Sassoon Stephanie A, Fama Rosemary, Rosenbloom Margaret J, O'Reilly Anne, Pfefferbaum Adolf, Sullivan Edith V
Neuroscience Program, SRI International, Menlo Park, California, USA.
Alcohol Clin Exp Res. 2007 Aug;31(8):1315-24. doi: 10.1111/j.1530-0277.2007.00426.x. Epub 2007 Jun 5.
Alcoholism (ALC) is highly prevalent in patients with human immunodeficiency virus (HIV) infection (HIV), and those with comorbidity (ALC+HIV) may suffer compounded deficits in cognitive and motor functions affected by both conditions. Given that each disease can adversely affect motor, visuospatial, and executive functions, we used an expanded version of the Digit Symbol (DS) test to assess the separate and combined effects of ALC and HIV infection on these cognitive and motor components.
Participants were 44 ALC, 43 HIV, 55 ALC+HIV, and 49 normal controls (NC). We modified DS test administration to assess sustained attention (grid completion speed), associative learning (number of boxes completed in 15-second epochs), and incidental learning (total number-symbol pairs correctly recalled) and also used ancillary tests of fine motor, visuospatial, and executive functions to assess their relationship with the different components of DS performance. All scores were corrected for age and education based on NC performance.
Neither single diagnosis group-ALC nor HIV-was impaired on DS score or grid completion speed compared with the NC group, but the dual-diagnosis ALC+HIV group was impaired. Greater lifetime alcohol consumption was associated with longer grid completion time in both ALC and ALC+HIV. The HIV group demonstrated associative learning on DS but ALC+HIV and ALC did not. All groups performed similarly on incidental learning. Multiple regression analyses demonstrated that executive functions, assessed by Color Trails 2, predicted traditional DS performance in all groups. Fine Finger Movement additionally predicted traditional DS performance and grid completion speed in HIV. Visuospatial function, assessed by ability to copy the Rey-Osterrieth complex figure, did not contribute independently to DS performance in either alcohol group.
Alcoholism combined with HIV infection resulted in deficits in visuospatial psychomotor function, as assessed by the DS test, although deficits were not observed in either disease condition alone. Neither alcohol group showed associative learning, and both had compromised sustained attention. Combined cognitive and motor adverse effects of alcoholism and HIV infection were manifest in psychomotor speed, sustained attention, and associative learning of visuospatial material and are testimony to the dangers of alcohol abuse even in relatively healthy patients with HIV infection.
酗酒（ALC）在人类免疫缺陷病毒（HIV）感染患者中非常普遍，而那些合并感染（ALC+HIV）的患者在受这两种疾病影响的认知和运动功能方面可能会出现复合性缺陷。鉴于每种疾病都会对运动、视觉空间和执行功能产生不利影响，我们使用了数字符号（DS）测试的扩展版本来评估酗酒和HIV感染对这些认知和运动成分的单独及联合影响。
参与者包括44名酗酒者（ALC）、43名HIV感染者、55名酗酒合并HIV感染者（ALC+HIV）以及49名正常对照者（NC）。我们修改了DS测试的实施方式，以评估持续注意力（网格完成速度）、联想学习（每15秒时间段内完成的方格数量）和偶发学习（正确回忆的数字-符号对总数），并使用精细运动、视觉空间和执行功能的辅助测试来评估它们与DS表现不同成分之间的关系。所有分数均根据正常对照者的表现进行年龄和教育程度校正。
与正常对照组相比，单一诊断组（酗酒组或HIV感染组）在DS分数或网格完成速度方面均未受损，但双重诊断的酗酒合并HIV感染组受损。在酗酒组和酗酒合并HIV感染组中，终生饮酒量越大，网格完成时间越长。HIV感染组在DS测试中表现出联想学习能力，而酗酒合并HIV感染组和酗酒组则没有。所有组在偶发学习方面表现相似。多元回归分析表明，通过色线测试2评估的执行功能可预测所有组的传统DS表现。精细手指运动还可预测HIV感染组的传统DS表现和网格完成速度。通过复制雷-奥斯特里思复杂图形的能力评估的视觉空间功能，在两个酗酒组中均未独立影响DS表现。
通过DS测试评估，酗酒合并HIV感染导致视觉空间心理运动功能缺陷，尽管单独任何一种疾病状态下均未观察到缺陷。两个酗酒组均未表现出联想学习能力，且二者的持续注意力均受损。酗酒和HIV感染对认知和运动的联合不利影响在心理运动速度、持续注意力以及视觉空间材料的联想学习方面均有体现，并证明即使在相对健康的HIV感染患者中，酗酒也是危险的。
