OBJECTIVE: HIV-associated neurocognitive disorder (HAND) occurs in a significant percentage of HIV-infected (HIV+) adults. Increased intraindividual variability (IIV) in cognitive function may be an early marker of emerging neurocognitive disorder, which suggests that IIV may be a sensitive measure of neurologic compromise in HIV. In the current study, we hypothesize that increased IIV may predict impending morbidity, including future cognitive decline and death. METHOD: In 708 HIV+ participants followed longitudinally for up to 14 years, we assessed the role of dispersion in forecasting death and cognitive decline. Incident neurocognitive impairment was predicted in a mixed-effects ordinal logistic regression model using age, gender, baseline mean cognitive functioning, CD4+, time followed, years of education, and dispersion at the previous visit. Death before the next visit was predicted in a binomial mixed-effects regression model using age, gender, baseline mean cognitive functioning, CD4+, time followed, years of education, and dispersion. RESULTS: Point-in-time dispersion and change in dispersion between visits predict future cognitive decline and death in HIV+ individuals. Individuals with greater dispersion at a visit or who had larger changes in dispersion between visits were more likely to demonstrate greater neurocognitive impairment at the subsequent visit. Greater IIV was also associated with an increased risk of death prior to the subsequent visit, even after controlling for HAND severity and global cognitive functioning. CONCLUSIONS: We conclude that the IIV in cognitive functioning may be more predictive of future disease consequence than mean level of cognitive functioning. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
OBJECTIVE:HIV-associated neurocognitive disorder (HAND) occurs in a significant percentage of HIV-infected (HIV+) adults. Increased intraindividual variability (IIV) in cognitive function may be an early marker of emerging neurocognitive disorder, which suggests that IIV may be a sensitive measure of neurologic compromise in HIV. In the current study, we hypothesize that increased IIV may predict impending morbidity, including future cognitive decline and death. METHOD: In 708 HIV+ participants followed longitudinally for up to 14 years, we assessed the role of dispersion in forecasting death and cognitive decline. Incident neurocognitive impairment was predicted in a mixed-effects ordinal logistic regression model using age, gender, baseline mean cognitive functioning, CD4+, time followed, years of education, and dispersion at the previous visit. Death before the next visit was predicted in a binomial mixed-effects regression model using age, gender, baseline mean cognitive functioning, CD4+, time followed, years of education, and dispersion. RESULTS: Point-in-time dispersion and change in dispersion between visits predict future cognitive decline and death in HIV+ individuals. Individuals with greater dispersion at a visit or who had larger changes in dispersion between visits were more likely to demonstrate greater neurocognitive impairment at the subsequent visit. Greater IIV was also associated with an increased risk of death prior to the subsequent visit, even after controlling for HAND severity and global cognitive functioning. CONCLUSIONS: We conclude that the IIV in cognitive functioning may be more predictive of future disease consequence than mean level of cognitive functioning. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Authors: Mark L Ettenhofer; Jessica Foley; Nina Behdin; Andrew J Levine; Steven A Castellon; Charles H Hinkin Journal: Arch Clin Neuropsychol Date: 2010-08-26 Impact factor: 2.813
Authors: A Antinori; G Arendt; J T Becker; B J Brew; D A Byrd; M Cherner; D B Clifford; P Cinque; L G Epstein; K Goodkin; M Gisslen; I Grant; R K Heaton; J Joseph; K Marder; C M Marra; J C McArthur; M Nunn; R W Price; L Pulliam; K R Robertson; N Sacktor; V Valcour; V E Wojna Journal: Neurology Date: 2007-10-03 Impact factor: 9.910
Authors: S Morgello; B B Gelman; P B Kozlowski; H V Vinters; E Masliah; M Cornford; W Cavert; C Marra; I Grant; E J Singer Journal: Neuropathol Appl Neurobiol Date: 2001-08 Impact factor: 8.090
Authors: Igor Grant; Donald R Franklin; Reena Deutsch; Steven P Woods; Florin Vaida; Ronald J Ellis; Scott L Letendre; Thomas D Marcotte; J H Atkinson; Ann C Collier; Christina M Marra; David B Clifford; Benjamin B Gelman; Justin C McArthur; Susan Morgello; David M Simpson; John A McCutchan; Ian Abramson; Anthony Gamst; Christine Fennema-Notestine; Davey M Smith; Robert K Heaton Journal: Neurology Date: 2014-05-09 Impact factor: 9.910
Authors: Steven Paul Woods; Julie D Rippeth; Alan B Frol; Joel K Levy; Elizabeth Ryan; Vicki M Soukup; Charles H Hinkin; Deborah Lazzaretto; Mariana Cherner; Thomas D Marcotte; Benjamin B Gelman; Susan Morgello; Elyse J Singer; Igor Grant; Robert K Heaton Journal: J Clin Exp Neuropsychol Date: 2004-09 Impact factor: 2.475
Authors: Jacob D Jones; Taylor Kuhn; Zanjbeel Mahmood; Elyse J Singer; Charles H Hinkin; April D Thames Journal: Neuropsychology Date: 2017-09-11 Impact factor: 3.424
Authors: Zaeema Naveed; Howard S Fox; Christopher S Wichman; Morshed Alam; Pamela May; Christine M Arcari; Jane Meza; Steven Totusek; Lorena Baccaglini Journal: Sci Rep Date: 2021-02-12 Impact factor: 4.379