Publication Abstract Display
Type: Published Abstract
Title: The diagnosis, course, biological and neuropathological correlates of HIV neurocognitive disorder.
Authors: Grant I, on behalf of the HNRC Group
Year: 1996
Publication: European Neuropsychopharmacology
Volume: 6 Issue: S3 Pages: 22
Abstract:Neurocognitive disorders -- dementia, minor cognitive motor disorder (MCMD), and neuropsychological impairment (NI) -- frequently complicate HIV infection. In those with AIDS, 4-7% become demented, and about 50% suffer from milder neurocognitive disorder (NI). Among asymptomatic seropositives, dementia is rare, but NI may occur in a third of cases. The neurocognitive impairment is ''subcortical'' in nature, with primary difficulties in attention, speeded information processing, and learning. Quantitated MRI morphometry indicates progressive shrinkage of subcortical structures as disease progresses. Postmortem evidence indicates viral burden especially in subcortical gray and adjacent white matter. Besides neuronal loss, there is progressive reduction in synaptodendritic complexity; these postmortem neuropathologic changes are correlated with antemortem MRI morphometric and neuropsychological indicators. The degree of reversibility of NI with currently available antiretroviral treatments is unclear, but promising new methods, including agents aimed at blocking excitotoxic injury, are on the horizon. The cognitive impairment, though subtle, has life quality implications, including higher likelihood of unemployment. Thus, detection and early treatment are paramount.

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