Litvin Pavel Y, Siders Craig A, Waite Erin N, Woo Ellen, Romero Elizabeth, Foley Jessica, Ettenhofer Mark L, Gooding Amanda L, Castellon Steven, Hinkin Charles, Wright Matthew J
Harbor-UCLA Medical Center, Los Angeles Biomedical Research Institute, Torrance, CA, USA.
California State University Long Beach, Long Beach, CA, USA.
Appl Neuropsychol Adult. 2021 Nov-Dec;28(6):685-696. doi: 10.1080/23279095.2019.1683562. Epub 2019 Oct 29.
Both Human Immunodeficiency Virus (HIV) and cocaine use have been associated with impairment in neuropsychological functioning. The high comorbidity between HIV and cocaine use highlights the importance of ascertaining whether there is a compounding effect of cocaine use in individuals with HIV. Among neuropsychological domains impacted by HIV, verbal memory deficits have received substantial attention partly because they have been associated with declines in functional status in HIV positive individuals. We collected California Verbal Learning Test-II data from HIV participants who met lifetime diagnostic criteria of cocaine abuse and/or dependence (HIV/CocDx+, = 80 & HIV/CocDx-, = 30, respectively) and those with and without recent cocaine use, which was confirmed by toxicology analysis (HIV/Coc+, = 56 & HIV/Coc-, = 57, respectively). The Item Specific Deficit Approach (ISDA) was employed to determine any additional cocaine-associated deficits in encoding, consolidation, and retrieval, which attempts to control for potential confounding factors of memory such as attention. Using conventional methods of evaluating memory profiles, we found that the HIV/Coc + group demonstrated worse learning, immediate and delayed free recall, and recognition in contrast to the HIV/Coc - group; although using the ISDA, we found that encoding was the only significant difference between HIV/Coc + and HIV/Coc-participant, with HIV/Coc - performing better. Our data suggest that for individuals with HIV, cocaine use is associated with a temporary decline in verbal memory, is characterized by greater encoding deficits, and these effects may reduce with abstinence. Clinically, our findings suggest that reduced encoding is the likely contributor to verbal memory decline in HIV/Coc + and these effects are partially reversible-at least to the level of their HIV/Coc - counterparts.
人类免疫缺陷病毒（HIV）感染和可卡因使用均与神经心理功能损害有关。HIV感染与可卡因使用之间的高共病率凸显了确定可卡因使用对HIV感染者是否具有复合效应的重要性。在受HIV影响的神经心理领域中，言语记忆缺陷受到了广泛关注，部分原因是它们与HIV阳性个体的功能状态下降有关。我们收集了符合可卡因滥用和/或依赖终身诊断标准的HIV参与者（分别为HIV/可卡因诊断阳性组，n = 80；HIV/可卡因诊断阴性组，n = 30）以及经毒理学分析确认有近期可卡因使用和无近期可卡因使用的参与者（分别为HIV/可卡因阳性组，n = 56；HIV/可卡因阴性组，n = 57）的加利福尼亚言语学习测验第二版数据。采用项目特异性缺陷方法（ISDA）来确定编码、巩固和检索过程中与可卡因相关的任何额外缺陷，该方法试图控制记忆的潜在混杂因素，如注意力。使用传统的记忆特征评估方法，我们发现与HIV/可卡因阴性组相比，HIV/可卡因阳性组在学习、即时和延迟自由回忆以及识别方面表现更差；尽管使用ISDA，我们发现编码是HIV/可卡因阳性和阴性参与者之间唯一的显著差异，HIV/可卡因阴性组表现更好。我们的数据表明，对于HIV感染者，可卡因使用与言语记忆的暂时下降有关，其特征是编码缺陷更大，并且这些影响可能随着戒断而减轻。临床上，我们的研究结果表明，编码减少可能是HIV/可卡因阳性者言语记忆下降的原因，并且这些影响至少在一定程度上是可逆的，可恢复到与HIV/可卡因阴性者相当的水平。
