Distal Sensory Polyneuropathy is Associated with Neuropsychological Test Performance among Persons with HIV

Department of Neurology, Mount Sinai School of Medicine, New York, New York.
Journal of the International Neuropsychological Society (Impact Factor: 2.96). 06/2012; 18(5):898-907. DOI: 10.1017/S1355617712000707
Source: PubMed


While distal sensory polyneuropathy (DSP) is the most common neurological condition associated with HIV, causing nerve damage in upper and lower extremities, its impact on neuropsychological test performance is unclear. In this study, we analyzed baseline data for 278 HIV-infected participants with comprehensive neurological and neurocognitive evaluations to examine the contribution of DSP and anatomic distribution of neuropathic signs (upper extremity or lower extremity) on standardized domain scores. We found that participants with DSP performed significantly worse in multiple domains containing timed psychomotor tests (i.e., motor, information processing speed and executive functioning). With regard to executive functioning, differences were limited to a test with a motor component (Trail Making Test, Part B). The group with clinically detectable neuropathic signs in the upper extremities and the group with signs limited to the lower extremities both performed worse in the motor domain than the group without DSP. Participants with DSP demonstrated a unique pattern of impairment limited to neuropsychological domains with timed psychomotor tests. These results suggest that caution should be used in interpretation of neuropsychological tests in patients with DSP, as some abnormalities may be exacerbated by peripheral nervous system pathology. (JINS, 2012, 19, 1-10).

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    • "Exclusion criteria for the current study included nonstandard assessment procedures, missing psychiatric or neuropsychological assessment, active psychosis, head injury with a loss of consciousness greater than 30 minutes, seizures, cerebral vascular accident, or other neurological condition considered to confound testing (e.g., neurosyphillis, blindness, cerebellar degeneration, CNS opportunistic infection). While there is evidence that peripheral neuropathy in HIV+ individuals is associated with specific neuropsychological deficits (Fellows et al., 2012), we chose not to exclude these participants as peripheral nerve disease may simultaneously occur with HIV-associated CNS pathology. A total of 191 participants met inclusion criteria for the current study. "
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