From the Departments of Neurological Sciences (B.J.L., T.J.M., A.I.W., M.S.M., T.W.W.), Internal Medicine (J.O., S.S.), and Pharmacology and Experimental Neuroscience (H.S.F.), University of Nebraska Medical Center, Omaha; and Department of Neurology (K.R.R.), University of North Carolina School of Medicine, Chapel Hill.
Neurology. 2018 Nov 13;91(20):e1860-e1869. doi: 10.1212/WNL.0000000000006504. Epub 2018 Oct 17.
To identify the neural markers of attention dysfunction in patients with HIV-associated neurocognitive disorder (HAND).
Sixty participants, including 40 HIV-infected adults (half with HAND) and 20 demographically matched controls performed a visual selective attention task while undergoing high-density magnetoencephalography. Neuronal activity related to selective attention processing was quantified and compared across the 3 groups, and correlated with neuropsychological measures of attention and executive function. Spontaneous neural activity was also extracted from these attention-related cortical areas and examined with respect to HAND status.
HIV-infected participants with and without HAND exhibited behavioral selective attention deficits on the magnetoencephalography task, as indicated by an increased flanker effect. Neuronal measures of flanker interference activity in the alpha and theta range revealed differential dynamics in attention-related brain areas across the 3 groups, especially in those with HAND. In addition, theta range flanker interference activity in the left inferior frontal and dorsolateral prefrontal cortex was associated with executive function and attention composite scores, respectively. Progressively stronger spontaneous alpha and theta activity was also found in unimpaired HIV-infected and HAND participants relative to controls across brain regions implicated in different components of attention processing.
Behavioral and neuronal metrics of selective attention performance distinguish participants with HAND from controls and unimpaired HIV-infected participants. These metrics, along with measures of local spontaneous neural activity, may hold promise as early markers of cognitive decline in participants with HIV infection and be useful prognostic indicators for HAND.
确定与 HIV 相关的认知障碍（HAND）患者注意力功能障碍的神经标志物。
共有 60 名参与者，包括 40 名 HIV 感染者（其中一半患有 HAND）和 20 名年龄匹配的对照者，他们在接受高密度脑磁图检查的同时进行视觉选择性注意任务。对 3 组参与者的选择性注意处理相关的神经元活动进行了量化和比较，并与注意力和执行功能的神经心理学测量结果进行了相关分析。还从这些与注意力相关的皮质区域中提取了自发的神经活动，并根据 HAND 状态进行了检查。
有和没有 HAND 的 HIV 感染者在脑磁图任务中表现出行为选择性注意力缺陷，这表现为侧翼效应增加。在 alpha 和 theta 范围内，侧翼干扰活动的神经元测量结果揭示了 3 组参与者注意力相关脑区的不同动态，特别是在 HAND 参与者中。此外，左侧额下回和背外侧前额叶皮质的 theta 范围侧翼干扰活动分别与执行功能和注意力综合评分相关。与对照组相比，未受损的 HIV 感染者和 HAND 参与者在大脑区域中表现出更强的自发 alpha 和 theta 活动，这些区域与注意力处理的不同成分有关。
选择性注意力表现的行为和神经元指标可将 HAND 参与者与对照组和未受损的 HIV 感染者区分开来。这些指标，以及局部自发神经活动的测量值，可能是 HIV 感染者认知能力下降的早期标志物，并可作为 HAND 的有用预后指标。
