title: "Frontal systems" behaviors in comorbid human immunodeficiency virus infection and methamphetamine dependency.
abstract: Human immunodeficiency virus (HIV) infection and methamphetamine (MA) dependence are associated with neural injury preferentially involving frontostriatal circuits. Little is known, however, about how these commonly comorbid conditions impact behavioral presentations typically associated with frontal systems dysfunction. Our sample comprised 47 HIV-uninfected/MA-nondependent; 25 HIV-uninfected/MA-dependent; 36 HIV-infected/MA-nondependent; and 28 HIV-infected/MA-dependent subjects. Participants completed self-report measures of "frontal systems" behaviors, including impulsivity/disinhibition, sensation-seeking, and apathy. They also underwent comprehensive neurocognitive and neuropsychiatric assessments that allowed for detailed characterization of neurocognitive deficits and comorbid/premorbid conditions, including lifetime Mood and Substance Use Disorders, Attention-Deficit/Hyperactivity Disorder, and Antisocial Personality Disorder. Multivariable regression models adjusting for potential confounds (i.e., demographics and comorbid/premorbid conditions) showed that MA dependence was independently associated with increased impulsivity/disinhibition, sensation-seeking and apathy, and HIV infection with greater apathy. However, we did not see synergistic/additive effects of HIV and MA on frontal systems behaviors. Global neurocognitive impairment was relatively independent of the frontal systems behaviors, which is consistent with the view that these constructs may have relatively separable biopsychosocial underpinnings. Future research should explore whether both neurocognitive impairment and frontal systems behaviors may independently contribute to everyday functioning outcomes relevant to HIV and MA.
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA, United States.
authors.forename: María J
authors.initials: MJ
authors.lastname: Marquine
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA, United States.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Iudicello
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA, United States.
authors.forename: Erin E
authors.initials: EE
authors.lastname: Morgan
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA, United States; Veterans Administration San Diego Healthcare System, San Diego, CA, United States.
authors.forename: Gregory G
authors.initials: GG
authors.lastname: Brown
authors.affiliation: Department of Medicine, University of California, San Diego, CA, United States.
authors.forename: Scott L
authors.initials: SL
authors.lastname: Letendre
authors.affiliation: Department of Neurosciences, University of California, San Diego, CA, United States.
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Ellis
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA, United States.
authors.forename: Reena
authors.initials: R
authors.lastname: Deutsch
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA, United States.
authors.forename: Steven Paul
authors.initials: SP
authors.lastname: Woods
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA, United States.
authors.forename: Igor
authors.initials: I
authors.lastname: Grant
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA, United States. Electronic address: rheaton@ucsd.edu.
authors.forename: Robert K
authors.initials: RK
authors.lastname: Heaton
mesh_terms: D000328:Adult; D000339:Affect; D019969:Amphetamine-Related Disorders / Q000150:complications / Q000523:psychology*; D057565:Apathy; D001288:Attention; D056344:Executive Function; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000523:psychology*; D006801:Humans; D007175:Impulsive Behavior / Q000150:complications / Q000523:psychology*; D008297:Male; D008570:Memory, Short-Term; D008694:Methamphetamine; D008875:Middle Aged; D009483:Neuropsychological Tests; D057566:Self Report
chemical_list: D008694:Methamphetamine
keywords: Apathy; HIV; Impulsive behavior; Sensation; Substance abuse