Prospective Memory in HIV-1 Infection

• Published in: Journal of clinical and experimental neuropsychology Vol. 28; no. 4; pp. 536 - 548
• Main Authors: Carey, Catherine L., Paul Woods, Steven, Rippeth, Julie D., Heaton, Robert K., Grant, Igor, the HIV Neurobehavioral Research Center (HNRC) Group
• Format: Journal Article
• Language: English
• Published: Colchester Taylor & Francis Group 01.05.2006; Taylor & Francis
• Subjects: Adult; Biological and medical sciences; Case-Control Studies; Cognition Disorders - physiopathology; Female; HIV Infections - physiopathology; Human viral diseases; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Infectious diseases; Learning - physiology; Male; Medical sciences; Memory - physiology; Middle Aged; Models, Psychological; Neuropsychological Tests; Predictive Value of Tests; ROC Curve; Sensitivity and Specificity; Time Factors; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Infection; Human; Immunopathology; Prospective memory; Viral disease; AIDS; Cognition; Immune deficiency
• ISSN: 1380-3395; 1744-411X
• DOI: 10.1080/13803390590949494

The cognitive deficits associated with HIV-1 infection are thought to primarily reflect neuropathophysiology within the fronto-striato-thalamo-cortical circuits. Prospective memory (ProM) is a cognitive function that is largely dependent on prefronto-striatal circuits, but has not previously been examined in an HIV-1 sample. A form of episodic memory, ProM involves the complex processes of forming, monitoring, and executing future intentions vis-à-vis ongoing distractions. The current study examined ProM in 42 participants with HIV-1 infection and 29 demographically similar seronegative healthy comparison (HC) subjects. The HIV-1 sample demonstrated deficits in time- and event-based ProM, as well as more frequent 24-hour delay ProM failures and task substitution errors relative to the HC group. In contrast, there were no significant differences in recognition performance, indicating that the HIV-1 group was able to accurately retain and recognize the ProM intention when retrieval demands were minimized. Secondary analyses revealed that ProM performance correlated with validated clinical measures of executive functions, episodic memory (free recall), and verbal working memory, but not with tests of semantic memory, retention, or recognition discrimination. Taken together, these findings indicate that HIV-1 infection is associated with ProM impairment that is primarily driven by a breakdown in the strategic (i.e., executive) aspects of retrieving future intentions, which is consistent with a prefronto-striatal circuit neuropathogenesis. The HNRC group is affiliated with the University of California, San Diego, the Naval Hospital, San Diego, and the San Diego Veterans Affairs Healthcare System, and includes: Director: Igor Grant, M.D.; Co-Directors: J. Hampton Atkinson, M.D., J. Allen McCutchan, M.D.; Center Manager: Thomas D. Marcotte, Ph.D.; Naval Hospital San Diego: Mark R. Wallace, M.D. (P.I.); Neuromedical Component: J. Allen McCutchan, M.D. (P.I.), Ronald J. Ellis, M.D., Ph.D., Scott Letendre, M.D., Rachel Schrier, Ph.D.; Neurobehavioral Component: Robert K. Heaton, Ph.D. (P.I.), Mariana Cherner, Ph.D., Julie Rippeth, Ph.D., Joseph Sadek, Ph.D., Steven Paul Woods, Psy.D., Corinna Young, Ph.D.; Imaging Component: Terry Jernigan, Ph.D. (P.I.), John Hesselink, M.D., Michael J. Taylor, Ph.D.; Neuropathology Component: Eliezer Masliah, M.D. (P.I.), Dianne Langford, Ph.D.; Clinical Trials Component: J. Allen McCutchan, M.D., J. Hampton Atkinson, M.D., Ronald J. Ellis, M.D., Ph.D., Scott Letendre, M.D.; Data Management Unit: Daniel R. Masys, M.D. (P.I.), Michelle Frybarger, B.A. (Data Systems Manager); Statistics Unit: Ian Abramson, Ph.D. (P.I.), and Deborah Lazzaretto, M.S. Catherine L. Carey is now in the Department of Psychiatry at the University of California, San Francisco. Julie Rippeth is now in the Department of Psychology at Walter Reed Army Medical Center. The research described was also supported by DA12065, MH59745, MH62512, and MH073419 from the National Institutes of Health. The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Navy, Department of Defense, nor the United States Government. The authors extend their gratitude to Sarah Raskin, Ph.D. for her generosity in supplying a complementary version of the MIST for use in this study. We also thank Jennifer Marquie, Emily Conover, Emily Jo Rajotte, J. Cobb Scott, and Richard Seghers for their assistance with data collection and coding. Aspects of these data were presented as part of a symposium at the 33rd Annual Meeting of the International Neuropsychological Society in St. Louis, MO.