Neuropsychological Dysfunction in HIV Infection:A Review.

Abstract

FIfty-six studies which used neuropsychological tests to investigate areas of function affected by central nervous system dysfunction in HIV were reviewed. Only studies which compared the performance of HIV + subjects to HIV - controls using analysis of variance techniques were included. The results are examined in terms of broad neuropsychological function domains, and are examined separately for asymptomatic and symptomatic subjects. Studies which did and did not find significant differences between HIV + and HIV - subjects were compared in terms of various confounding factors such as risk groups, number of tests, sample size and subject characteristics. There was evidence for some dysfunction among subjects who are otherwise asymptomatic in the areas of verbal memory (27% of studies), executive function (43%), motor performance (20%) and information processing (44%). Studies of subjects with more advanced HIV infection showed consistent evidence of abnormal functioning in the areas of verbal (48% of studies) and visual memory (43%), executive functioning (71%), complex attention (62%), motor performance (37%) and information processing (69%). These deficits occurred prior to the onset of clinically apparent dementia. There were no consistent significant differences between studies which did and did not find significant differences between HIV + and HIV - subjects in terms of most of the confounding variables investigated, although studies of ASX subjects were more likely to find differences between HIV + subjects and controls with larger neuropsychological test battereies. However, much of the variation in results due to the neuropsychological tests used. In many cases, tests which relied on functions with a frontal lobe component were more likely to find significant results.