Cognitive mechanisms of switching in HIV-associated category fluency deficits

• Published in: Journal of clinical and experimental neuropsychology Vol. 30; no. 7; pp. 797 - 804
• Main Authors: Iudicello, Jennifer E., Woods, Steven Paul, Weber, Erica, Dawson, Matthew S., Scott, J. Cobb, Carey, Catherine L., Grant, Igor, The HIV Neurobehavioral Research Center (HNRC) Group
• Format: Journal Article
• Language: English
• Published: Colchester Taylor & Francis Group 01.10.2008; Taylor & Francis
• Subjects: Adult; Adult and adolescent clinical studies; Attention - physiology; Biological and medical sciences; Cognition Disorders - diagnosis; Cognition Disorders - etiology; Cognitive processes; Female; HIV Infections - complications; Human immunodeficiency virus; Human viral diseases; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Infectious diseases; Language Disorders - diagnosis; Language Disorders - etiology; Male; Medical sciences; Middle Aged; Neuropsychological assessment; Neuropsychological Tests; Nouns; Organic mental disorders. Neuropsychology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Verbal Behavior - physiology; Verbal fluency; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Human; Immunopathology; Verbal fluency; Retroviridae; AIDS; Cognition; Immune deficiency; Lentivirus; Infection; Virus; Language; Viral disease; Task switching; Human immunodeficiency virus; Categorization; Noun
• ISSN: 1380-3395; 1744-411X
• DOI: 10.1080/13803390701779578

HIV infection is associated with deficits in category fluency, but the underlying cognitive mechanisms of such impairments have not been determined. Considering the preferential disruption of the structure and function of frontostriatal circuits in HIV disease, the present study evaluated the hypothesis that HIV-associated category fluency deficits are driven by impaired switching. Study participants were 96 HIV-infected individuals and 43 demographically comparable healthy comparison volunteers who were administered a standard measure of animal fluency and an alternating category fluency task (i.e., fruits and furniture) in a randomized order. Consistent with prior research on letter fluency, HIV infection was associated with greater impairments in switching, but not semantic clustering within the animal fluency task. Moreover, a significant interaction was observed whereby the HIV-associated deficits in switching were exacerbated by the explicit demands of the alternating fluency task. Across both fluency tasks, switching demonstrated generally small correlations with standard clinical measures of executive functions, working memory, and semantic memory. Collectively, these findings suggest that HIV-associated category fluency deficits are driven by switching impairments and related cognitive abilities (e.g., mental flexibility), perhaps reflecting underlying neuropathology within prefrontostriatal networks.