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Publication Abstract Display
Type: Published Abstract
Title: Relationship between neuropsychological impairment and post-mortem findings of HIV-associated brain disease.
Authors: Cherner M, Moore DJ, Masliah E, Ellis R, Heaton RK, Grant I, and the HNRC Group
Year: 2002
Publication: Journal of the International Neuropsychological Society
Volume: 8 Issue: 2 Pages: 314
Abstract:"Previous work in neuroAIDS has yielded inconsistent findings on the relationship between cognitive deficits and neuropathology. Recent examination of clinico-pathologic correlations suggests that ante mortem neuropsychological impairment is a highly specific indicator of HIV-related brain disease. Evidence of HIV encephalitis (HIVE) and neurodegenerative changes were determined in 39 HIV seropositive study participants who had been assessed during life with a comprehensive neuropsychological (NP) battery. Cognitive impairment was determined using blind clinical ratings based on demographically corrected NP test scores. Presence of HIVE was based on post-mortem immunocytochemical detection of the viral envelope protein gp41 or by Amplicor HIV PCR in multiple brain areas, as well as by histopathologic evidence, such as microgliosis, presence of multinucleated giant cells, and myelin pallor in several brain regions. Neurodegenerative changes evidenced by dendritic simplification were measured as the area of neuropil covered by microtubule associated protein 2 (MAP2) immunoreactive dendrites in a number of brain areas. Presence of neurocognitive impairment in life was almost always predictive of HIVE, whether or not frank neurodegeneration was evident. Among 18 Ss with NP impairment, 17 (94%) had HIVE, compared to 42% of NP normals, and 78% had both HIVE and neurodegeneration, compared to 19% of normals. Results suggest that if cognitive impairment is detected, there is a very strong likelihood that HIV related changes will be manifest in brain tissue. Information about neuropsychological status can be an important tool to help select HIV1 patients for pharmacologic treatments that target the central nervous system.

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