Department of Psychology, University of Miami, Coral Gables, FL, United States.
Department of Psychology, Florida Atlantic University, Davie, FL, United States.
Neurosci Biobehav Rev. 2015 Aug;55:147-64. doi: 10.1016/j.neubiorev.2015.04.008. Epub 2015 May 2.
Apathy remains a common neuropsychiatric disturbance in the Human Immunodeficiency Virus (HIV-1) despite advances in anti-retroviral treatment (ART). The goal of the current review is to recapitulate findings relating apathy to the deleterious biobehavioral effects of HIV-1 in the post-ART era. Available literatures demonstrate that the emergence of apathy with other neurocognitive and neuropsychiatric symptoms may be attributed to neurotoxic effects of viral proliferation, e.g., aggregative effect of Tat and gp120 on apoptosis, transport and other enzymatic reactions amongst dopaminergic neurons and neuroglia. An assortment of neuroimaging modalities converge on the severity of apathy symptoms associated with the propensity of the virus to replicate within frontal-striatal brain circuits that facilitate emotional processing. Burgeoning research into functional brain connectivity also supports the effects of microvascular and neuro-inflammatory injury linked to aging with HIV-1 on the presentation of neuropsychiatric symptoms. Summarizing these findings, we review domains of HIV-associated neurocognitive and neuropsychiatric impairment linked to apathy in HIV. Taken together, these lines of research suggest that loss of affective, cognitive and behavioral inertia is commensurate with the neuropathology of HIV-1.
尽管抗逆转录病毒治疗 (ART) 取得了进展，但艾滋病病毒 (HIV-1) 患者仍普遍存在冷漠等神经精神障碍。目前综述的目的是总结与 HIV-1 后 ART 时代中冷漠与 HIV-1 的有害生物行为影响相关的研究结果。现有文献表明，随着其他神经认知和神经精神症状的出现，冷漠可能归因于病毒增殖的神经毒性作用，例如，Tat 和 gp120 对凋亡的聚集作用、多巴胺能神经元和神经胶质中的运输和其他酶反应。各种神经影像学方法都集中在与病毒在前额纹状体大脑回路中复制倾向相关的冷漠症状的严重程度上，这些回路促进了情绪处理。对与 HIV-1 相关的与衰老相关的微血管和神经炎症损伤的功能脑连接的新兴研究也支持了神经精神症状的出现。总结这些发现，我们回顾了与 HIV 相关的神经认知和神经精神障碍相关的冷漠相关的领域。综上所述，这些研究表明，情感、认知和行为惯性的丧失与 HIV-1 的神经病理学相一致。
