Advancing the science of neurocognitive physiology in adolescents living with HIV

项目摘要 与艾滋病病毒感染者（ALHIV）相比， 他们的未感染的同龄人，但潜在的神经生理学被认为是基本的基石， 复杂的认知过程尚未在这一人群中得到严格的研究。因此，有一个临界点- 临床上需要对ALHIV患者的神经生理学和认知功能进行全面研究，特别是在Sa- 非洲撒哈拉沙漠地区，具有独特的健康和社会人口风险因素， 艾滋病毒感染的影响。拟议项目的具体目标是：（1）确定艾滋病毒的影响 感染对围产期感染青少年神经生理学和神经认知功能影响， 扩张因素;（2）通过以下方式建立撒哈拉以南非洲跨学科神经生理学研究的能力： 支持教师发展的强化培训和神经生理学方法学的分层指导， cal技术。核心假设是ALHIV将表现出神经生理学改变和认知受损 与未暴露的同龄人相比。这项研究的基本原理是，利用事件相关的潜力， 事件相关电位（ERP）是唯一适合确定哪些感觉和信息处理阶段受损， 导致ALHIV的认知异常在目标1中，我们将确定艾滋病毒感染对 围产期感染青少年的神经生理学和神经认知，并确定潜在的介导社会因素 人口和健康/医疗因素。为了实现这一目标，我们将描述ERP响应及其关系， 与未感染青少年（n=50/组）相比，ALHIV（14-17岁）对认知功能的影响， 建立一个模型，以确定儿童时期的因素预测不良的神经生理和认知结果。 认知和感觉ERP范式，联想运动学习和运动协调任务，以及文化 将在目标1内进行NIH液体认知测试的改编版本。在目标2中，我们将 通过支持教师的强化培训，建立跨学科神经生理学研究的能力， 神经生理学方法学技术的指导和分层指导。在这一目标下，我们将... 在莫伊大学的培训项目中， 工作，用于临床和研究目的。这将通过每月一次的一系列培训讲习班来实现 虚拟研讨会和现场监督，这将在一个全国性的研讨会，以促进神经， 在肯尼亚进行生理学研究合作。这项拟议的工作意义重大，因为它将是第一个 在撒哈拉以南非洲对ALHIV进行全面的神经生理学研究，莫伊大学将是唯一一所 肯尼亚具有可持续神经生理学研究能力的学术中心。为这项提案提供资金将 加强和促进国家合作，以查明健康和社会人口因素， 干预和促进治疗目标的确定，以改善个人的结果， 在非洲大陆上。

PROJECT SUMMARY Adolescents living with HIV (ALHIV) have been shown to experience neurocognitive impairment compared to their uninfected peers, but the underlying neurophysiology considered to be the fundamental building blocks of complex cognitive processing have not been rigorously studied within this population. Therefore, there is a crit- ical need for a comprehensive study of neurophysiology and cognitive function in ALHIV, especially in sub-Sa- haran Africa, which comes with unique health and socio-demographic risk factors that compound the adverse effects of HIV infection. The specific objectives of the proposed project is to: (1) determine the impact of HIV infection on neurophysiology and neurocognition in perinatally-infected adolescents and identify potential me- diating factors; and (2) build capacity for interdisciplinary neurophysiological research in sub-Saharan Africa by supporting intensive training for faculty development and tiered mentoring in neurophysiological methodologi- cal techniques. The central hypothesis is that ALHIV will show altered neurophysiology and impaired cognition compared to their unexposed peers. The rationale for this study is that evaluations utilizing event-related poten- tials (ERP) are uniquely suited determine which sensory and information processing stages are impaired and contribute to cognitive abnormalities in ALHIV. In Aim 1, we will determine the impact of HIV infection on neurophysiology and neurocognition in perinatally-infected adolescents and identify potential mediating socio- demographic and health/medical factors. To achieve this aim we will characterize ERP responses and their rela- tionship to cognitive function in ALHIV (14-17 years old) compared to uninfected adolescents (n=50/group) to develop a model to determine childhood factors predictive of poor neurophysiological and cognitive outcomes. Cognitive and sensory ERP paradigms, associative motor learning and motor coordination tasks, and a culturally adapted version of the NIH Toolbox Fluid Cognition tests will be administered within Aim 1. In Aim 2, we will build capacity for interdisciplinary neurophysiological research by supporting intensive training for faculty de- velopment and tiered mentoring in neurophysiological methodological techniques. Within this aim, we will sup- port the faculty and students within the Moi University’s training programs in performing neuropsychological work, for both clinical and research purposes. This will be done through a series of training workshops, monthly virtual seminars, and on-site supervision, which will culminate within a national symposium to foster neuro- physiological research collaboration across Kenya. The proposed work is significant because it will be the first comprehensive neurophysiological study of ALHIV in sub-Saharan Africa, and Moi University will be the only Kenyan academic center with sustainable capacity for research in neurophysiology. Funding this proposal would strengthen and promote national collaboration aimed at identifying mediating health and sociodemographic fac- tors for intervention and facilitating the identification of therapeutic targets to improve the outcomes of individ- uals across the African continent.