennifer Monzones, Alyssa Arentoft, Kaori Kubo Germano, Susan Morgello and Debra E. Henniger (Cultural Diversity and Ethnic Minority Psychology, 2008[Oct], Vol 14[4], 315-325). The eighth and ninth co-authors were printed in the incorrect order. The correct order of authorship is as follows: Monica Rivera Mindt, Desiree Byrd, Elizabeth L. Ryan, Reuben Robbins, Jennifer Monzones, Alyssa Arentoft, Kaori Kubo Germano, Debra E. Henniger, and Susan Morgello. They appear correctly in this record. (The following abstract of the original article appeared in record 2008-14898-005.) Hispanic individuals in the U.S. have been disproportionately impacted by HIV/AIDS, yet little is known regarding the neuropsychological sequelae of HIV within the Hispanic population. This study characterized neuropsychological (NP) test performance of HIV+ English-speaking Hispanic participants (n = 51) and investigated the combined roles of sociocultural factors (e.g., ethnicity, socioeconomic status [SES] proxy, and reading level) on NP test performance among our HIV+ Hispanic and non-Hispanic White participants (n = 49). Results revealed that the pattern of NP impairment in HIV+ Hispanic participants is consistent with the frontal-striatal pattern observed in HIV-associated CNS sequelae, and the overall prevalence of global NP impairment was high compared to previous reports with more ethnically homogeneous, non-Hispanic White cohorts. Multivariate prediction models that considered both sociocultural factors and CD4 count revealed that reading level was the only unique predictor of global NP functioning, learning, and attention/working memory. In contrast, ethnicity was the only unique predictor of abstraction/executive functioning. This study provides support for the use of neuropsychological evaluation in detecting HIV-associated NP impairment among HIV+ Hispanic participants and adds to the growing literature regarding the importance of considering sociocultural factors in the interpretation of NP test performance. (PsycINFO Database Record (c) 2009 APA, all rights reserved).
Cultural Diversity and Ethnic Minority Psychology 10/2009; 15(4):433. · 1.36 Impact Factor
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Ann-Gel S Palermo,
Maria L Soto-Greene,
Vera S Taylor,
Ray Cornbill,
Jerry Johnson,
Monica Rivera Mindt, Desiree Byrd,
Gary C Butts,
Janice Herbert-Carter,
Yvonne W Fry-Johnson,
Quentin T Smith,
George Rust,
A Hal Strelnick
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ABSTRACT: Despite recent drastic cutbacks in federal funding for programs to diversify academic medicine, many such programs survive and continue to set examples for others of how to successfully increase the participation of minorities underrepresented in the healthcare professions and, in particular, how to increase physician and nonphysician minority medical faculty. This article provides an overview of such programs, including those in historically black colleges and universities, minority-serving institutions, research-intensive private and public medical schools, and more primary care-oriented public medical schools. Although the models for faculty development developed by these successful schools overlap, each has unique features worthy of consideration by other schools seeking to develop programs of their own. The ingredients of success are discussed in detail in another article in this theme issue of the Mount Sinai Journal of Medicine, "Successful Programs in Minority Faculty Development: Ingredients of Success."
Mount Sinai Journal of Medicine A Journal of Translational and Personalized Medicine 12/2008; 75(6):523-32. · 2.00 Impact Factor
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ABSTRACT: Hispanic individuals in the U.S. have been disproportionately impacted by HIV/AIDS, yet little is known regarding the neuropsychological sequelae of HIV within the Hispanic population. This study characterized neuropsychological (NP) test performance of HIV+ English-speaking Hispanic participants (n = 51) and investigated the combined roles of sociocultural factors (e.g., ethnicity, socioeconomic status [SES] proxy, and reading level) on NP test performance among our HIV+ Hispanic and non-Hispanic White participants (n = 49). Results revealed that the pattern of NP impairment in HIV+ Hispanic participants is consistent with the frontal-striatal pattern observed in HIV-associated CNS sequelae, and the overall prevalence of global NP impairment was high compared to previous reports with more ethnically homogeneous, non-Hispanic White cohorts. Multivariate prediction models that considered both sociocultural factors and CD4 count revealed that reading level was the only unique predictor of global NP functioning, learning, and attention/working memory. In contrast, ethnicity was the only unique predictor of abstraction/executive functioning. This study provides support for the use of neuropsychological evaluation in detecting HIV-associated NP impairment among HIV+ Hispanic participants and adds to the growing literature regarding the importance of considering sociocultural factors in the interpretation of NP test performance.
Cultural Diversity and Ethnic Minority Psychology 11/2008; 14(4):315-25. · 1.36 Impact Factor
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ABSTRACT: Scientific attention to cultural considerations in child neuropsychological assessment has not developed parallel to the focus these issues have received in adult and elderly neuropsychological assessment. There are limited data on the presence, magnitude, etiology, and implications of culture-related differences in cognitive test performance among children. This preliminary report reviews the available empirical literature on the current state of multicultural neuropsychological assessment in children. The review identified articles by searching PubMed and PsycINFO databases, and the tables of contents of Developmental Neuropsychology and Child Neuropsychology from 2003-2008. Of the 1,834 abstracts reviewed, ten papers met inclusion criteria for the review. Five studies were completed in America; four of these compared performance between ethnic groups while the fifth examined neighborhood level poverty indicators exclusively within African-American children. Of the five international studies, all established local normative data and/or were exploratory investigations of neuropsychological functions in specific cultural groups, including Taiwanese infants, South African youth, and bilingual British children. Taken together, the results yield important clinical and research data that begin to inform many of the complex and fascinating mechanisms by which ethnic identity and culture impact cognitive development and the neuropsychological assessment of children. A critique of the existing literature and directions for future research are provided.
Neuropsychology Review 10/2008; 18(3):214-22. · 6.62 Impact Factor
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ABSTRACT: Cognitive impairment has long been recognized as a manifestation of human immunodeficiency virus (HIV) infection. However, highly active antiretroviral therapy (HAART) has altered the neurologic manifestations of HIV.
To develop a measure to quantify the motor abnormalities included in the original descriptions of HIV-associated dementia (HAD); to determine whether motor, affective, and behavioral dysfunction predict cognitive impairment; and to determine whether quantitative motor testing is a helpful adjunct in the diagnosis of HAD in a complex population from the HAART era.
Neurologic and neuropsychological data were collected from the Manhattan HIV Brain Bank, a longitudinal cohort study of patients with advanced HIV. The HIV-Dementia Motor Scale (HDMS) was developed and validated and cognitive and affective or behavioral function was quantified using global neuropsychological T scores, the Beck Depression Inventory (BDI), and an independent assessment of apathy. Relationships among cognitive, motor, affective, and behavioral performance were examined using correlation, linear regression, and analyses of variance.
An urban AIDS research center.
A total of 260 HIV-positive, predominantly minority patients.
The HDMS scores and global neuropsychological T scores.
The HDMS and BDI scores were independent predictors of cognitive impairment. Significant cognitive impairment was found in patients with motor dysfunction. Patients diagnosed as having HAD had a greater degree of motor impairment than those with other neurocognitive diagnoses.
Motor, affective, and behavioral abnormalities predict cognitive impairment in HIV-positive patients in this HAART-era cohort. The HDMS may be useful in the assignment of HIV-associated neurocognitive impairment in HIV populations in which normative data or neuropsychological test design is not optimal.
Archives of neurology 09/2008; 65(8):1096-101. · 6.31 Impact Factor
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ABSTRACT: The WRAT-3 Reading subtest (WRS) may be inappropriate in diseases having disproportionate impact on populations with educational disadvantages (i.e., HIV/AIDS). To understand how low literate individuals would perform on an IQ test requiring minimal education, the General Ability Measure for Adults (GAMA) was studied. HIV+ participants completed WRS, GAMA, and neuropsychological tests. Participants with low WRS (<80 SS) but higher GAMA (>or=80 SS) had significantly better overall neuropsychological functioning than those with <80 SS on both tests. The GAMA may be a useful test when disparities in educational quality render reading-based measures of IQ a poor surrogate of premorbid function.
The Clinical Neuropsychologist 05/2008; 22(6):1018-34. · 2.12 Impact Factor
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ABSTRACT: The current study aimed to identify the primary informal caregivers of a group of urban HIV+ adults (n = 250) and to determine relationships between demographic, medical, and substance use characteristics and caregivers types. Reported caregiver types included 36.8% familial, 22.4% significant other, and 22.8% institutional or other caregiver relationships. The remaining 18% of the sample reported having no individual that rendered informal care. Factors associated with the absence of an informal caregiver included African American race and low education. Hispanic participants reported the highest frequency of family caregivers while participants with a history of substance disorder were less likely to identify a significant other as a caregiver. This study demonstrates the evolving nature of informal caregiving in HIV, race- and education-related disparities in the absence of primary caregivers, and the importance of sociocultural and demographic factors in the study of HIV caregiving.
AIDS and Behavior 10/2007; 13(2):337-47. · 3.49 Impact Factor
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ABSTRACT: Educational attainment is an important factor in the interpretation of cognitive test scores but years of education are not necessarily synonymous with educational quality among racial/ethnic minority populations. This study investigated the comparability of educational attainment with reading level and examined whether discrepancies in education and reading level accounted for differences in neuropsychological test performance between HIV+ racial/ethnic minority and nonminority participants. Study participants (N=200) were derived from the Manhattan HIV Brain Bank (MHBB) where 50% of the cohort had < or =8th grade reading level but only 5% had < or =8 years of education. Significantly lower reading ability and education was found among African Americans and Hispanics, and these participants were more likely to have discrepant reading and education levels compared to non-Hispanic Whites. Discrepancy in reading and education level was associated with worse neuropsychological performance while racial/ethnic minority status was not. As years of schooling overestimated racial/ethnic minority participants' educational quality, standard norms based on education may inflate impairment rates among racial/ethnic minorities. Identifying appropriate normative standards is and will continue to be important in the detection of cognitive impairment in racial/ethnic minorities with HIV.
Journal of the International Neuropsychological Society 11/2005; 11(7):889-98. · 2.76 Impact Factor
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ABSTRACT: Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a well-recognized clinical sleep disorder that results in chronically fragmented sleep and recurrent hypoxemia. The primary daytime sequelae of the disorder include patient reports of excessive daytime sleepiness, depression, and attention and concentration problems. It has been well established that OSAHS negatively impacts certain aspects of cognitive functioning. The primary goals of this article are to (1) clarify the pattern of cognitive deficits that are specific to OSAHS; (2) identify the specific cognitive domains that improve with treatment; and (3) elucidate the possible mechanisms of cognitive dysfunction in OSAHS. At the conclusion of the paper, we propose a potential neurofunctional theory to account for the etiology of cognitive deficits in OSAHS. Thirty-seven peer-reviewed articles were selected for this review. In general, findings were equivocal for most cognitive domains. Treatment, however, was noted to improve attention/vigilance in most studies and consistently did not improve constructional abilities or psychomotor functioning. The results are discussed in the context of a neurofunctional theory for the effects of OSAHS on the brain.
Journal of the International Neuropsychological Society 10/2004; 10(5):772-85. · 2.76 Impact Factor
