Psychological Medicine

Original Article

Verbal working memory storage and processing deficits in HIV-1 asymptomatic and symptomatic individuals

M. K.  YORK  c1 a1, J. J.  FRANKS  a1, R. R.  HENRY  a1 and W. J.  HAMILTON  a1
a1 From the Department of Neurosurgery, Baylor College of Medicine, Houston, TX; and Department of Psychology, Vanderbilt University, Nashville, TN, USA


Background. Verbal working memory (WM), which relies on intact functioning of frontostriatal circuits, has been suggested as a cognitive domain that is preferentially affected in HIV-1 infection. Although several studies have found WM impairments in HIV-1 infected patients, Baddeley's classic WM model has not been studied extensively in this population.

Methods. We used two cognitive neuropsychological approaches to examine verbal WM deficits in 18 HIV-1 seronegative, 16 HIV-1 asymptomatic, and 20 HIV-1 symptomatic patients. First, based on Baddeley's WM model of the Phonological Loop, we used the phonological similarity effect and the irrelevant speech effect to evaluate each individual's phonological store, and the word-length effect and the articulatory suppression effect to evaluate the articulatory control process. Secondly, an individual differences approach, which focuses on the capacity limitation of the WM system and potentially integrates the functions of Baddeley's Central Executive component with the Phonological Loop, was adopted. We evaluated each patient's simultaneous storage and processing of auditory material using the Verbal Memory Span test.

Results. The HIV-1 symptomatic individuals, but not the HIV-1 asymptomatic subjects, demonstrated impaired short-term storage of verbal material in the phonological store on Baddeley's measures. Although the HIV-1 asymptomatic and symptomatic subjects demonstrated intact rehearsal of speech-based material in the articulatory control process, both groups demonstrated impairment on the Verbal Memory Span test.

Conclusions. These findings suggest that deficits in simultaneous short-term storage and processing occur during both early and later stages of HIV-1 infection.

c1 Address for correspondence: Dr Michele K. York, Department of Neurosurgery, Baylor College of Medicine, 6560 Fannin, Suite 944, Houston, TX 77030, USA.