       Document 0520
 DOCN  M9640520
 TI    Early central nervous system response to HIV infection: sleep distortion
       and cognitive-motor decrements.
 DT    9604
 AU    White JL; Darko DF; Brown SJ; Miller JC; Hayduk R; Kelly T; Mitler MM;
       Department of Neuropharmacology, Scripps Research Institute, La; Jolla,
       California, USA.
 SO    AIDS. 1995 Sep;9(9):1043-50. Unique Identifier : AIDSLINE MED/96085719
 AB    OBJECTIVE: To repeat and extend findings suggesting that sleep
       disturbance, excessive daytime sleepiness, and degraded cognitive-motor
       abilities may be early markers of central nervous system (CNS)
       involvement in HIV infection. DESIGN: A controlled, cross-sectional,
       prospective analysis. SETTING: Clinical research center at a teaching
       hospital and a military health research center. SUBJECTS: Twenty-three
       HIV-positive (mean CD4+ count, 387 +/- 162 x 10(6)/l) and 13
       seronegative men who were Naval personnel or participants of the
       University of California, San Diego HIV Neurobehavioral Research Center.
       MAIN OUTCOME MEASURES: Nocturnal and daytime sleep electroencephalogram,
       electromyogram, and electrocardiogram. Simple and complex
       cognitive-motor performance assessed via computerized tasks. RESULTS:
       Comparison of sleep parameters based on HIV status, length of time
       infected, zidovudine use, and CD4+ count indicated that CD4+ T cells >
       400 x 10(6)/l were associated with a distortion in nocturnal sleep
       characterized by increased stages 3 and 4 non-rapid eye movement (i.e.,
       slow-wave) sleep in the latter portion of the night and reduced
       nocturnal awakenings. HIV-positive patients were no sleepier in the
       daytime than controls. Cognitive-motor performance revealed deficits in
       both accuracy and efficiency for HIV-positive patients. CONCLUSION:
       Asymptomatic HIV-positive patients with CD4+ counts > 400 x 10(6)/l
       demonstrate a statistically significant increase in slow-wave sleep
       during the latter portion of the night and less arousability. CD4+
       lymphocyte count in the early phases of HIV infection appears to
       differentiate between various levels of HIV disease progression with
       respect to certain CNS measurements of nocturnal sleep and
       cognitive-motor performance. Sleep structure distortion remains one of
       the earliest and most consistently replicable physiological signs of HIV
       infection. This distortion may provide a link to immune function,
       disease progression, and cognitive-motor disability in HIV infection.
 DE    Adult  Arousal/PHYSIOLOGY  AIDS Dementia
       Complex/*DIAGNOSIS/PHYSIOPATHOLOGY  Brain/PHYSIOPATHOLOGY  Circadian
       Rhythm/PHYSIOLOGY  Cognition Disorders/*DIAGNOSIS/PHYSIOPATHOLOGY
       Cross-Sectional Studies  CD4 Lymphocyte Count  Human  HIV
       Seropositivity/DIAGNOSIS/PHYSIOPATHOLOGY  Male  Middle Age
       *Neuropsychological Tests  Prospective Studies  Psychomotor
       Disorders/*DIAGNOSIS/PHYSIOPATHOLOGY  Reaction Time/PHYSIOLOGY  Sleep
       Disorders/*DIAGNOSIS/PHYSIOPATHOLOGY  Sleep Stages/PHYSIOLOGY  Support,
       U.S. Gov't, Non-P.H.S.  Support, U.S. Gov't, P.H.S.
       Wakefulness/PHYSIOLOGY  JOURNAL ARTICLE

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

