| Publication Abstract Display | | Type: Published Abstract | | Title: Clinical diagnosis and risk factors for HIV-associated minor cognitive-motor disorder. | | Authors: Ellis RJ, Heaton RK, Marcotte TD, McCutchan JA, Deutsch R, Abramson I, Grant I, and the HNRC Group | | Year: 1996 | | Publication: Journal of NeuroVirology | | Volume: 2 Issue: Pages: 36 | | Abstract:RATIONALE. Clinical criteria for HIV-associated minor cognitive-motor disorder (MCMD) have been proposed, but not evaluated. Risk factors, prognosis and treatments are undefined
METHODS. We studied a cohort of HIV-infected volunteers without frank dementia. MCMD was diagnosed according to published criteria (AAN, 1991) requiring objective evidence of cognitive impairment on neuropsychological (NP) testing; mild, but symptomatic functional decline from a previous baseline; and the absence of etiologic explanations other than HIV.
RESULTS. Of 494 included subjects, 65% were NP normal (NL) and 35% showed global impairment. Among impaired subjects, 36% met criteria for MCMD; the remainder were subsyndromally impaired (NPI). Disease stage was the principal risk factor for MCMD: among seropositives free of opportunistic disease, 4% met MCMD criteria, compared to 28% of those with minor opportunistic diseases, and 32% of those with AIDS-defining illnesses. After adjusting for the effect of disease stage, the risk for MCMD increased in association with abnormally high concentrations of serum globulins, and cerebrospinal fluid beta-2-microglobulin (B2MG), but did not differ according to age, education, gender, CD4 lymphocyte count, body ass, or B2MG in serum. Median survival times in MCMD, NPI and NL groups were 2.2, 3.8 and 5.1 years, respectively.
CONCLUSIONS. Both systematic and CNS-specific immune dysregulation may contribute to MCMD. Because MCMD is common and is associated with longer survival than HIV-associated dementia, patients with MCMD may be better suited for interventional trials. |
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