Rubin Leah H, Cook Judith A, Weber Kathleen M, Cohen Mardge H, Martin Eileen, Valcour Victor, Milam Joel, Anastos Kathryn, Young Mary A, Alden Christine, Gustafson Deborah R, Maki Pauline M
Department of Psychiatry, University of Illinois at Chicago, 912 S Wood St, Chicago, IL, 60612, USA,
J Neurovirol. 2015 Aug;21(4):422-32. doi: 10.1007/s13365-015-0331-5. Epub 2015 Mar 20.
In contrast to findings from cohorts comprised primarily of HIV-infected men, verbal memory deficits are the largest cognitive deficit found in HIV-infected women from the Women's Interagency HIV Study (WIHS), and this deficit is not explained by depressive symptoms or substance abuse. HIV-infected women may be at greater risk for verbal memory deficits due to a higher prevalence of cognitive risk factors such as high psychosocial stress and lower socioeconomic status. Here, we investigate the association between perceived stress using the Perceived Stress Scale (PSS-10) and verbal memory performance using the Hopkins Verbal Learning Test (HVLT) in 1009 HIV-infected and 496 at-risk HIV-uninfected WIHS participants. Participants completed a comprehensive neuropsychological test battery which yielded seven cognitive domain scores, including a primary outcome of verbal memory. HIV infection was not associated with a higher prevalence of high perceived stress (i.e., PSS-10 score in the top tertile) but was associated with worse performance on verbal learning (p < 0.01) and memory (p < 0.001), as well as attention (p = 0.02). Regardless of HIV status, high stress was associated with poorer performance in those cognitive domains (p's < 0.05) as well as processing speed (p = 0.01) and executive function (p < 0.01). A significant HIV by stress interaction was found only for the verbal memory domain (p = 0.02); among HIV-infected women only, high stress was associated with lower performance (p's < 0.001). That association was driven by the delayed verbal memory measure in particular. These findings suggest that high levels of perceived stress contribute to the deficits in verbal memory observed in WIHS women.
与主要由感染艾滋病毒的男性组成的队列研究结果不同，言语记忆缺陷是女性机构间艾滋病毒研究（WIHS）中感染艾滋病毒女性所发现的最大认知缺陷，且这种缺陷不能用抑郁症状或药物滥用解释。由于认知风险因素（如高心理社会压力和较低社会经济地位）的患病率较高，感染艾滋病毒的女性可能面临更高的言语记忆缺陷风险。在此，我们调查了1009名感染艾滋病毒的WIHS参与者和496名有感染艾滋病毒风险的未感染参与者中，使用感知压力量表（PSS - 10）测量的感知压力与使用霍普金斯言语学习测试（HVLT）测量的言语记忆表现之间的关联。参与者完成了一套全面的神经心理测试，得出七个认知领域得分，包括言语记忆这一主要结果。艾滋病毒感染与高感知压力（即PSS - 10得分处于最高三分位数）的较高患病率无关，但与言语学习（p < 0.01）、记忆（p < 0.001）以及注意力（p = 0.02）方面的较差表现相关。无论艾滋病毒感染状况如何，高压力与这些认知领域（p值 < 0.05）以及处理速度（p = 0.01）和执行功能（p < 0.01）方面的较差表现相关。仅在言语记忆领域发现了显著的艾滋病毒与压力交互作用（p = 0.02）；仅在感染艾滋病毒的女性中，高压力与较低表现相关（p值 < 0.001）。这种关联尤其由延迟言语记忆测量所驱动。这些发现表明，高感知压力水平导致了WIHS女性中观察到的言语记忆缺陷。
