Andrew J Levine1, Eileen Martin2, Cynthia A Munro3, Ned Sacktor4, Steve Horvath5, James T Becker6. 1. a Department of Neurology , David Geffen School of Medicine at the University of California Los Angeles , Los Angeles , CA , USA. 2. b Department of Psychiatry , Rush University Medical Center , Chicago , IL , USA. 3. c Departments of Psychiatry and Neurology , Johns Hopkins University School of Medicine , Baltimore , MD , USA. 4. d Department of Neurology , Johns Hopkins University School of Medicine , Baltimore , MD , USA. 5. e Departments of Human Genetics and Biostatistics , David Geffen School of Medicine at the University of California Los Angeles , Los Angeles , CA , USA. 6. f Departments of Psychiatry, Neurology, and Psychology , University of Pittsburgh , Pittsburgh , PA , USA.
Abstract
INTRODUCTION: HIV-associated neurocognitive disorders (HAND) are estimated to affect approximately 50% of infected individuals at any one time. Dispersion, a type of intraindividual variability in neurocognitive test performance, has been identified as a potential behavioral marker of HAND; however, the specificity of dispersion to HAND and how it is influenced by participant effort when taking neurocognitive tests remain unclear. METHOD: Data were analyzed from 996 (474 HIV-, 522 HIV+) men enrolled in the Multicenter AIDS Cohort Study (MACS). Dispersion was calculated based on the standard deviation of an individual's test scores within a single assessment. Effort was determined using the Visual Analogue Effort Scale. Predictors of dispersion were determined using stepwise linear regression. Dispersion was compared between the HIV serostatus groups using analysis of covariance (ANCOVA), considering demographic and psychosocial variables that differed between the groups. RESULTS: Contrary to our hypothesis, dispersion was not influenced by effort. Instead, poorer neurocognitive ability and race were the sole predictors of dispersion. Dispersion did not differ between the serostatus groups. CONCLUSIONS: Our results indicate that dispersion is a valid indicator of neurocognitive dysfunction that is not due to suboptimal effort; however, it is not specific to HIV and is therefore of limited utility as a behavioral marker of HIV-related neurocognitive impairment.
INTRODUCTION: HIV-associated neurocognitive disorders (HAND) are estimated to affect approximately 50% of infected individuals at any one time. Dispersion, a type of intraindividual variability in neurocognitive test performance, has been identified as a potential behavioral marker of HAND; however, the specificity of dispersion to HAND and how it is influenced by participant effort when taking neurocognitive tests remain unclear. METHOD: Data were analyzed from 996 (474 HIV-, 522 HIV+) men enrolled in the Multicenter AIDS Cohort Study (MACS). Dispersion was calculated based on the standard deviation of an individual's test scores within a single assessment. Effort was determined using the Visual Analogue Effort Scale. Predictors of dispersion were determined using stepwise linear regression. Dispersion was compared between the HIV serostatus groups using analysis of covariance (ANCOVA), considering demographic and psychosocial variables that differed between the groups. RESULTS: Contrary to our hypothesis, dispersion was not influenced by effort. Instead, poorer neurocognitive ability and race were the sole predictors of dispersion. Dispersion did not differ between the serostatus groups. CONCLUSIONS: Our results indicate that dispersion is a valid indicator of neurocognitive dysfunction that is not due to suboptimal effort; however, it is not specific to HIV and is therefore of limited utility as a behavioral marker of HIV-related neurocognitive impairment.
Authors: Lindsay J Hines; Eric N Miller; Charles H Hinkin; Jeffery R Alger; Peter Barker; Karl Goodkin; Eileen M Martin; Victoria Maruca; Ann Ragin; Ned Sacktor; Joanne Sanders; Ola Selnes; James T Becker Journal: Brain Imaging Behav Date: 2016-09 Impact factor: 3.978