COGNITIVE DISORDERS AT HIV-INFECTION

Abstract

The aim is to establish the frequency and features of cognitive impairment in HIV patients.

Patients and methods: 116 patients with HIV infection in different clinical stages of the disease were examined. All patients underwent neuropsychological examination which included testing using a number of scales and tests. Before neuropsychological testing  all respondents were offered questionnaires to assess the presence and severity of depressive symptoms (Beck depression scale – Beck A. T. et al., 1961) and assessing the level of situational (reactive) anxiety (Spielberger-Khanin test, 1976). Character accentuation was determined by the Leonhard K test, personal characteristics according to the multifactor questionnaire Kettell R. B. (1949). The control group consisted of 39 practically healthy volunteers that is fully comparable in age and gender with the study group.

Results and conclusions. Clinical signs of HIV-associated CNS lesions are found in 22.4 % of HIV patients in the form of a moderate decrease in neurocognitive functions. Moreover with increasing degree of immunodeficiency, the number of people with mild cognitive impairment increases.

HIV infection is the cause of minimal focal neurological symptoms in the form of symptoms of oral automatism and vestibular-atactic disorders (P<0.05–0.001). Almost every second patient with mild cognitive impairment has vestibulo-cerebral syndrome, pyramidal syndrome (less often), extrapyramidal syndrome (even less often). The difference in the frequency of all these neurological symptoms is statistically significant – P<0.05–0.001 in comparison with healthy people.

Assessment of disorders of higher cortical functions in the I–II clinical stage of HIV infection proved predominant changes in somatosensory gnosis, memory, attention, significant changes in dynamic praxis. HIV-infected in stage III dynamic praxis IV almost always inferior in the ability to focus, write, read, memorize (first of all series of numbers), count, in visual, somatosensory, auditory gnosis, dynamic praxis as well as in intelligence (P<0.05–0.001).

In the III–IV clinical stages of HIV infection, most patients were in a state of subdepression, accompanied by a high level of anxiety (compared with relatively healthy individuals P<0.001).