title: Evaluation of a Cognitive Rehabilitation Protocol in HIV Patients with Associated Neurocognitive Disorders: Efficacy and Stability Over Time.
abstract: The primary aim of the present study was to evaluate the efficacy and stability over time of a cognitive rehabilitation protocol (restorative and compensatory approach) in HIV/AIDS patients with HIV-associated Neurocognitive Disorder (HAND). At baseline, 32 HIV/AIDS patients (16 with and 16 without HAND) were assessed with a neuropsychological battery (i.e., pre-assessment) consisting of 22 tests covering eight cognitive domains. Then, the experimental group was administered over 4 months a cognitive rehabilitation protocol aimed at improving four cognitive domains by means of eight paper and pencil/computer-based exercises. The control group received guideline-adherent clinical care (i.e., standard of care). At the end of the cognitive treatment, both groups were re-administered the neuropsychological battery (i.e., post-assessment). Additionally, 6 months after post-assessment, the experimental group was given the same neuropsychological battery (i.e., follow up-assessment). In order to test the efficacy of the cognitive rehabilitation protocol, we compared between groups the results of the neuropsychological battery at the pre- and post-assessments. In order to evaluate the stability over time, the effects of the cognitive rehabilitation protocol was examined comparing within the experimental group the results of the neuropsychological battery at post- and follow up-assessments. Our results show that the two groups did not differ at the pre-assessment, but differed at post-assessment. Specifically, the experimental group showed a significant improvement in five domains (Learning and memory, Abstraction/executive functioning, Verbal fluency, Attention/working memory, and Functional), whereas the control group significantly worsened in the same domains. The improvement of the experimental group did not change in the follow up-assessment in two domains (Abstraction/executive functioning, Attention/working memory, and Functional). Overall, these findings support the efficacy and, to some extent, the stability over time of our cognitive rehabilitation protocol.
authors.affiliation: Division A of Infectious Diseases, Amedeo of Savoia Hospital Torino, Italy ; SpAtial, Motor and Bodily Awareness Research Group, Department of Psychology, University of Torino Torino, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Livelli
authors.affiliation: Division A of Infectious Diseases, Amedeo of Savoia Hospital Torino, Italy.
authors.forename: Gian Carlo
authors.initials: GC
authors.lastname: Orofino
authors.affiliation: Unit of Infectious Diseases, Department of Medical Sciences, University of Torino Torino, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Calcagno
authors.affiliation: Division A of Infectious Diseases, Amedeo of Savoia Hospital Torino, Italy.
authors.forename: Mariana
authors.initials: M
authors.lastname: Farenga
authors.affiliation: Division A of Infectious Diseases, Amedeo of Savoia Hospital Torino, Italy.
authors.forename: Donatella
authors.initials: D
authors.lastname: Penoncelli
authors.affiliation: Division A of Infectious Diseases, Amedeo of Savoia Hospital Torino, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Guastavigna
authors.affiliation: Division A of Infectious Diseases, Amedeo of Savoia Hospital Torino, Italy.
authors.forename: Sinibaldo
authors.initials: S
authors.lastname: Carosella
authors.affiliation: Division A of Infectious Diseases, Amedeo of Savoia Hospital Torino, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Caramello
authors.affiliation: SpAtial, Motor and Bodily Awareness Research Group, Department of Psychology, University of Torino Torino, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Pia
keywords: HAND; HIV; HIV-associated neurocognitive disorders; cognitive impairment; neurocognitive rehabilitation