Neuropsychological evaluation and follow up in jcv- and non-jcv-related leukoencephalopathies in HIV infection

The introduction of highly active antiretroviral therapy does not seem to have altered the incidence of progressive multifocal leukoencephalopathy (PML) in HIV infection. Moreover, the occurrence of a HIV-related leukoencephalopathy, called not determined leukoencephalopaties (NDLE), has been report...

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Bibliographic Details
Published in:Neurological sciences 2011-10, Vol.32 (5), p.833-839
Main Authors: Zucchella, C., Sinforiani, E., Tavazzi, E., Del Bue, S., Novati, S., Maserati, R., Ceroni, M., Bastianello, S., Minoli, L., Ferrante, P., Marchioni, E.
Format: Article
Language:English
Subjects:
Adult
Aged
Antiretroviral Therapy, Highly Active
Benign
Cognitive ability
Data processing
Executive function
Female
highly active antiretroviral therapy
HIV Infections - drug therapy
HIV Infections - psychology
HIV Infections - virology
Human immunodeficiency virus
Humans
Infection
JC Virus - isolation & purification
Leukoencephalopathy
Leukoencephalopathy, Progressive Multifocal - drug therapy
Leukoencephalopathy, Progressive Multifocal - psychology
Leukoencephalopathy, Progressive Multifocal - virology
Magnetic resonance imaging
Male
Medicine
Medicine & Public Health
Middle Aged
Neurology
Neuropsychological Tests
Neuroradiology
Neurosciences
Neurosurgery
Original Article
Progressive multifocal leukoencephalopathy
Psychiatry
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Summary:The introduction of highly active antiretroviral therapy does not seem to have altered the incidence of progressive multifocal leukoencephalopathy (PML) in HIV infection. Moreover, the occurrence of a HIV-related leukoencephalopathy, called not determined leukoencephalopaties (NDLE), has been reported. As neuropsychological impairment remains highly prevalent in HIV infection, the aim of this study is to describe the neuropsychological profile of PML and NDLE patients, analyzing the time-related changes. Clinical and neuropsychological data from 32 patients (17 PML, 15 NDLE) were compared with two control groups: (1) asymptomatic HIV+ patients without magnetic resonance imaging evidence of leukoencephalopathy; (2) age-/gender-/education-matched healthy subjects. Patients with rapidly worsening PML were significantly impaired on all neuropsychological tests, while PML with more benign course and NDLE groups showed a dysexecutive pattern of impairment. Asymptomatic HIV+ subjects showed mild and isolated cognitive deficits, without functional impact. Cognitive impairment should therefore be considered a key feature from HIV infection diagnosis.
ISSN:1590-1874
1590-3478
DOI:10.1007/s10072-011-0626-0