Boccellari A A, Dilley J W, Yingling C D, Chambers D B, Tauber M A, Moss A R, Osmond D H
Department of Psychiatry, San Francisco General Hospital, CA 94110.
Arch Neurol. 1993 May;50(5):517-21. doi: 10.1001/archneur.1993.00540050067018.
To explore the relationship of immune dysfunction to neurophysiological measures of brain-stem conduction time.
Three-year longitudinal prospective cohort study; results of time 1 analyses reported.
San Francisco (California) General Hospital, Departments of Psychiatry and Epidemiology.
Volunteer sample of 55 human immunodeficiency virus (HIV)-positive and 37 HIV-negative homosexual men recruited from a larger cohort of homosexual men followed up since 1983 at San Francisco General Hospital as part of an ongoing study of the natural history and course of HIV type 1 infection.
None.
Auditory brain-stem responses and somatosensory evoked potentials for subjects stratified separately on HIV serostatus, Centers for Disease Control and Prevention symptom groupings, and absolute CD4 counts.
The HIV-positive subjects had an increased wave III-V interpeak latency of the right ear auditory brain-stem response compared with the HIV-negative subjects (t test, P < .05). There were no significant differences among the three Centers for Disease Control and Prevention groupings on any evoked potential measure. When HIV-positive subjects were stratified on a measure of immune functioning, ie, CD4 counts, individuals with greater immune suppression were more impaired on speed of auditory brain-stem conduction time (Mann-Whitney U test, P < .05). Furthermore, 85% of subjects impaired on this evoked potential measure had CD4 counts of less than 0.40 x 10(9)/L (400/microL), whereas only 15% of those impaired on this measure had CD4 counts of greater than 0.40 x 10(9)/L.
Asymptomatic HIV-positive subjects who do not have evidence of immune suppression do not appear to be at greater risk for neurophysiological impairment than HIV-negative subjects. The HIV-positive individuals who are immune suppressed (even while asymptomatic) appear to have an increased likelihood of central conduction time slowing as measured by evoked potential procedures.
探讨免疫功能障碍与脑干传导时间神经生理学指标之间的关系。
为期三年的纵向前瞻性队列研究；报告了第1阶段分析的结果。
旧金山（加利福尼亚州）总医院，精神病学和流行病学系。
从1983年起在旧金山总医院对一大群同性恋男性进行随访的志愿者样本，其中55名人类免疫缺陷病毒（HIV）阳性和37名HIV阴性同性恋男性，这是对1型HIV感染自然史和病程进行的一项正在进行的研究的一部分。
无。
根据HIV血清学状态、疾病控制与预防中心症状分组以及绝对CD4细胞计数分别对受试者进行分层，测量其听觉脑干反应和体感诱发电位。
与HIV阴性受试者相比，HIV阳性受试者右耳听觉脑干反应的III-V波峰间潜伏期延长（t检验，P <.05）。在任何诱发电位指标上，疾病控制与预防中心的三个分组之间均无显著差异。当根据免疫功能指标（即CD4细胞计数）对HIV阳性受试者进行分层时，免疫抑制程度较高的个体在听觉脑干传导时间速度方面受损更严重（曼-惠特尼U检验，P <.05）。此外，在该诱发电位指标上受损的受试者中，85%的CD4细胞计数低于0.40×10⁹/L（400/μL），而在该指标上受损的受试者中，只有15%的CD4细胞计数高于0.40×10⁹/L。
没有免疫抑制证据的无症状HIV阳性受试者似乎与HIV阴性受试者相比，发生神经生理学损害的风险并不更高。免疫抑制的HIV阳性个体（即使无症状）似乎通过诱发电位程序测量，出现中枢传导时间减慢的可能性增加。
