Jana Szanyi1, Jan Kremlacek2, Zuzana Kubova2, Miroslav Kuba2, Pavel Gebousky3, Jaroslav Kapla3, Juraj Szanyi3,4, Frantisek Vit2, Jana Langrova2. 1. Department of Pathological Physiology, Charles University - Faculty of Medicine in Hradec Kralove, Simkova 870, 500 03, Hradec Kralove, Czech Republic. szanyi@lfhk.cuni.cz. 2. Department of Pathological Physiology, Charles University - Faculty of Medicine in Hradec Kralove, Simkova 870, 500 03, Hradec Kralove, Czech Republic. 3. Department of Infectious Diseases, Faculty Hospital in Hradec Kralove, Hradec Kralove, Czech Republic. 4. Department of Epidemiology, Faculty of Military Health Sciences, University of Defence in Hradec Kralove, Hradec Kralove, Czech Republic.
Abstract
PURPOSE: The aim of this neurophysiological study was to monitor changes in the visual and cognitive function of HIV-infected patients treated with combination antiretroviral therapy. METHODS: Eleven adult Czech HIV+ patients, with a mean age of 35 years and CD4 cell count ≥ 230 × 106 cells/L of blood at the time of enrollment, underwent four to six examinations over the course of 2.5 years to evaluate pattern-reversal and motion-onset visual evoked potentials (P-VEPs and M-VEPs), visually driven oddball event-related potentials (ERPs) and Montreal Cognitive Assessments. In addition to evaluating the intraindividual change in the observed parameters, we also compared patient data to data from eleven age- and gender-matched controls. RESULTS: We did not find any significant differences in P-VEPs between the patients and controls or in the paired comparison of the first and last visit. The only significant finding for P-VEPs was a linear trend in prolongation of the 20' P-VEP P100 peak time. In M-VEPs, we found a significant intergroup difference in the N160 peak time recorded during the first visit for peripheral M-VEPs only. During the last visit, all N160 peak times for patients differed significantly from those of the control group. The only intervisit difference close to the level of significance was for peripheral M-VEPs, which confirmed the trend analysis. No significant differences between patients and controls were found in the ERPs, but the P300 peak time showed a significant difference between the first and last visits, as confirmed by the trend. Patient reaction time was not significantly delayed at the first visit; however, it was prolonged with time, as confirmed by the trend. CONCLUSION: Our aim was to evaluate whether antiretroviral treatment in HIV+ patients is sufficient to preserve brain visual function. The optic nerve and primary visual cortex function tested by the P-VEPs seem to be preserved. The prolongation of the M-VEPs suggests an individually detectable decline in CNS function, but these changes did not show a progression during the follow-up. From a longitudinal perspective, the trends in peak time prolongation of the 20' P-VEP, peripheral M-VEP, ERP and reaction time suggest a faster decline than that caused by aging in healthy populations, as previously described in a cross-sectional study.
PURPOSE: The aim of this neurophysiological study was to monitor changes in the visual and cognitive function of HIV-infectedpatients treated with combination antiretroviral therapy. METHODS: Eleven adult Czech HIV+ patients, with a mean age of 35 years and CD4 cell count ≥ 230 × 106 cells/L of blood at the time of enrollment, underwent four to six examinations over the course of 2.5 years to evaluate pattern-reversal and motion-onset visual evoked potentials (P-VEPs and M-VEPs), visually driven oddball event-related potentials (ERPs) and Montreal Cognitive Assessments. In addition to evaluating the intraindividual change in the observed parameters, we also compared patient data to data from eleven age- and gender-matched controls. RESULTS: We did not find any significant differences in P-VEPs between the patients and controls or in the paired comparison of the first and last visit. The only significant finding for P-VEPs was a linear trend in prolongation of the 20' P-VEP P100 peak time. In M-VEPs, we found a significant intergroup difference in the N160 peak time recorded during the first visit for peripheral M-VEPs only. During the last visit, all N160 peak times for patients differed significantly from those of the control group. The only intervisit difference close to the level of significance was for peripheral M-VEPs, which confirmed the trend analysis. No significant differences between patients and controls were found in the ERPs, but the P300 peak time showed a significant difference between the first and last visits, as confirmed by the trend. Patient reaction time was not significantly delayed at the first visit; however, it was prolonged with time, as confirmed by the trend. CONCLUSION: Our aim was to evaluate whether antiretroviral treatment in HIV+ patients is sufficient to preserve brain visual function. The optic nerve and primary visual cortex function tested by the P-VEPs seem to be preserved. The prolongation of the M-VEPs suggests an individually detectable decline in CNS function, but these changes did not show a progression during the follow-up. From a longitudinal perspective, the trends in peak time prolongation of the 20' P-VEP, peripheral M-VEP, ERP and reaction time suggest a faster decline than that caused by aging in healthy populations, as previously described in a cross-sectional study.
Authors: Miroslav Kuba; Jan Kremláček; Jana Langrová; Zuzana Kubová; Jana Szanyi; František Vít Journal: Vision Res Date: 2012-04-04 Impact factor: 1.886
Authors: V A Cardenas; D J Meyerhoff; C Studholme; J Kornak; J Rothlind; H Lampiris; J Neuhaus; R M Grant; L L Chao; D Truran; M W Weiner Journal: J Neurovirol Date: 2009-07 Impact factor: 2.643
Authors: Zuzana Kubová; Jana Szanyi; Jana Langrová; Jan Kremlácek; Miroslav Kuba; Karel Honegr Journal: J Clin Neurophysiol Date: 2006-10 Impact factor: 2.177
Authors: Scott M Hammer; Joseph J Eron; Peter Reiss; Robert T Schooley; Melanie A Thompson; Sharon Walmsley; Pedro Cahn; Margaret A Fischl; Jose M Gatell; Martin S Hirsch; Donna M Jacobsen; Julio S G Montaner; Douglas D Richman; Patrick G Yeni; Paul A Volberding Journal: JAMA Date: 2008-08-06 Impact factor: 56.272