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Isolating Cognitive and Neurologic HIV Effects in Substance-Dependent, Confounded Cohorts: A Pilot Study

Published online by Cambridge University Press:  28 February 2013

Desiree A. Byrd ,
Jessica Robinson-Papp ,
Monica Rivera Mindt ,
Letty Mintz ,
Kathryn Elliott ,
Quenesha Lighty  and
Susan Morgello
Desiree A. Byrd*
Affiliation:
Department of Neurology, Mount Sinai School of Medicine, New York, New York
Jessica Robinson-Papp
Affiliation:
Department of Neurology, Mount Sinai School of Medicine, New York, New York
Monica Rivera Mindt
Affiliation:
Department of Neurology, Mount Sinai School of Medicine, New York, New York Department of Psychology, Fordham University, New York, New York
Letty Mintz
Affiliation:
Department of Neurology, Mount Sinai School of Medicine, New York, New York
Kathryn Elliott
Affiliation:
Department of Neurology, Mount Sinai School of Medicine, New York, New York
Quenesha Lighty
Affiliation:
Department of Psychology, the City University of New York, New York, New York
Susan Morgello
Affiliation:
Department of Neurology, Mount Sinai School of Medicine, New York, New York
*
Correspondence and reprint requests to: Desiree A. Byrd, Department of Neurology, Box 1052, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029. E-mail: desiree.byrd@mssm.edu
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Abstract

Controversy exists as to whether effects of HIV infection can be detected in the cognitive profiles of substance users, with methodological differences in degree of control for confounding factors a major contributor to empirical discrepancies. To address this shortcoming, we conducted a small but well-controlled study aimed at isolating HIV neurocognitive (NC) effects in a group of chronic substance users. Thirty HIV-negative substance users were individually matched to 30 HIV-positive substance users on relevant medical and demographic factors, including reading level and methadone therapy status. Results revealed that reading level, methadone maintenance therapy, and positive urine toxicology each exerted significant influence on NC function, and that HIV status was a significant predictor of learning and speeded processing after these control factors were considered. The HIV-positive group also displayed significantly more neurologically assessed motor impairment (p < .05), which was specifically related to impaired cognition in this group and independent of degree of immunocompromise. These data demonstrate the need for increased attention to clinical/demographic characteristics of groups under study. They also show that with applied methodological rigor, the deleterious effects of HIV on cognition can be parsed from substance use, even in small samples with chronic and active use histories. (JINS, 2013, 19, 1–11)

Keywords

CognitionAIDSneuropsychological testsillicit drugsconfoundsmotor dysfunction
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 19 , Issue 4 , April 2013 , pp. 463 - 473
Copyright
Copyright © The International Neuropsychological Society 2013

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