       Document 0664
 DOCN  M9620664
 TI    [Cognition disorders in HIV infection. Validation of a brief
       neuropsychological evaluation battery]
 DT    9602
 AU    Desi M; Seibel N; Korezlioglu J; Silvestre D; Linard F; Service de
       Neurologie, Hopital de Bicetre, Le Kremlin-Bicetre.
 SO    Encephale. 1995 Jul-Aug;21(4):289-94. Unique Identifier : AIDSLINE
       MED/96004062
 AB    The objective of our study was the elaboration and the validation of a
       brief neuropsychological battery sensitive to the main cognitive and
       psychomotor deficits in HIV+ patients with HIV encephalopathy and
       cognitive impairment associated with seropositivity. We evaluated the
       sensitivity of this brief battery with respect to a large
       neuropsychological battery of standardized tests. METHODOLOGY: A brief
       battery (BB) (30 mn, with simple and portable material) of 5
       standardized subtests and 7 new elaborated tests and a large battery
       (LB) (2 h to 2 h 30) of 16 standardized subtests, were constituted. Both
       screened 6 major cognitive areas (attention, memory, visuospatial
       function, psychomotor speed, motor dexterity, language). On the LB,
       subjects' age and educational level were considered while appraising
       performances to determine whether subjects had normal cognitive status
       (less than 4 abnormal test scores), borderline cognitive impairment (4
       or 5 abnormal test scores); on the BB norms for the new tests were
       generated from the results of 24 HIV+ subjects with normal cognitive
       status on the LB and 15 HIV- subjects of a control group; performance on
       the BB was considered normal if less than 3 test scores were abnormal,
       or impaired if more than 3 test scores were abnormal. Conclusions
       deduced from the assessments with BB were compared to those obtained
       from LB. For all subjects, a possible anxio-depressive component was
       evaluated on the basis of DSM III-R criteria and clinical scales (MADRS
       and STAXI). Subjects were included in the study notwithstanding mode of
       contamination and stage of illness and anxiodepressive antecedents;
       patients with identified brain disease or evolutive non neurological
       pathology were not included. 102 evaluations were performed on a
       population of HIV+ patients comprising 89 men and 13 women: 19 CDC II,
       35 CDC III or IV C 2 and 48 CDC IV; 76 homosexuals, 8 heterosexuals, 16
       drug users and 2 transfused. RESULTS: the BB led to the same conclusions
       for 90.6% of the 53 impaired cases (on LB) and for 96% of the 24 normal
       cases. The reliability of the BB is therefore of 92%; there was only 1
       false positive (less than 2%) and less than 6.5% false negatives. Among
       the 25 subjects with borderline cognitive impairment, half were impaired
       and half were normal on the BB; most (84%) presented with
       anxio-depressive symptoms. COMMENTS AND CONCLUSION: The brief battery
       (BB) testing 6 cognitive functions could be considered as a sensitive,
       practical instrument for rapid detection of cognitive impairment in HIV+
       patients, with a few rate of false positive or negative diagnosis.
       However, it is not adequate for determining whether psychiatric or/and
       organic brain pathology is at the origin of the deficit. Evaluation and
       follow-up of a possible anxio-depressive component has to be considered
       together before concluding.
 DE    Adult  Aged  AIDS Dementia Complex/*DIAGNOSIS/PSYCHOLOGY  Cognition
       Disorders/*DIAGNOSIS/PSYCHOLOGY  English Abstract  Female  Human  HIV
       Seropositivity/PSYCHOLOGY  Male  Middle Age  Neuropsychological
       Tests/*STATISTICS & NUMER DATA  Psychometrics  Reference Values
       Reproducibility of Results  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

