Neurobehavioral Consequences of HTLV-III Brain Infection and Acquired Immune Deficiency Syndrome (AIDS) Encephalopathy: A Prospective Study.

摘要

The main objectives of Phase I have been attained. Detailed, prospective, multidisciplinary neurobehavioral evaluations are ongoing in 72 HIV+, largely asymptomatic patients; plus 62 normal, depressed, or neurologic diseased controls. We have shown variable abnormalities in EEG, EPs, & MRI, as well as more consistent abnormalities in CSF & specific cognitive tasks of attention & information processing. This latter occurs in a subgroup of HIV+ patients, but not in depressed controls, & is associated with otherwise normal performance on standard tests of intelligence, language, & memory. Performance on reaction time tasks has been shown to deteriorate over time & is highly correlated with changes in CSF quinolinic acid, an excitatory neurotoxin. However, it must be emphasized that the presence of these abnormalities per se cannot at present be translated into an indication of impaired job performance. Phase II studies will establish the incidence of information processing disorders in HIV+ patients by using a briefer but more focused battery in a larger & less biased population. A brief neurobehavioral screening battery has been developed & successfully tested for use in therapeutic trials. In collaboration with the Department of Psychiatry, we will also explore the interaction between these findings & psychiatric & psychosocial variables. MRI, CSF, EEF, & other CNS biologic abnormalities uncovered in Phase I, will be pursued in the original patients as well as in a subgroup of new patients, including more advanced patients with AIDS. (sdw)