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


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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    • "In the WIHS, high levels of perceived stress and elevated anxiety were associated with decreases in verbal learning and memory only within the context of HIV (Rubin et al. 2015; Rubin et al. 2014). In WIHS participants , verbal memory deficits are associated with alterations in hippocampal function during verbal encoding and recognition as measured with functional magnetic resonance imaging (fMRI) (Maki et al. 2009). It, therefore, stands to reason that PTSD might contribute to deficits in verbal memory in HIV+ women. "
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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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    • "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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