NEUROIMAGING OF HIV AND COMORBID DISORDERS

描述(摘自申请者摘要)：神经影像研究 目前提出的不同于现有的许多关于 艾滋病毒/艾滋病在几个实质性领域的神经生理学影响。为 例如，拟议的研究不会完全集中在以下几个子集 患有严重痴呆症的HIV/AIDS患者处于疾病的晚期。 其次，它也不会只专注于核实神经学或 主观性和未知性的神经心理分期系统 特异性和可靠性。第三，拟议的研究不会排除 艾滋病毒/艾滋病患者，女性或患有精神障碍的患者。这个 拟议研究的重点将转向量化的 在更广泛的样本中评估艾滋病毒/艾滋病患者的损害程度 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血清阴性的受试者。所有的 受试者将接受相同的程序，其中包括结构化的 医学和心理评估。将尝试匹配 关于几个神经生理学相关背景变量的组(即， 抑郁程度、吸毒史、性别和年龄)。依存性措施 将包括几种定量的脑电测量，感官 诱发电位潜伏期和波幅，以及地形图分析 内源性事件相关电位。其他从属措施将包括 平衡、震颤和眼球运动的客观和定量测量。这个 这项研究的总体目标是构建一个多变量模型，在这个模型中 人们可以测试各种风险因素(例如反社会人格)的作用 精神障碍)，共病障碍(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A、B期、 或C；病毒载量、CD4+计数、肿瘤坏死因子-α)在介导、扩增或 增加了神经生理损害的程度。此外, 将收集脑脊液中细胞因子和β-趋化因子活性的测量结果 以检验它们与神经生理学的相关性 同意接受腰椎手术的HIV/AIDS患者亚组的功能 刺穿了。第二项研究将评估以上列出的相同措施 45名艾滋病毒/艾滋病患者在启动标准前和3个月后 抗病毒药物治疗方案与45例未用药的HIV/AIDS患者的比较 (由于药物不耐受或不依从性)，他们也要进行两次检测。 对不同组的变化分数进行分析将允许进行正式测试 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.