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The HNRC 500-Neuropsychology of Hiv infection at different disease stages

Published online by Cambridge University Press:  26 February 2009

Robert K. Heaton
Affiliation:
University of California at San Diego, Dept. of Psychiatry, La Jolla, CA 92093
Igor Grant
Affiliation:
University of California at San Diego, Dept. of Psychiatry, La Jolla, CA 92093 Veterans Affairs Medical Center-San Diego, La Jolla, CA 92161
Nelson Butters
Affiliation:
University of California at San Diego, Dept. of Psychiatry, La Jolla, CA 92093 Veterans Affairs Medical Center-San Diego, La Jolla, CA 92161
Desireé A. White
Affiliation:
University of California at San Diego, Dept. of Psychiatry, La Jolla, CA 92093
Donald Kirson
Affiliation:
University of California at San Diego, Dept. of Psychiatry, La Jolla, CA 92093
J. Hampton Atkinson
Affiliation:
University of California at San Diego, Dept. of Psychiatry, La Jolla, CA 92093
J. Allen McCutchan
Affiliation:
University of California at San Diego, Dept. of Psychiatry, La Jolla, CA 92093
Michael J. Taylor
Affiliation:
University of California at San Diego, Dept. of Psychiatry, La Jolla, CA 92093
Mark D. Kelly
Affiliation:
University of California at San Diego, Dept. of Psychiatry, La Jolla, CA 92093
Ronald J. Ellis
Affiliation:
University of California at San Diego, Dept. of Psychiatry, La Jolla, CA 92093 Veterans Affairs Medical Center-San Diego, La Jolla, CA 92161
Tanya Wolfson
Affiliation:
University of California at San Diego, Dept. of Psychiatry, La Jolla, CA 92093
Robert Velin
Affiliation:
University of California at San Diego, Dept. of Psychiatry, La Jolla, CA 92093
Thomas D. Marcotte
Affiliation:
University of California at San Diego, Dept. of Psychiatry, La Jolla, CA 92093
John R. Hesselink
Affiliation:
University of California at San Diego, Dept. of Psychiatry, La Jolla, CA 92093 Veterans Affairs Medical Center-San Diego, La Jolla, CA 92161
Terry L. Jernigan
Affiliation:
University of California at San Diego, Dept. of Psychiatry, La Jolla, CA 92093 Veterans Affairs Medical Center-San Diego, La Jolla, CA 92161
James Chandler
Affiliation:
U.S. Naval Medical Center-San Diego, CA, 92134
Mark Wallace
Affiliation:
U.S. Naval Medical Center-San Diego, CA, 92134
Ian Abramson
Affiliation:
University of California at San Diego, Dept. of Psychiatry, La Jolla, CA 92093

Abstract

The present study examined neuropsychological (NP) functioning and associated medical, neurological, brain magnetic resonance imaging (MRI), and psychiatric findings in 389 nondemented males infected with Human Immunodeficiency Virus-Type 1 (HIV-1), and in 111 uninfected controls. Using a comprehensive NP test battery, we found increased rates of impairment at each successive stage of HIV infection. HIV-related NP impairment was generally mild, especially in the medically asymptomatic stage of infection, and most often affected attention, speed of information processing, and learning efficiency; this pattern is consistent with earliest involvement of subcortical or frontostriatal brain systems. NP impairment could not be explained on the bases of mood disturbance, recreational drug or alcohol use, or constitutional symptoms; by contrast, impairment in HIV-infected subjects was related to central brain atrophy on MRI, as well as to evidence of cellular immune activation and neurological abnormalities linked to the central nervous system. (JINS, 1995, 1, 231–251.)

Type
Research Articles
Copyright
Copyright © The International Neuropsychological Society 1995

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References

American Academy of Neurology AIDS Task Force (1991). No menclature and research case definitions for neurologic man ifestations of human immunodeficiency virus-type 1 (HIV-1) infection. Neurology, 41, 778785.CrossRefGoogle Scholar
American Psychiatric Association. (1987). Diagnostic and Sta tistical Manual of M ental Disorders, Third Edition, Revised. Washington, DC: Author.Google Scholar
Beck, A.T. (1976). Cognitive therapy and the emotional disorders. New York: Hoeber.Google Scholar
Boccellari, A.A., Dilley, J.W., Chambers, D.B., Yingling, C.D., Tauber, M.A., Moss, A.R., & Osmond, D.H. (1993). Immune function and neuropsychological performance in HIV-1 infected homosexual men. Journal of Acquired Immune Deficiency Syndromes, 6, 592601.Google ScholarPubMed
Bornstein, R.A., Fama, R., Rosenberger, P., Whitacre, C.C., Para, M.F., Nasrallah, H.A., & Fass, R.J. (1993a). Drug and alcohol use and neuropsychological performance in asymp tomatic HIV infection. Journal of Neuropsychiatry and Clinical Neurosciences, 5(3), 254259.Google Scholar
Bornstein, R.A., Nasrallah, H.A., Para, M.F., Fass, R.J., Whitacre, C.C., & Rice, R.R. (1991). Rate of CD4 decline and neuropsychological performance in HIV infection. Ar chives of Neurology, 48, 704707.CrossRefGoogle ScholarPubMed
Bornstein, R.A., Nasrallah, H.A., Para, M.F., Whitacre, C.C., Rosenberger, P., & Fass, R.J. (1993b). Neuropsychological performance in symptomatic and asymptomatic HIV infection. AIDS, 7, 519524.CrossRefGoogle ScholarPubMed
Bornstein, R.A., Nasrallah, H.A., Para, M.F., Whitacre, C.C., Rosenberger, P., Fass, R.J., & Rice, R. (1992). Neuropsy chological performance in asymptomatic HIV infection. The Journal of Neuropsychiatry and Clinical Neurosciences, 4(4),386394.Google Scholar
Bornstein, R.A., Pace, P., Rosenberger, P., Nasrallah, H.A., Para, M.F., Whitacre, C.C., & Fass, R.J. (1993c). Depression and neuropsychological performance in asymptomatic HIV infection. American Journal of Psychiatry, 150(6), 922927.Google ScholarPubMed
Brew, B.J., Bhalla, R.B., Fleisher, M., Paul, M., Khan, A., Schwartz, M.K., & Price, R.W. (1989). Cerebrospinal fluid beta-1-microglobulin in patients infected with human immunodeficiency virus. Neurology, 39, 830834.CrossRefGoogle ScholarPubMed
Butters, N., Grant, I., Haxby, J., Judd, L.L., Martin, A., McClelland, J., Pequegnat, W., Schacter, D., & Stover, E. (1990). Assessment of AIDS-related cognitive changes: Recommendations of the NIMH workshop on neuropsychological assessment approaches. Journal of Clinical and Experimental Neuropsychology, 12(6), 963978.CrossRefGoogle ScholarPubMed
Centers for Disease Control. (1992). 1993 revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. Morbidity and Mortality Weekly Report, 41 (Suppl. 44–17), 119.Google Scholar
Collier, A.C., Marra, C., Coombs, R.W., Claypoole, K., Cohen, W., Longstreth, W.T., Townes, B.D., Maravilla, K.R., Crichlow, C., Murphy, V.L., & Handsfield, H.H. (1992). Central nervous system manifestations of human immuno deficiency virus infection without AIDS. Journal of A cquired Immune Deficiency Syndromes, 5, 229241.Google Scholar
Day, J.J., Grant, I., Atkinson, J.H., Brysk, L.T., McCutchan, J.A., Hesselink, J.R., Heaton, R.K., Weinrich, J.D., Spector, S.A., & Richman, D.D. (1992). Incidence of dementia in a two year follow-up of AIDS and ARC patients on an initial Phase II AZT placebo-controlled study: San Diego Cohort. Journal of Neuropsychiatry, 4(1), 1520.Google Scholar
Filley, C.M., Heaton, R.K., Thompson, L.L., Nelson, L.M., & Franklin, G.M. (1990). Effects of disease course on neuropsychological functioning in multiple sclerosis. In Rao, S.M. (Ed.), Neurobehavioral aspects of multiple sclerosis (pp. 136148). New York: Oxford University Press.Google Scholar
Folstein, M.F., Folstein, S.E., & McHugh, P.R. (1975). Minimental state: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.CrossRefGoogle Scholar
Fransblau, A., Letz, R., Hershman, D., Mason, P., Wallace, J.I., & Bekesi, J.G. (1991). Quantitative neurologic and neurobehavioral testing of persons infected with human immunodeficiency virus type 1. Archives of Neurology, 48, 263268.CrossRefGoogle Scholar
Gibbs, A., Andrewes, D.G., Szmukler, G., Mulhall, B., & Bowden, S.C. (1990). Early HIV-related neuropsychological im pairment: Relationship to age of viral infection. Journal of Clinical and Experimental Neuropsychology, 12(5), 766780.CrossRefGoogle Scholar
Grant, I., Adams, K.M., Carlin, A.S., Rennick, P., Judd, L.L., & Schooff, K. (1978). The collaborative neuropsychological study of polydrug abusers. Archives of General Psychiatry, 35, 10631074.CrossRefGoogle Scholar
Grant, I., Adams, K., & Reed, R. (1979). Normal neuropsycho logical abilities of alcoholic men in their late thirties. American Journal of Psychiatry, 136, 12631269.Google Scholar
Grant, I., Atkinson, J., Hesselink, J.R., Kennedy, C.J., Richman, D.D., Spector, S.A., & McCutchan, J.A. (1987). Evidence for early central nervous system involvement in the acquired immunodeficiency syndrome (AIDS) and other human immunodeficiency virus (HIV) infections. Studies with neuropsychologic testing and magnetic resonance imaging. Annals of Internal Medicine, 107, 828836.CrossRefGoogle ScholarPubMed
Grant, I., Caun, K., Kingsley, D.P.E., Winer, J., Trimble, M.R., & Pinching, A.J. (1992). Neuropsychological and NMR abnormalities in HIV infection. The St. Mary's Queen Square Study. Neuropsychiatry, Neuropsychology, and Behavioral Neurology, 5, 185193.Google Scholar
Grant, I., Heaton, R.K., McSweeny, A.J., Adams, K.M., & Timms, R.M. (1982). Neuropsychologic findings in hypox emic chronic obstructive pulmonary disease. Archives of In ternal Medicine, 142, 14701476.Google Scholar
Grant, I. & Martin, A. (1994). Neuropsychology of HIV infection. New York: Oxford University Press.Google Scholar
Grant, I., Olshen, R.A., Atkinson, J.H., Heaton, R.K., Nelson, J., McCutchan, A.J., & Weinrich, J.D. (1993). Depressed mood does not explain neuropsychological deficits in HIV-infected persons. Neuropsychology, 7(1), 5361.CrossRefGoogle Scholar
Grassi, M.P., Perin, C., Clerici, F., Zocchetti, C., Cargnel, A., & Mangoni, A. (1993). Neuropsychological performance in HIV-1-infected drug abusers. Acta Neurologica Scandinavica, 88, 119122.CrossRefGoogle ScholarPubMed
Hamilton, M. (1959). The assessment of anxiety states by rating. Behavioral Journal of Medicine and Psychology, 32, 5055.CrossRefGoogle ScholarPubMed
Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry, 23, 5662.CrossRefGoogle ScholarPubMed
Heaton, R.K. (1992). Comprehensive norms for an expanded Halstead-Reitan Battery; A supplement for the WAIS-R. Odessa, FL: Psychological Assessment Resources, Inc.Google Scholar
Heaton, R.K., Grant, I., Anthony, W.Z., & Lehman, R.A.W. (1981). A comparison of clinical and automated interpretation of the Halstead-Reitan Battery. Journal of Clinical Neuropsychology, 3, 121141.CrossRefGoogle ScholarPubMed
Heaton, R.K., Grant, I., & Matthews, C.G. (1991). Comprehensive norms for an expanded Halstead-Reitan Battery: Demographic corrections, research findings, and clinical applications. Odessa, FL: Psychological Assessment Re sources. Inc.Google Scholar
Heaton, R.K., Kirson, D., Velin, R.A., Grant, I., & the HNRC Group. (1994). The utility of clinical ratings for detecting early cognitive change in HIV infection. In Grant, I. & Martin, A. (Eds.), Neuropsychology of HIV infection (pp. 188206). New York: Oxford University Press.Google Scholar
Heaton, R.K., Nelson, L.M., Thompson, D.S., Burks, J.S., & Franklin, G.M. (1985). Neuropsychological findings in relapsing-remitting and chronic-progressive multiple sclerosis. Journal of Consulting and Clinical Psychology, 53, 103110.CrossRefGoogle ScholarPubMed
Heaton, R.K., Velin, R.A., McCutchan, J.A., Gulevich, S., Atkinson, J.H., Wallace, M.R., Godfrey, H., Kirson, D., Grant, I., & the HNRC Group. (1994). Neuropsychological impairment in HIV-infection: Implications for employment. Psychosomatic Medicine, 56, 817.CrossRefGoogle ScholarPubMed
Hesselink, J.R.;. Jernigan, T.L., & Heindel, W.C. (1994). Structural brain imaging of HIV infection. In Grant, I. and Martin, A. (Eds.), Neuropsychology of HIV infection (pp. 108129). New York: Oxford University Press.Google Scholar
Hestad, K., McArthur, J.H., Dal Pan, G.J., Seines, O.A., Nance-Sproson, T.E., Aylward, E., Mathews, V.P., & McArthur, J.C. (1993). Regional brain atrophy in HIV-1 infection: Association with specific neuropsychological test performance. Acta Neurologica Scandinavica, 88, 112118.CrossRefGoogle ScholarPubMed
Hinkin, C.H., van Gorp, W.G., Satz, P., Weisman, J.D., Thommes, J., & Buckingham, S. (1992). Depressed mood and its relationship to neuropsychological test performance in HIV-1 seropositive individuals. Journal of Clinical and Experimental Neuropsychology, 14(2), 289297.CrossRefGoogle ScholarPubMed
Jakobsen, J., Smith, T., Gaub, J., Helweg-Larsen, S., & Trojaborg, W. (1989). Progressive neurological dysfunction during latent HIV infection. British Medical Journal, 299, 225228.CrossRefGoogle ScholarPubMed
Janssen, R.S., Saykin, A.J., Kaplan, J.E., Spira, T.J., Pinsky, P.F., Sprehn, G.C., Hoffman, J.C, Mayer, W.B. Jr., & Schonberger, L.B. (1988). Neurological complications of human immunodeficiency virus infection in patients with lymphadenopathy syndrome. Annals of Neurology, 23, 4955.CrossRefGoogle Scholar
Janssen, R.S., Nwanyanwu, O.C., Selik, R.M., & Stehr-Green, J.K. (1992). Epidemiology of human immunodeficiency virus encephalopathy in the United States. Neurology, 42, 14721476.CrossRefGoogle ScholarPubMed
Jernigan, T.L., Archibald, S., Hesselink, J.R., Atkinson, J.H., Velin, R.A., McCutchan, J.A., Chandler, J., & Grant, I. (1993). MRI morphometric analysis of cerebral volume loss in HIV infection. Archives of Neurology, 50, 250255.CrossRefGoogle Scholar
Kaemingk, K.L. & Kaszniak, A.W. (1989). Neuropsychological aspects of human immunodeficiency virus infection. The Clinical Neuropsychologist, 3(4), 309326.CrossRefGoogle Scholar
Kokkevi, A., Hatzakis, A., Maillis, A., Pittadaki, J., Zalonis, J., Samartzis, D., Touloumi, G., Mandalaki, T., & Stefanis, C. (1991). Neuropsychological assessment of HlV-scropositive hemophiliacs. AIDS, 5, 12231229.CrossRefGoogle Scholar
Koralnik, I.J., Beaumanoir, A., Hauslcr, R., Kohler, A., Safran, A.B., Delacoux, R., Vibert, D., Mayer, E., Burkhard, P., & Nahory, A. (1990). A controlled study of early neurologic abnormalities in men with asymptomatic human immunodeficiency virus infection. New England Journal of Medicine, 323, 864870.CrossRefGoogle ScholarPubMed
Krikorian, R., Wrobel, A.J., Mcinecke, C., Liang, W.M., & Kay, J. (1990). Cognitive deficits associated with human immunodeficiency virus encephalopathy. The Journal of Neu ropsychiatry and Clinical Neurosciences, 2, 256260.Google ScholarPubMed
Lan, S.-P., Ryan, C.M., Adams, K.M., Grant, I., Heaton, R.K., Rand, L.I., Jacobson, A.M., Nathan, D.M., & Cleary, P.A. (1994). A screening algorithm to identify clinically significant changes in neuropsychological functions in the Diabetes Control and Complications Trial (DCCT Research Group). Journal of Clinical and Experimental Neuropsychology, 16(2), 303316.CrossRefGoogle Scholar
Law, W.A., Martin, A., Mapou, R.L., Toller, T.L., Salazar, A.M., Temoshok, L.R., & Rundell, J.R. (1994). Working memory in individuals with HIV infection. Journal of Consulting and Clinical Neuropsychology, 16(2), 173182.CrossRefGoogle ScholarPubMed
Levin, H.S., Williams, D.H., Borucki, M.J., Hillman, G.R., Williams, J.B., Guinto, F.C., Amparo, E.G., Crow, W.N., & Pollard, R.B. (1990). Magnetic resonance imaging and neuropsychological findings in human immunodeficiency virus infection. Journal of Acquired Immune Deficiency Syndromes, 3(8), 757762.Google ScholarPubMed
Levy, R.M., Bredesen, D.E., & Rosenblum, M.L. (1985). Neurological manifestations of the acquired immunodeficiency syndrome (AIDS): Experience at UCSF and review of the literature. Journal of Neurosurgery, 62, 475495.CrossRefGoogle ScholarPubMed
Lezak, M.D. (1983). Neuropsychological assessment. (2nd ed.). New York: Oxford University Press.Google Scholar
Lunn, S., Skydsbjerg, M., Schulsinger, H., Parnas, J., Pedersen, C., & Mathiesen, L. (1991). A preliminary report on the neuropsychologic sequelae of human immunodeficiency virus. Archives of General Psychiatry, 48, 139142.CrossRefGoogle ScholarPubMed
Maj, M., Satz, P., Janssen, R., Zaudig, M.Starace, F., D'Elia, L., Sughondhabirom, B., Mussa, M., Naber, D., Ndetei, D., Schulte, G., & Sartorius, N. (1994). WHO Neuropsychiatric AIDS study, cross-sectional Phase II: Neuropsychological and neurological findings. Archives of General Psychiatry, 51, 5161.CrossRefGoogle ScholarPubMed
Mapou, R.L., Law, W.A., Martin, A., Kampen, D., Salazar, A.M., & Rundell, J.R. (1993). Neuropsychological performance, mood, and complaints of cognitive and motor difficulties in individuals infected with the Human Immuno deficiency Virus. Journal of Neuropsychiatry and Clinical Neurosciences, 5(1), 8693.Google Scholar
Martin, A. (1994). HIV, cognition, and the basal ganglia. In Grant, I. & Martin, A. (Eds.), Neuropsychology of HIV infection (pp. 234259). New York: Oxford University Press.Google Scholar
Martin, E.M., Robertson, L.C., Edelstein, H.E., Jagust, W.I., Sorenson, D.J., San Giovanni, D., & Chirurgi, V.A. (1992). Performance of patients with early HIV-1 infection on the Stroop Task. Journal of Clinical and Experimental Neuro psychology, 14, 857868.CrossRefGoogle ScholarPubMed
Mayeux, R., Stern, Y., Tang, M.-X., Todak, G., Marder, K., Sano, M., Richards, M., Stein, Z., Ehrhardt, A.A., & Gorman, J.M. (1993). Mortality risks in gay men with human immunodeficiency virus infection and cognitive impairment. Neurology, 43, 176182.CrossRefGoogle ScholarPubMed
McAllister, R.H., Herns, M.V., Harrison, M.J.G., Newman, S.P., Connolly, S., Fowler, C.J., Fell, M.Durrance, P., Manji, H., Kendall, B.E., & Valentine, A.R. (1992). Neurological and neuropsychological performance in HIV seropositive men without symptoms. Journal of Neurology, Neurosurgery, and Psychiatry, 55, 143148.CrossRefGoogle ScholarPubMed
McArthur, J.C. (1994). Neurological and neuropathological manifestations of HIV infection. In Grant, I. & Martin, A. (Eds.), Neuropsychology of HIV infection (pp. 56107). New York: Oxford University Press.Google Scholar
McArthur, J.C., Cohen, B.A., Selnes, O.A., Kumar, A.J., Cooper, K., McArthur, J.H., Soucy, G., Cornblath, D.R., Chimel, J.S., Wang, M.-C., Starkey, D.L., Ginsburg, H., Ostrow, D.G., Johnson, R.T., Phair, J.P., & Polk, B.F. (1989). Low prevalence of neurological and neuropsychological abnormalities in otherwise healthy HIV-1-infected individuals: Results from the Multicenter AIDS Cohort Study. Annals of Neurology, 26(5), 601611.CrossRefGoogle ScholarPubMed
McArthur, J.C., Hoover, D.R., Bacellar, H., Miller, E.N., Cohen, B.A., Becker, J.T., Graham, N.M.H., McArthur, J.H., Selnes, O.A., Jacobson, L.P., Visscher, B.R., Concha, M., & Saah, A. (1993). Dementia in AIDS patients: Incidence and risk factors. Neurology, 43, 22452253.CrossRefGoogle ScholarPubMed
McArthur, J.C., Nance-Sproson, T.E., Griffin, E.D., Hoover, D., Selnes, O.A., Miller, E.N., Margolick, J.B., Cohen, B.A., Farzadegan, H., & Saah, A. (1992). The diagnostic utility of elevation in cerebrospinal fluid ß2-microglobulin in HIV-1 dementia. Neurology, 42, 17071712.CrossRefGoogle Scholar
McKegney, F.P., O'Dowd, M.A., Feiner, C., Selwyn, P., Drucker, E., & Friedland, G.H. (1990). A prospective comparison of neuropsychologic function in HIV-seropositive and seronegative methadone-maintained patients. AIDS, 4, 565569.CrossRefGoogle ScholarPubMed
McNair, D.M., Lorr, M., & Droppleman, L.F. (1980). Manual for Profile of Mood States. San Diego: Educational and Industrial Testing Service.Google Scholar
Mehta, P., Gulevich, S.J., Thal, L.J., Jin, H., Olichney, J.M., McCutchan, J.A., Heaton, R.K., Hurray, C.A., Kirson, D., Kaplanski, G., Nelson, J., Atkinson, J.H., Wallace, M.R., Grant, I., & the HNRC Group. (1995). Neurological symp toms, not signs, are common in early HIV infection. Jour nal of Neuro-AIDS (in press).Google Scholar
Miller, E.N., Selnes, O.A., McArthur, J.C., Satz, P., Becker, J.T., Cohen, B.A., Sheridan, K., Machado, A.M., van Gorpt, W.G., & Visscher, B. (1990). Neuropsychological performance in HIV-1 infected homosexual men: The Multicenter AIDS Cohort Study (MACS). Neurology, 40, 197203.CrossRefGoogle ScholarPubMed
Naber, D., Perro, C., Schick, U., Schmauss, M., Erfurth, A., Bove, D., Goebel, F.D., & Hippius, H. (1990). Psychiatric symptoms and neuropsychological deficits in HIV infection. Neuropsychopharmacology, 745755.CrossRefGoogle Scholar
Navia, B.A., Cho, E.S., Petito, C.K., & Price, R.W. (1986b). The AIDS dementia complex: II. Neuropathology. Annals of Neurology, 19, 525535.CrossRefGoogle ScholarPubMed
Navia, B.A., Jordan, B.D., & Price, R.W. (1986a). The AIDS dementia complex: I. Clinical features. Annals of Neurology, 19, 517524.CrossRefGoogle ScholarPubMed
Navia, B.A. & Price, R.W. (1987). The acquired immunodeficiency syndrome dementia complex as the presenting or sole manifestation of human immunodeficiency virus infection. Archives of Neurology, 44, 6569.CrossRefGoogle ScholarPubMed
Peavy, G., Jacobs, D., Salmon, D.P., Butters, N., Delis, D.C., Taylor, M., Massman, P., Stout, J.C., Heindel, W.C., Kirson, D., Atkinson, J.H., Chandler, J.L., Grant, I., & the HNRC Group. (1994). Verbal memory performance of patients with human immunodeficiency virus infection: Evidence of subcortical dysfunction. Journal of Clinical and Experimental Neuropsychology, 16, 508523.CrossRefGoogle ScholarPubMed
Perdices, M. & Cooper, D.A. (1989). Simple and choice reaction time in patients with human immunodeficiency virus in fection. Annals of Neurology, 25, 460467.CrossRefGoogle Scholar
Perry, S., Belsky-Barr, D., Barr, W.B., & Jacobsberg, L. (1989). Neuropsychological function in physically asymptomatic, HIV-seropositive men. Journal of Neuropsychiatry, 1(3), 296302.Google ScholarPubMed
Poutianinen, E., Iivanainen, M., Elovaara, I., Valle, S.L., & Lahdevirta, J. (1988). Cognitive changes as early signs of HIV infection. Ada Neurologica Scandinavica, 78, 4952.CrossRefGoogle Scholar
Poutianinen, E., Elovaara, I., Raininko, R., Hokkanen, L., Valle, S.L., Lahdevirta, J., & Iivanainen, M. (1993). Cognitive performance in HIV-1 infection: Relationship to severity of disease and brain atrophy. Acta Neurologica Scandinavica, 87, 8894.CrossRefGoogle Scholar
Price, R.W. & Brew, B.J. (1988). The AIDS dementia complex. Journal of Infectious Diseases, 158, 10791083.CrossRefGoogle ScholarPubMed
Pumarola-Sune, T., Navia, B.A., Cordon-Cardo, C., Cho, E.S., & Price, R.W. (1987). HIV antigen in the brains of patients with the AIDS dementia complex. Annals of Neurology, 21, 490496.CrossRefGoogle ScholarPubMed
Reinvang, I., Froland, S.S., & Skripeland, V. (1991). Prevalence of neuropsychological deficit in HIV infection. Incipient signs of AIDS dementia complex in patients with AIDS. Acta Neurologica Scandinavica, 83, 289293.CrossRefGoogle ScholarPubMed
Reitan, R.M. & Wolfson, D. (1993). The Halstead-Reitan Neuropsychological Test Battery (2nd ed.) Tucson, AZ: Neuro psychology Press.Google Scholar
Riccio, M., Pugh, K., Jadresic, D., Burgess, A., Thompson, C., Wilson, B., Lovett, E., Baldeweg, T., Hawkins, D.A., & Catalan, J. (1993). Neuropsychiatric aspects of HIV-1 infection in gay men: Controlled investigation of psychiatric, neuropsychological and neurological status. Journal of Psycho somatic Research, 37(8), 819830.CrossRefGoogle ScholarPubMed
Riedel, R.R., Helmstaedter, C., Bulau, P., Durwen, H.F., Brackmann, H., Fimmers, R., Clarenbach, P., Miller, E.N., & Bottcher, M. (1992). Early signs of cognitive deficits among human immunodeficiency virus-positive hemophiliacs. Acta Psychiatrica Scandinavica, 85, 321326.CrossRefGoogle ScholarPubMed
Royal, W., Updike, M., Selnes, O.A., Proctor, T.V., Nance-Sproson, L., Solomon, L., Vlahov, D., Cornblath, D.R., & McArthur, J.C. (1991). HIV-1 infection and nervous system abnormalities among a cohort of intravenous drug users. Neurology, 41, 19051910.CrossRefGoogle ScholarPubMed
Rubinow, D.R., Berrettini, C.H., Browers, P., & Lane, H.C. (1988). Neuropsychiatric consequences of AIDS. Annals of Neurology, 23(Supp.), 2426.CrossRefGoogle ScholarPubMed
Saykin, A.J., Janssen, R.S., Sprehn, G.C., Kaplan, J.E., Spira, T.J., & Weller, P. (1988). Neuropsychological dysfunction in HIV-infection: Characterization in lymphadenopathy cohort. International Journal of Clinical Neuropsychology, 10(2), 8195.Google Scholar
Saykin, A.J., Janssen, R.S., Sprehn, G.C., Kaplan, J.E., Spira, T.J., & O'Connor, B. (1991). Longitudinal evaluation of neuropsychological function in homosexual men with HIV infection: 18-month follow-up. Journal of Neuropsychiatry, 3, 286298.Google ScholarPubMed
Schmitt, F.A., Bigley, J.W., McKinnis, R., Logue, P.E., Evans, R.W., Drucker, J.L., & the AZT Collaborative Working Group. (1988). Neuropsychological outcome of zidovudine (AZT) treatment of patients with AIDS and AIDS-related complex. New England Journal of Medicine, 319, 15731578.CrossRefGoogle ScholarPubMed
Selnes, O.A., McArthur, J.C., Royal, W., III, Updike, M.L., Nance-Sproson, T., Concha, M., Gordon, B., Solomon, L., & Vlahov, D. (1992). HIV-1 infection and intravenous drug use: Longitudinal neuropsychological evaluation of asymptomatic subjects. Neurology, 42, 19241930.CrossRefGoogle ScholarPubMed
Skoraszewski, J.J., Ball, J.D., & Mikulka, P. (1991). Neuropsychological functioning of HIV-infected males. Journal of Clinical and Experimental Neuropsychology, 13(2), 278290.CrossRefGoogle ScholarPubMed
Snider, W.D., Simpson, D.M., Nielsen, S., Gold, J.W., Metroka, C.E., & Posner, J.B. (1983). Neurological complications of acquired immune deficiency syndrome: Analysis of 50 patients. Annals of Neurology, 14, 403418.CrossRefGoogle ScholarPubMed
Sonnerborg, A.B., von Stedingk, L.V., Hansson, L.O., & Strannegard, O.O. (1989). Elevated neopterin and beta 2-microglobulin levels in blood and cerebrospinal fluid occur early in HIV-1 infection. AIDS, 3, 277283.CrossRefGoogle ScholarPubMed
Sorenson, D.J., Martin, E.M., & Robertson, L.C. (1994). Visual attention in HIV-1 infection. Neuropsychology, 8, 424432.CrossRefGoogle Scholar
Spitzer, R.L., Williams, J.B., Gibbon, M., & First, M.B. (1990). Structured Clinical Interview for DSM-111-R. Washington, DC: American Psychiatric Association.Google Scholar
Stern, Y., Marder, K., Bell, K., Chen, J., Dooneief, G., Goldsten, M.A., Mindry, D., Richards, M., Sano, M., Williams, J., Gorman, J., Ehrhardt, A., & Mayeux, R. (1991). Multidisciplinary baseline assessment of homosexual men with and without human immunodeficiency virus infection: Neurological and neuropsychological findings. Archives of General Psychiatry, 48, 131138.CrossRefGoogle ScholarPubMed
Tross, S., & Hirsch, D.A. (1988). Psychological distress and neuropsychological complications of HIV infection and AIDS. American Psychologist, 43(11), 929934.CrossRefGoogle ScholarPubMed
Tross, S., Price, R.W., Navia, B., Thaler, H.T., Gold, J., Hirsch, D.A., & Sidtis, J.J. (1988). Neuropsychological characterization of the AIDS dementia complex: A preliminary report. AIDS, 2, 8188.CrossRefGoogle ScholarPubMed
van Gorp, W.G., Miller, E.N., Satz, P., & Visscher, B. (1989). Neuropsychological performancein HIV-1 immunocompromised patients: A preliminary report. Journal of Clinical and Experimental Neuropsychology, 11, 763773.CrossRefGoogle Scholar
van Gorp, W.G., Satz, P., Hinkin, C., Selnes, O., Miller, E.N., McArthur, J., Cohen, B., Paz, D., & the Multicenter AIDS Cohort Study (MACS). (1991). Metacognition in HIV-1 seropositive asymptomatic individuals: Self-ratings versus objective neuropsychological performance. Journal of Clinical and Experimental Neuropsychology, 13(5), 812819.CrossRefGoogle ScholarPubMed
Wechsler, D. (1981). Wechsler Adult Intelligence Scale-Revised. New York: The Psychological Corporation.Google Scholar
White, D.A., Heaton, R.K., & Monsch, A.U. 1995. Neuropsy chological studies of asymptomatic human immunodeficiency virus-Type 1 infected individuals. Journal of International Neuropsychological Society, 1, (3), 304315.CrossRefGoogle Scholar
Wilkins, J.W., Robertson, K.R., Snyder, C.R., Robertson, W.K., van der Horst, C., & Hall, C.D. (1991). Implications of self-reported cognitive and motor dysfunction in HIV-positive patients. American Journal of Psychiatry, 148(5), 641643.Google ScholarPubMed