Prabhakar Varsha, Martin Talora, Müller-Oehring Eva M, Goodcase Ryan, Schulte Tilman, Poston Kathleen L, Brontë-Stewart Helen M
Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, United States.
Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States.
Front Aging Neurosci. 2020 Oct 7;12:539598. doi: 10.3389/fnagi.2020.539598. eCollection 2020.
: Motor and cognitive deficits were compared in aging, chronically treated human immunodeficiency virus (HIV) people, people with mild-to-moderate stage Parkinson's disease (PD), and healthy controls. : Groups consisted of 36 people with PD, 28 with HIV infection, and 28 healthy controls. Motor function was assessed with the Unified Parkinson's Disease Rating Scale (MDS-UPDRS-III) and a rapid alternating finger tapping (RAFT) task on an engineered keyboard known as Quantitative Digitography (QDG). Executive function, verbal memory, and visuospatial processing were assessed using standard neuropsychological tests. : HIV demonstrated RAFT deficits similar to PD such as reduced amplitude ( = 0.023) and greater amplitude variability ( = 0.019) in the index finger when compared to controls. This fine motor disturbance correlated with HIV's immune health, measured by their CD4 T cell count ( < 0.01). The UPDRS did not yield motor differences between HIV and controls. Executive function and verbal memory were impaired in HIV ( = 0.006, = 0.016, respectively), but not in PD; visuospatial processing was similarly impaired in HIV and PD ( < 0.05) although motor deficits predominated in PD. : Fine motor bradykinesia measured quantitatively by QDG RAFT holds promise as a marker of motor decline related to current immune health in aging HIV patients and may be useful in longitudinal studies regarding mechanisms of immunosenescence vs. potential toxicity of combination antiretroviral therapy (cART) in this population. Additionally, motor and cognitive networks in HIV may be affected differently as the disease progresses as observed in the differential patterns of impairment between HIV and PD, providing insight into the mechanisms of brain deterioration in HIV.
对老年慢性治疗的人类免疫缺陷病毒(HIV)感染者、轻度至中度帕金森病(PD)患者和健康对照者的运动和认知缺陷进行了比较。研究组包括36名帕金森病患者、28名HIV感染者和28名健康对照者。使用统一帕金森病评定量表(MDS - UPDRS - III)和一种名为定量数字描记法(QDG)的特制键盘上的快速交替手指敲击(RAFT)任务来评估运动功能。使用标准神经心理学测试评估执行功能、言语记忆和视觉空间处理能力。与对照组相比,HIV感染者表现出与帕金森病患者类似的RAFT缺陷,如食指振幅降低(P = 0.023)和振幅变异性更大(P = 0.019)。这种精细运动障碍与通过CD4 T细胞计数衡量的HIV免疫健康状况相关(P < 0.01)。UPDRS未显示HIV感染者与对照组之间存在运动差异。HIV感染者的执行功能和言语记忆受损(分别为P = 0.006和P = 0.016),但帕金森病患者未出现这种情况;HIV感染者和帕金森病患者的视觉空间处理能力同样受损(P < 0.05),尽管帕金森病患者以运动缺陷为主。通过QDG RAFT定量测量的精细运动迟缓有望作为老年HIV患者当前免疫健康相关运动衰退的标志物,并且可能有助于该人群中关于免疫衰老机制与联合抗逆转录病毒疗法(cART)潜在毒性的纵向研究。此外,正如在HIV感染者和帕金森病患者之间不同的损伤模式中所观察到的,随着疾病进展,HIV感染者的运动和认知网络可能受到不同影响,这为了解HIV患者脑功能衰退机制提供了线索。
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