COGNITIVE NEUROPSYCHOLOGY OF HIV AND MDMA ABUSE

HIV 和 MDMA 滥用的认知神经心理学

• 批准号: 6659703
• 负责人: Eileen Martin
• 金额: $ 38.28万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-30 至 2005-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6659703
• 关键词: 3,4 methylenedioxymethamphetamine; AIDS therapy; HIV infections; bisexual; brain subcortex; clinical research; cognition; drug abuse; frontal lobe /cortex; high risk behavior /lifestyle; homosexuals; human immunodeficiency virus 1; human subject; ketamine; neuropsychology; substance abuse epidemiology; substance abuse related behavior; therapy compliance

DESCRIPTION: (Applicant's Abstract) The long-term objectives of this research are to employ a cognitive neuropsychological model to conceptualize the effects of HIV and club drug abuse on the brain, to relate these effects to critical behaviors such as high risk sexual and injection practices in HIV-seropositive and seronegative men who have sex with men (MSMs), and to obtain preliminary data on the relationship between these effects and adherence with antiretroviral therapy. The abuse of MDMA ("Ecstasy'), ketamine ("Special K") and other club drugs is on the rise among MSMs and evidence indicates that the majority of club drugs have known or potential neurotoxic effects; however, neurocognition and club drug use has not been studied in MSMs or in the context of HIV infection. HIV infection and abuse of MDMA, the most common club drug of abuse among MSMs, cause dysfunction in overlapping frontal-subcortical brain regions. This study will evaluate the question of whether a history of MDMA abuse in the context of HIV infection will increase vulnerability to neurocognitive deficits, a question with significant potential diagnostic and therapeutic implications. We assume that careful study of specific cognitive functions mediated by different frontal-subcortical circuits will permit characterization of HIV-related cognitive impairment and its manifestation in persons who abuse MDMA. The specific aims of this investigation are to compare the performance of HIV-seropositive (HIV+) and HIV-seronegative (HIV-) MSMs with a current or past history of MDMA abuse and control groups of HIV+ and HIV- MSMs with no history of MDMA abuse on measures of decision-making, working memory, response inhibition and prospective memory, "executive" functions dependent on the integrity of prefrontal-subcortical pathways and potential mechanisms of HIV-related cognitive dysfunction; to evaluate the association of HIV serostatus and MDMA abuse with executive functions and sexual and drug use-related risk behavior; and to obtain preliminary data on levels of adherence with antiretroviral therapy in HIV+ MSMs with and without a history of MDMA abuse. The study will evaluate cognitive function in these groups employing state of the art computerized measures developed to model specific impairments associated with dysfunction of frontal-subcortical circuits. Data from the proposed study will advance knowledge of cognitive aspects of HIV-1 infection in the context of MDMA abuse; the practical implications of how cognitive impairment associated with HIV and club drug abuse influences behavior; and recent attempts to bridge the gap on how specific cognitive impairment can influence risk behavior and medication and adherence.

描述：（申请人的摘要） 这项研究的长期目标是采用认知 神经心理学模型概念化艾滋病毒和俱乐部药物的影响 滥用大脑，将这些影响与诸如高的关键行为联系起来 艾滋病毒 - 呼吸阳性男性的性和注射习惯 与男性发生性关系的人（MSM），并获得有关 这些作用与抗逆转录病毒疗法的依从性之间的关系。 滥用MDMA（“摇头丸”），氯胺酮（“特殊K”）和其他俱乐部毒品是 在MSM和证据之间的兴起表明大多数俱乐部毒品 具有已知或潜在的神经毒性作用；但是，神经认知和俱乐部 在MSMS或HIV感染的背景下，尚未对药物使用进行研究。艾滋病病毒 MDMA感染和滥用MDMA是MSM中最常见的滥用俱乐部药物， 在重叠的额叶大脑区域重叠。这项研究 将评估MDMA滥用历史是否在 艾滋病毒感染将增加对神经认知缺陷的脆弱性，一个 具有重大潜在诊断和治疗意义的问题。我们 假设仔细研究由不同的特定认知功能 额叶额叶电路将允许与HIV相关的表征 认知障碍及其在滥用MDMA的人中的表现。这 这项调查的具体目的是比较 具有电流或过去 MDMA滥用和对照组的HIV+和HIV- MSM的历史 MDMA滥用决策，工作记忆，回应的措施 抑制和前瞻性记忆，“执行”功能取决于 前额叶途径的完整性和潜在机制的完整性 与HIV相关的认知功能障碍；评估艾滋病毒的关联 血统和MDMA滥用行政功能以及性和药物 与使用相关的风险行为；并获得有关级别的初步数据 在有或没有病史的HIV+ MSMS中遵守抗逆转录病毒疗法 MDMA滥用。该研究将评估这些组的认知功能 采用最新的计算机措施来建模特定的计算机措施 与额皮层电路功能障碍相关的障碍。数据 从拟议的研究中，将进一步了解HIV-1的认知方面 在MDMA滥用的背景下感染；如何实现如何 与艾滋病毒和俱乐部药物滥用相关的认知障碍影响 行为;以及最近试图弥合特定认知如何的差距 损害会影响风险行为，药物和依从性。