Stern R A, Silva S G, Chaisson N, Evans D L
Department of Psychiatry and Human Behavior, University School of Medicine, Providence, RI, USA.
Arch Neurol. 1996 Feb;53(2):148-53. doi: 10.1001/archneur.1996.00550020052015.
To evaluate the influence of cognitive reserve or brain reserve capacity on neuropsychological performance in early human immunodeficiency virus (HIV)-1 infection.
Cross-sectional group comparison study, based on neuropsychological performance, of HIV-1 seropositive and HIV-1 seronegative participants.
Seventy-five medically asymptomatic HIV-1-seropositive homosexual or bisexual men and 50 HIV-1-seronegative homosexual or bisexual male controls. Subjects were grouped by HIV-1 status (seropositive vs seronegative) and by cognitive reserve scores (low reserve vs high reserve).
Cognitive reserve scores were based on a combination of years of education, a measure of occupational attainment, and an estimate of premorbid intelligence. Performance on a battery of neuropsychological tests was summarized by empirically derived factor scores and clinical summary ratings.
The HIV-1-seropositive subjects with low cognitive reserve scores exhibited significantly greater deficits on measures of attention and information processing speed, verbal learning and memory, executive functioning, and visuospatial performance than did the HIV-1-seropositive subjects with high cognitive reserve scores. In contrast, there were no significant group differences on these measures between both groups of HIV-1-seronegative subjects.
Early neuropsychological impairments in HIV-1 infection are most evident in individuals with lower cognitive reserve. As has been found in other neurologic disorders, such as Alzheimer's disease, individuals with greater cognitive reserve may be less sensitive to the initial clinical effects of the underlying neuropathologic process.
评估认知储备或脑储备能力对早期人类免疫缺陷病毒（HIV）-1感染患者神经心理表现的影响。
基于神经心理表现的HIV-1血清阳性和HIV-1血清阴性参与者的横断面组间比较研究。
75名医学上无症状的HIV-1血清阳性同性恋或双性恋男性以及50名HIV-1血清阴性同性恋或双性恋男性对照。根据HIV-1状态（血清阳性与血清阴性）和认知储备分数（低储备与高储备）对受试者进行分组。
认知储备分数基于受教育年限、职业成就测量和病前智力估计的综合指标。通过经验得出的因子分数和临床总结评分来总结一系列神经心理测试的表现。
认知储备分数低的HIV-1血清阳性受试者在注意力和信息处理速度、言语学习和记忆、执行功能以及视觉空间表现等测量指标上的缺陷明显大于认知储备分数高的HIV-1血清阳性受试者。相比之下，两组HIV-1血清阴性受试者在这些测量指标上没有显著的组间差异。
HIV-1感染早期的神经心理损害在认知储备较低的个体中最为明显。正如在其他神经系统疾病（如阿尔茨海默病）中所发现的那样，认知储备较高的个体可能对潜在神经病理过程的初始临床影响不太敏感。
