title: A diffusion tensor imaging and neuropsychological study of prospective memory impairment in South African HIV positive individuals.
abstract: HIV-associated prospective memory (ProM) impairment has emerged, in earlier studies as a significant predictor of medication management and independence in activities of daily living. The relationship between ProM and white matter integrity in HIV has not previously been investigated. Participants, including 128 HIV-infected individuals and 32 healthy controls, were assessed using a comprehensive neuropsychological evaluation and both objective and subjective measures of ProM. Diffusion tensor imaging (DTI) was utilized to investigate the relationship of white matter integrity to ProM in a randomly selected subsample of 40 HIV positive subjects, using a whole brain voxel-based approach to define fractional anisotrophy (FA) and mean diffusion (MD). Total prospective memory was significantly poorer in the HIV positive group when compared with healthy controls (p = 0.023). Time-based ProM was poorer in the HIV group compared to healthy controls both without prompts (p = 0.001) and with prompts (p = 0.001). Poor Total ProM score correlated with performance on neuropsychological tests of executive functioning, information processing speed, learning, and working memory (p < 0.05). Those HIV positive participants with poor ProM had significantly decreased FA in the regions of superior corona radiata (p = 0.0035), the corpus collosum (p = 0.006) and the cingulum (p = 0.0033) when compared to those who were HIV positive with good ProM. This study reinforces the importance of ProM assessment in HIV.
authors.affiliation: Department of Psychiatry and Mental Health, University of Cape Town, Anzio Road Observatory, 7925 Cape Town, South Africa. hoare.jax@googlemail.com
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Hoare
authors.affiliation: Department of Psychiatry and Mental Health, University of Cape Town, Anzio Road Observatory, 7925 Cape Town, South Africa. hoare.jax@googlemail.com
authors.forename: Hoare
authors.initials: H
authors.lastname: Jacqueline
authors.forename: Jenny
authors.initials: J
authors.lastname: Westgarth-Taylor
authors.forename: Westgarth-Taylor
authors.initials: WT
authors.lastname: Jenny
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Fouche
authors.forename: Fouche
authors.initials: F
authors.lastname: Jean-Paul
authors.forename: Bruce
authors.initials: B
authors.lastname: Spottiswoode
authors.forename: Spottiswoode
authors.initials: S
authors.lastname: Bruce
authors.forename: Robert
authors.initials: R
authors.lastname: Paul
authors.forename: Paul
authors.initials: P
authors.lastname: Robert
authors.forename: Kevin
authors.initials: K
authors.lastname: Thomas
authors.forename: Thomas
authors.initials: T
authors.lastname: Kevin
authors.forename: Dan
authors.initials: D
authors.lastname: Stein
authors.forename: Stein
authors.initials: S
authors.lastname: Dan
authors.forename: John
authors.initials: J
authors.lastname: Joska
authors.forename: Joska
authors.initials: J
authors.lastname: John
mesh_terms: D015526:AIDS Dementia Complex / Q000473:pathology / Q000503:physiopathology / Q000523:psychology; D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D056324:Diffusion Tensor Imaging / Q000379:methods*; D005260:Female; D006679:HIV Seropositivity / Q000473:pathology* / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000473:pathology* / Q000503:physiopathology / Q000821:virology; D009413:Nerve Fibers, Myelinated / Q000378:metabolism / Q000473:pathology*; D013019:South Africa; D055815:Young Adult