Paul Robert, Flanigan Timothy P, Tashima Karen, Cohen Ronald, Lawrence Jay, Alt Elizabeth, Tate David, Ritchie Corrine, Hinkin Charles
Brown Medical School, Department of Psychiatry and Human Behavior, Center for AIDS Research & Centers for Behavioral and Preventive Medicine, 1 Hoppin Street, Providence, RI 02903, USA.
J Neuropsychiatry Clin Neurosci. 2005 Winter;17(1):114-8. doi: 10.1176/jnp.17.1.114.
Apathy is a prominent neuropsychiatric symptom associated with human immunodeficiency virus (HIV). The increased frequency of apathy in this population may reflect the direct involvement of the virus on the central nervous system (CNS), but the severity of apathy has not been shown to consistently relate to markers of disease activity or other neuropsychiatric complications of the virus. We examined the relationship between ratings of apathy and performance on measures of cognitive function and immune system status in a sample of HIV-infected patients. Apathy was significantly elevated among HIV-infected individuals compared to healthy comparison subjects. Apathy was significantly related to performance on measures of learning efficiency and a measure of cognitive flexibility. Ratings of apathy did not relate to CD4 cell count, but they were associated with disease duration. In addition, ratings of depression were independent of ratings of apathy. These findings suggest that apathy does not co-vary with a proxy measure of active disease status, but apathy does relate to several measures of cognitive dysfunction in patients with HIV. As such, the increased prevalence of apathy among HIV-infected adults may reflect HIV-associated neurologic dysfunction.
冷漠是一种与人类免疫缺陷病毒（HIV）相关的突出神经精神症状。该人群中冷漠发生率的增加可能反映了病毒对中枢神经系统（CNS）的直接影响，但冷漠的严重程度尚未被证明与疾病活动标志物或该病毒的其他神经精神并发症始终相关。我们在一组HIV感染患者样本中研究了冷漠评分与认知功能及免疫系统状态测量指标表现之间的关系。与健康对照受试者相比，HIV感染者中的冷漠程度显著升高。冷漠与学习效率测量指标及认知灵活性测量指标的表现显著相关。冷漠评分与CD4细胞计数无关，但与疾病持续时间相关。此外，抑郁评分与冷漠评分无关。这些发现表明，冷漠与活动性疾病状态的替代指标并非共同变化，但冷漠确实与HIV患者的几种认知功能障碍测量指标相关。因此，HIV感染成年人中冷漠患病率的增加可能反映了与HIV相关的神经功能障碍。
