NEUROIMAGING OF HIV AND COMORBID DISORDERS

描述（改编自申请人摘要）：神经影像学研究 目前提出的建议与许多现有的研究不同 艾滋病毒/艾滋病在几个实质性领域的神经生理学影响。对于 例如，拟议的研究不会专门关注 艾滋病毒/艾滋病患者在疾病末期患有严重痴呆。 其次，它也不会仅仅专注于验证神经系统或 神经心理学分期系统是主观且未知的 特异性和可靠性。第三，拟议的研究不会排除 女性艾滋病毒/艾滋病患者或患有精神疾病的患者。的 拟议研究的重点将转向定量 对更广泛的艾滋病毒/艾滋病患者样本的损伤程度进行评估 使用客观可靠的神经生理学工具。为此，我们 将招募 120 名 HIV-1 血清阳性和 120 名 HIV-1 血清阴性受试者。所有的 受试者将经历相同的程序，其中包括结构化的 医学和心理评估。将尝试匹配 对几个神经生理学相关背景变量进行分组（即 抑郁程度、吸毒史、性别和年龄）。相关措施 将包括几种定量脑电图测量、感觉 诱发潜在潜伏期和振幅，以及地形分析 内源性事件相关电位。其他相关措施将包括 平衡、震颤和眼球运动的客观和定量测量。的 该研究的总体目标是构建一个多元模型，其中 人们可以测试各种风险因素的作用（例如，反社会人格 障碍）、合并症（例如情绪障碍、可卡因、酒精或海洛因） 依赖性）和疾病严重程度的标志（例如 CDC 临床分期 A、B、 或 C；病毒载量、CD4 计数、TNF-α）在介导、放大或 增加神经生理损伤的程度。此外， 将收集细胞因子和β趋化因子活性的脑脊髓测量值 为了检查它们与神经生理学的相关性 同意接受腰椎手术的艾滋病毒/艾滋病患者亚群的功能 穿刺。二次研究将评估上面列出的相同措施 标准启动前和启动后 3 个月内的 45 名 HIV/AIDS 患者 抗病毒药物治疗方案与 45 名未接受药物治疗的 HIV/AIDS 患者的比较 （由于药物不耐受或不依从）也接受了两次测试。 对各组变化分数的分析将允许对 抗病毒治疗对神经生理状态的影响。

DESCRIPTION (Adapted From The Applicants Abstract): The neuroimaging study proposed presently differs from many of the extant studies of the neurophysiological effects of HIV/AIDS in several substantive areas. For example, the proposed study will not focus exclusively on thc subset of HIV/AIDS patients with profound dementia in the terminal stages of disease. Secondly, it will also not focus exclusively upon verifying a neurological or neuropsychological staging system which is subjective and has unknown specificity and reliability. Thirdly, the proposed study will not exclude HIV/AIDS patients who are female or possess comorbid psychiatric disorders. The focus of the proposed study will instead be directed toward the quantitative assessment of degrees of impairment in a broader sample of HIV/AIDS patients using objective and reliable neurophysiological tools. For this purpose, we will recruit 120 HIV-1 seropositive and 120 HIV-1 seronegative subjects. All of the subjects will undergo identical procedures which will include structured medical and psychological evaluations. An attempt will be made to match the groups on several neurophysiologically relevant background variables (i.e., depression level, drug use history, gender, and age). The dependent measures will include several quantitative electroencephalographic measures, sensory evoked potential latencies and amplitudes, and topographic analyses of endogenous event-related potentials. Additional dependent measures will include objective and quantitative measures of balance, tremor, and eye movements. The overall goal of the study will be to construct a multivariate model in which one can test the role of various risk factors (e.g., antisocial personality disorder), comorbid disorders (e.g., mood disorder; cocaine, alcohol, or heroin dependence), and markers of disease severity (e.g., CDC clinical stages A, B, or C; viral load, CD4+ count, TNF-alpha) in either mediating, amplifying, or adding to the degree of neurophysiological impairment. In addition, cerebrospinal measures of cytokine and beta-chemokine activity will be gathered for the purpose of examining their correlation with neurophysiological functioning in the subset of HIV/AIDS patients who consent to a lumbar puncture. A secondary study will evaluate the same measures listed above among 45 HIV/AIDS patients before and 3 months after the initiation of a standard antiviral medication regimen as compared to 45 unmedicated HIV/AIDS patients (because of medication intolerance or noncompliance) who are also tested twice. An analysis of change scores across groups will permit a formal test of the effects of antiviral treatment on neurophysiological status.