Goethe K E, Mitchell J E, Marshall D W, Brey R L, Cahill W T, Leger G D, Hoy L J, Boswell R N
Department of Psychology, Wilford Hall US Air Force Medical Center, Lackland Air Force Base, Tex. 78236-5300.
Arch Neurol. 1989 Feb;46(2):129-33. doi: 10.1001/archneur.1989.00520380029008.
Although individuals with acquired immunodeficiency syndrome (AIDS) are often impaired on a variety of neuropsychological tasks, questions remain as to when neuropsychological decline can be reliably detected during the course of human immunodeficiency virus (HIV) infection. Detailed neuropsychological testing was accomplished on a cohort of 83 immunologically and neurologically intact asymptomatic HIV-infected individuals drawn from a larger pool of 649 US Air Force personnel with HIV antibodies. These asymptomatic subjects were compared with a group of HIV-negative subjects, and no significant differences in neuropsychological functioning were found. No significant neuropsychological differences were found as a function of cerebrospinal fluid abnormalities in these asymptomatic subjects. When data from 13 subjects with immune compromise were included in the analyses, those with abnormal cerebrospinal fluid values performed significantly poorer on a task of verbal memory, suggesting that cognitive dysfunction is antedated by immunological decline. Methodological problems that inhibit specification of the incidence, prevalence, and natural history of HIV-related cognitive impairment are discussed, as are data suggesting that previously published high estimates of the frequency of HIV-related dementia may not be representative of all HIV-infected populations.
尽管获得性免疫缺陷综合征（AIDS）患者在各种神经心理学任务上常常表现受损，但对于在人类免疫缺陷病毒（HIV）感染过程中何时能够可靠地检测到神经心理学衰退仍存在疑问。对从649名携带HIV抗体的美国空军人员中抽取的83名免疫和神经功能正常的无症状HIV感染者进行了详细的神经心理学测试。将这些无症状受试者与一组HIV阴性受试者进行比较，未发现神经心理学功能存在显著差异。在这些无症状受试者中，未发现神经心理学差异与脑脊液异常有关。当将13名免疫功能受损受试者的数据纳入分析时，脑脊液值异常的受试者在言语记忆任务上的表现明显较差，这表明认知功能障碍先于免疫功能衰退出现。文中讨论了抑制HIV相关认知障碍发病率、患病率和自然史明确的方法学问题，以及表明先前公布的HIV相关痴呆高频率估计可能不代表所有HIV感染人群的数据。
