Department of Psychiatry, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Geroscience Center for Brain Health and Metabolism (Gero), Faculty of Medicine, University of Chile, Santiago, Chile.
Departament of Infectious Diseases, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
Neuropsychologia. 2020 Sep;146:107545. doi: 10.1016/j.neuropsychologia.2020.107545. Epub 2020 Jun 25.
Neurological soft signs (NSS) are frequently found in severe mental disorders, such as Alzheimer's disease, schizophrenia or HIV associated neurocognitive disorder (HAND) which includes asymptomatic neurocognitive impairment (ANI), mild neurocognitive disorder (MND) and HIV-associated dementia. To characterize NSS in patients with HIV we examined them with respect to neuropsychological deficits typically found in the disorder. 67 HIV + patients without a history of head trauma, opportunistic infections, severe psychiatric disorders or acute confounding comorbidities of the Central nervous system (CNS) were recruited. NSS and neuropsychological deficits were examined on the Heidelberg scale and the Cambridge Neuropsychological Test Automated Battery (CANTAB), respectively. Semantic and phonemic verbal fluency were additionally established. According to NIMH and NINDS criteria, 18 patients were diagnosed with ANI and 21 with MND, 28 showed no cognitive deficits. NSS total scores were significantly correlated with several cognitive domains and NSS subscales. These correlations were confirmed when motor performance was entered as a covariate. According to our findings, NSS in HIV positive patients are significantly correlated with deficits in a broad range of neuropsychological domains. Similar findings were reported in schizophrenia, emphasizing the transdiagnostic character of NSS and supporting NSS examination in screening HIV patients for HAND.
神经学软体征（NSS）在严重精神障碍中经常出现，如阿尔茨海默病、精神分裂症或 HIV 相关神经认知障碍（HAND），包括无症状神经认知障碍（ANI）、轻度神经认知障碍（MND）和 HIV 相关痴呆。为了描述 HIV 患者的 NSS，我们检查了与该疾病中常见的神经心理缺陷相关的 NSS。我们招募了 67 名没有头部外伤、机会性感染、严重精神障碍或急性中枢神经系统（CNS）合并症病史的 HIV 阳性患者。NSS 和神经心理缺陷分别在海德堡量表和剑桥神经心理学测试自动化电池（CANTAB）上进行检查。此外，还建立了语义和语音流畅性。根据 NIMH 和 NINDS 标准，18 名患者被诊断为 ANI，21 名患者被诊断为 MND，28 名患者没有认知缺陷。NSS 总分与多个认知领域和 NSS 子量表显著相关。当将运动表现作为协变量纳入时，这些相关性得到了证实。根据我们的发现，HIV 阳性患者的 NSS 与广泛的神经心理领域的缺陷显著相关。在精神分裂症中也有类似的发现，这强调了 NSS 的跨诊断特征，并支持在筛查 HAND 的 HIV 患者时进行 NSS 检查。
