Variable patterns of neuropsychological performance in HIV-1 infection
Variable patterns of neuropsychological performance in HIV-1 infection
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DOI：
10.1080/13803390701565225
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发表时间：
2008-01-01
影响因子：
2.2
通讯作者：
Heaton, R. K.
中科院分区：
文献类型：
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作者：
Dawes, S.;Suarez, P.;Heaton, R. K.
基于先前的群体研究结果，HIV感染的神经心理学结果出现了一种典型模式：执行功能、运动技能、信息处理速度和学习能力受损，记忆保留、大部分语言技能和视觉空间功能完好。我们检查了553名HIV阳性成人的神经心理学结果，以确定HIV感染个体中出现的模式的数量。一个相对全面的神经心理学电池的因素分析确定了6个组成因素：言语记忆（VeM），视觉记忆（ViM），处理速度（PS），注意/工作记忆（a /WM），执行功能（EF）和运动(M)。这些因子得分被提交给分层聚类分析，以确定队列中适当数量的聚类或模式。然后根据Lange、Iverson、Senior和Chelune（2002）的方法，通过K-means分析确定最终的聚类隶属度。发现6个集群的解决方案是最合适的。集群的定义是基于对因子得分的间接评分，以表明相对优势和劣势（独立于整体表现水平）：集群1：强EF；集群2：强M、弱VeM和EF；集群3：强PS，弱ViM和EF；集群4：强VeM，弱M；集群5：强A/WM；集群6：强VeM，弱EF。不同组的神经心理损伤率不同，但所有6个组都包含大量受损和未受损的个体。群集成员不能用人口统计学变量或精神病学或神经医学混淆来解释。因此，在这一系列具有代表性的神经心理学测试中，似乎没有一种单一的、与HIV感染相关的神经心理学损伤的原型模式。
Based upon prior findings with group means, a prototypical pattern of neuropsychological results with HIV infection has emerged: impaired executive functioning, motor skills, speed of information processing, and learning, with intact memory retention, most language skills, and visuospatial functioning. We examined neuropsychological results from 553 HIV+ adults to determine the number of patterns seen among individuals with HIV infection. Factor analysis of a relatively comprehensive neuropsychological battery identified 6 component factors: verbal memory (VeM), visual memory (ViM), processing speed (PS), attention/working memory (A/WM), executive function (EF), and motor (M). These factor scores were submitted to hierarchical cluster analysis, to determine the appropriate number of clusters or patterns in the cohort. Final cluster membership was then determined by K-means analysis, based on the Lange, Iverson, Senior, and Chelune (2002) method. A 6-cluster solution was found to be most appropriate. The definitions of the clusters were based upon ipsative scoring of factor scores to indicate relative strengths and weaknesses (independent of overall level of performance): Cluster 1: strong EF; Cluster 2: strong M, weak VeM and EF; Cluster 3: strong PS, weak ViM and EF; Cluster 4: strong VeM, weak M; Cluster 5: strong A/WM; Cluster 6: strong VeM, weak EF. Neuropsychological-impairment rates differed across clusters, but all 6 clusters contained substantial numbers of impaired and unimpaired individuals. Cluster membership was not explained by demographic variables or psychiatric or neuromedical confounds. Thus, there does not appear to be a single, prototypical pattern of neuropsychological impairment associated with HIV infection for this battery of representative neuropsychological tests.