a1 Departments of Neurology and Psychology, University of Helsinki, Finland
a2 Department of Neurology, University of Tampere, Finland
Eighty-five subjects at various stages of human immunodeficiency virus (HIV-1) infection and 39 seronegative controls underwent neurological and neuropsychological evaluation to assess the relationship between cognitive test results and subjective complaints (cognitive, affective, motor, and other). The effect of psychiatric disorders on the association between cognitive performance and complaints of the patients was also examined. Patients with symptomatic infection had higher frequency of complaints than subjects at asymptomatic stage. Detailed neuropsychological examination confirmed a strong association between poor verbal memory and cognitive complaints. Poor performance on cognitive speed and flexibility was associated with motor complaints and motor abnormalities. These associations were not explained by psychiatric disorders or elevated depression questionnaire scores. Our observations indicate that, especially in symptomatic HIV-1 infection, cognitive changes reported by patients often reflect “objective” cognitive decline, and may be the earliest signs of HIV-1 associated cognitive disorder. No direct relationship was observed between “subjective” complaints and neuropsychological performance of asymptomatic subjects. Understanding the significance of reported cognitive changes have important therapeutic implications. (JINS, 1996, 2, 219–225.)
(Received September 01 1994)
(Accepted July 12 1995)
Reprint requests to: Erja Poutiainen. Department of Neurology, Helsinki University Hospital, SF–00290 Helsinki, Finland.