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Determinants of Risk-Taking in HIV-Associated Neurocognitive Disorders

机译：艾滋病毒相关神经认知障碍风险的决定因素

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Objective: Decision-making involves fronto-striatal brain areas that are particularly vulnerable to the effects of HIV infection. Some studies report impaired decision-making in people with HIV/AIDS with past or present addictions and/or accompanying HIV-associated neurocognitive disorders (HAND). The authors investigated risk-based decision-making in HIV/AIDS, separating individuals with or without accompanying HAND. Method: A total of 288 HIV-infected persons underwent standardized neuropsychological testing. Participants were profiled based on neuropsychological and clinical assessments into 2 groups, neurocognitively normal (NN, n = 205) and HAND (n = 83). Risk-based decision-making was assessed via the Game of Dice Task (GDT). Sample characteristics were summarized by principal component analysis (PCA) prior to regression analyses predicting GDT performance. Results: The NN group performed within the normative range of the GDT, but the HAND group was impaired in all GDT measures. Across all participants, GDT performance was predicted by a combination of psychiatric comorbidities, alcohol abuse, education/premorbid IQ, and neuropsychological performance. Further analyses revealed marijuana use as an important additional predictor of impaired GDT performance. Within the GDT-impaired HAND group only, past or present immunosuppression emerged as the most robust predictor of GDT performance. Metabolic disorders and antiretroviral toxicity were also predictors of GDT performance in the HAND group. Conclusion: The majority of HIV-infected individuals were unimpaired in the GDT. Some influence of psychiatric and substance use comorbidities on GDT performance emerged in the entire cohort. However, GDT deficits were restricted to individuals with HAND, related to immunosuppression, metabolic disorders and antiretroviral toxicity in this group only.
机译：目的：决策涉及专门易受艾滋病毒感染的影响的前纹脑区域。有些研究报告，艾滋病毒/艾滋病的人们有过去或目前的成瘾和/或伴随的艾滋病毒相关神经认知障碍（手）。作者调查了艾滋病毒/艾滋病的风险决策，分离有或没有陪同的人。方法：共288名艾滋病毒感染者接受了标准化的神经心理学检测。将参与者根据神经心理学和临床评估分为2组，神经认知正常（NN，N = 205）和手（n = 83）。通过骰子任务（GDT）的游戏评估基于风险的决策。在预测GDT性能的回归分析之前，通过主成分分析（PCA）总结了样本特征。结果：NN组在GDT的规范范围内进行，但在所有GDT措施中，手组受损。在所有参与者中，通过精神病合并，酒精滥用，教育/前置智慧和神经心理学表现的组合预测GDT性能。进一步分析显示大麻用作GDT性能受损的重要预测因素。仅在GDT障碍的手机组中，过去或目前的免疫抑制作为GDT性能最强大的预测因子。代谢紊乱和抗逆转录病毒毒性也是手机组中GDT性能的预测因子。结论：大多数艾滋病毒感染的个体在GDT中未受吸化。精神疗法和物质的影响力在整个队列中出现的GDT性能。然而，GDT缺陷仅限于用手的个体，仅与此组中的免疫抑制，代谢紊乱和抗逆转录病毒毒性有关。

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