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Distal Sensory Polyneuropathy is Associated with Neuropsychological Test Performance among Persons with HIV

Published online by Cambridge University Press:  12 June 2012

Robert P. Fellows ,
Desiree A. Byrd ,
Kathryn Elliott ,
Jessica Robinson-Papp ,
Monica Rivera Mindt  and
Susan Morgello
Robert P. Fellows*
Affiliation:
Department of Neurology, Mount Sinai School of Medicine, New York, New York
Desiree A. Byrd
Affiliation:
Department of Neurology, Mount Sinai School of Medicine, New York, New York
Kathryn Elliott
Affiliation:
Department of Neurology, Mount Sinai School of Medicine, New York, New York
Jessica Robinson-Papp
Affiliation:
Department of Neurology, Mount Sinai School of Medicine, New York, New York
Monica Rivera Mindt
Affiliation:
Department of Neurology, Mount Sinai School of Medicine, New York, New York
Susan Morgello
Affiliation:
Department of Neurology, Mount Sinai School of Medicine, New York, New York
*
Correspondence and reprint requests to: Robert P. Fellows, Department of Neurology, Box 1134 Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029. E-mail: robert.fellows@mssm.edu
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Abstract

While distal sensory polyneuropathy (DSP) is the most common neurological condition associated with HIV, causing nerve damage in upper and lower extremities, its impact on neuropsychological test performance is unclear. In this study, we analyzed baseline data for 278 HIV-infected participants with comprehensive neurological and neurocognitive evaluations to examine the contribution of DSP and anatomic distribution of neuropathic signs (upper extremity or lower extremity) on standardized domain scores. We found that participants with DSP performed significantly worse in multiple domains containing timed psychomotor tests (i.e., motor, information processing speed and executive functioning). With regard to executive functioning, differences were limited to a test with a motor component (Trail Making Test, Part B). The group with clinically detectable neuropathic signs in the upper extremities and the group with signs limited to the lower extremities both performed worse in the motor domain than the group without DSP. Participants with DSP demonstrated a unique pattern of impairment limited to neuropsychological domains with timed psychomotor tests. These results suggest that caution should be used in interpretation of neuropsychological tests in patients with DSP, as some abnormalities may be exacerbated by peripheral nervous system pathology. (JINS, 2012, 19, 1–10)

Keywords

HIVCognitive disordersPeripheral neuropathyPsychomotor performanceNeuropsychological testsAcquired immunodeficiency syndrome
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 18 , Issue 5 , September 2012 , pp. 898 - 907
Copyright
Copyright © The International Neuropsychological Society 2012

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