Neurocognitive Intra-individual Variability Within HIV+ Adults with and Without Current Substance Use

Overview

Journal Neuropsychology

Publisher American Psychological Association

Specialty Neurology

Date 2019 Dec 31

PMID 31886690

Citations 8

Authors

Miguel Arce Renteria

Desiree Byrd

Kelly Coulehan

Caitlin Miranda

Armando Fuentes

Ana K Rosario

Emily P Morris

Monica Rivera Mindt

Affiliations

Soon will be listed here.

Abstract

Objective: HIV infection and current substance use (SU) are linked to cognitive and functional deficits, yet findings on their combined effects are mixed. Neurocognitive intraindividual variability, measured as dispersion of scores across a neuropsychological battery, is associated with worse cognitive outcomes and functional deficits among HIV+ adults but has not been studied in the context of HIV+ adults with current SU. We hypothesized that, among HIV+ adults, current SU would be associated with greater dispersion, that greater dispersion would be associated with worse medication adherence, and that this relationship would be worse among substance users.

Method: Forty HIV+ adults completed neuropsychological, psychiatric, SU, and medical evaluations and an electronic medication adherence measure. General linear models evaluated the main effect of SU status on neurocognitive dispersion, and models stratified by SU status evaluated the effect of dispersion on medication adherence, adjusting for relevant covariates.

Results: The SU+ group showed greater dispersion than did the SU- group, t(38) = 2.74, p = .049, d = 0.81, but this association did not survive multiple comparisons. Stratified analyses indicated a negative relationship between dispersion and medication adherence among the SU+ group but not in the SU- group; however, this effect was reduced after accounting for depressive symptoms.

Conclusions: We found preliminary evidence that current SU is associated with greater neurocognitive dispersion among HIV+ adults. SU and neurocognitive dispersion may have a synergistic effect on medication adherence; however, this effect is largely accounted for by depressive symptoms. Future research should examine progression of dispersion in HIV and consequent neurocognitive and functional deficits in those with current SU. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

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References

Jones J, Kuhn T, Mahmood Z, Singer E, Hinkin C, Thames A . Longitudinal intra-individual variability in neuropsychological performance relates to white matter changes in HIV. Neuropsychology. 2017; 32(2):206-212. PMC: 5845766. DOI: 10.1037/neu0000390. View

Basso M, Bornstein R . Effects of past noninjection drug abuse upon executive function and working memory in HIV infection. J Clin Exp Neuropsychol. 2003; 25(7):893-903. DOI: 10.1076/jcen.25.7.893.16489. View

Fassbender C, Lesh T, Ursu S, Salo R . Reaction time variability and related brain activity in methamphetamine psychosis. Biol Psychiatry. 2014; 77(5):465-74. PMC: 4315764. DOI: 10.1016/j.biopsych.2014.07.028. View

Levine A, Hardy D, Barclay T, Reinhard M, Cole M, Hinkin C . Elements of attention in HIV-infected adults: evaluation of an existing model. J Clin Exp Neuropsychol. 2007; 30(1):53-62. PMC: 2886732. DOI: 10.1080/13803390601186684. View

Bunce D, Anstey K, Christensen H, Dear K, Wen W, Sachdev P . White matter hyperintensities and within-person variability in community-dwelling adults aged 60-64 years. Neuropsychologia. 2007; 45(9):2009-15. DOI: 10.1016/j.neuropsychologia.2007.02.006. View

Tractenberg R, Pietrzak R . Intra-individual variability in Alzheimer's disease and cognitive aging: definitions, context, and effect sizes. PLoS One. 2011; 6(4):e16973. PMC: 3079725. DOI: 10.1371/journal.pone.0016973. View

Fernandez-Serrano M, Perez-Garcia M, Verdejo-Garcia A . What are the specific vs. generalized effects of drugs of abuse on neuropsychological performance?. Neurosci Biobehav Rev. 2010; 35(3):377-406. DOI: 10.1016/j.neubiorev.2010.04.008. View

Vriesendorp R, Cohen A, Kristanto P, Vrijens B, Rakesh P, Anand B . Adherence to HAART therapy measured by electronic monitoring in newly diagnosed HIV patients in Botswana. Eur J Clin Pharmacol. 2007; 63(12):1115-21. PMC: 2071959. DOI: 10.1007/s00228-007-0369-2. View

Galvan F, Burnam M, Bing E . Co-occurring psychiatric symptoms and drug dependence or heavy drinking among HIV-positive people. J Psychoactive Drugs. 2003; 35 Suppl 1:153-60. DOI: 10.1080/02791072.2003.10400510. View

10.

Murtha S, Cismaru R, Waechter R, Chertkow H . Increased variability accompanies frontal lobe damage in dementia. J Int Neuropsychol Soc. 2002; 8(3):360-72. DOI: 10.1017/s1355617702813170. View

11.

Lovden M, Schmiedek F, Kennedy K, Rodrigue K, Lindenberger U, Raz N . Does variability in cognitive performance correlate with frontal brain volume?. Neuroimage. 2012; 64:209-15. PMC: 3508369. DOI: 10.1016/j.neuroimage.2012.09.039. View

12.

Woods S, Rippeth J, Frol A, Levy J, Ryan E, Soukup V . Interrater reliability of clinical ratings and neurocognitive diagnoses in HIV. J Clin Exp Neuropsychol. 2004; 26(6):759-78. DOI: 10.1080/13803390490509565. View

13.

Gaskill P, Calderon T, Coley J, Berman J . Drug induced increases in CNS dopamine alter monocyte, macrophage and T cell functions: implications for HAND. J Neuroimmune Pharmacol. 2013; 8(3):621-42. PMC: 4303241. DOI: 10.1007/s11481-013-9443-y. View

14.

Heaton R, Franklin D, Ellis R, McCutchan J, Letendre S, LeBlanc S . HIV-associated neurocognitive disorders before and during the era of combination antiretroviral therapy: differences in rates, nature, and predictors. J Neurovirol. 2010; 17(1):3-16. PMC: 3032197. DOI: 10.1007/s13365-010-0006-1. View

15.

Kumar A, Fernandez J, Singer E, Commins D, Waldrop-Valverde D, Ownby R . Human immunodeficiency virus type 1 in the central nervous system leads to decreased dopamine in different regions of postmortem human brains. J Neurovirol. 2009; 15(3):257-74. PMC: 9618304. DOI: 10.1080/13550280902973952. View

16.

Anderson A, Jones J, Thaler N, Kuhn T, Singer E, Hinkin C . Intraindividual variability in neuropsychological performance predicts cognitive decline and death in HIV. Neuropsychology. 2018; 32(8):966-972. PMC: 6234088. DOI: 10.1037/neu0000482. View

17.

Schretlen D, Munro C, Anthony J, Pearlson G . Examining the range of normal intraindividual variability in neuropsychological test performance. J Int Neuropsychol Soc. 2003; 9(6):864-70. DOI: 10.1017/S1355617703960061. View

18.

Rabkin J, McElhiney M, Ferrando S, van Gorp W, Lin S . Predictors of employment of men with HIV/AIDS: a longitudinal study. Psychosom Med. 2004; 66(1):72-8. DOI: 10.1097/01.psy.0000108083.43147.6d. View

19.

Ettenhofer M, Foley J, Castellon S, Hinkin C . Reciprocal prediction of medication adherence and neurocognition in HIV/AIDS. Neurology. 2010; 74(15):1217-22. PMC: 2865732. DOI: 10.1212/WNL.0b013e3181d8c1ca. View

20.

MacDonald S, Li S, Backman L . Neural underpinnings of within-person variability in cognitive functioning. Psychol Aging. 2009; 24(4):792-808. DOI: 10.1037/a0017798. View