Title

The relation between clinical neuroimaging findings and patterns of neuropsychological functioning in school-age children with perinatally acquired HIV infection

Date of Award

2002

Availability

Article

Degree Name

Doctor of Philosophy (Ph.D.)

Department

Psychology

First Committee Member

F. Daniel Armstrong, Committee Chair

Second Committee Member

Peter Mundy, Committee Member

Abstract

Disease-related neurological and neuropsychological impairments associated with long-term functional impairments are more frequently seen in children perinatally infected with HIV than in adults with the disease. The relation between disease-related effects on the CNS of a child and changes in associated specific neuropsychological functions over time is not yet well understood. The purpose of this study was to expand our understanding of the relationship between clinically significant findings on MRI/CT brain scans and neurodevelopmental dysfunction in school-age and adolescent children infected with HIV.Forty-two children ages 5--13 years were included in the present study. Each participant completed a comprehensive neurodevelopmental evaluation and received neuroimaging of the brain (MRI or CT scan) as part of their ongoing medical care. The neuroimaging studies were interpreted by a radiologist, and the participants were divided into three groups based on the neuroimaging findings: no clinical findings; atrophy only; and atrophy + white matter changes. Participants were then regrouped based on whether or not calcifications were present on neuroimaging, regardless of other neuroimaging findings.The atrophy + white matter group was found to be significantly younger than the group with no clinical findings on neuroimaging, with a trend toward the atrophy + white matter group being significantly younger than the atrophy only group also observed. Analyses did not demonstrate significant differences in performance on measures of verbal and nonverbal cognitive functioning, visual motor integration and fine motor speed and dexterity among the study participants grouped by neuroimaging findings. Exploratory analyses found that viral load was a significant predictor of neuroimaging group membership. CD4 count predicted whether children demonstrated Verbal IQ scores above or below the level of mental retardation, while viral load predicted performance on nonverbal cognitive functioning and visual-motor integration abilities.The benefits and implications for future studies are discussed, including increased understanding of the relation between neuropsychological functioning and the degree and impact of CNS involvement and greater understanding of later emergence of neurodevelopmental deficits in children with perinatally-acquired HIV infection.

Keywords

Psychology, Psychobiology; Psychology, Clinical

Link to Full Text

http://access.library.miami.edu/login?url=http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3056630