Prospective Memory in HIV-1 Infection

HIV-1 感染中的前瞻性记忆

• 批准号: 7026523
• 负责人: Steven Paul Woods
• 金额: $ 30.93万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-03-04 至 2008-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7026523
• 关键词: AIDS /HIV neuropathy; HIV infections; antiAIDS agent; behavioral /social science research tag; clinical research; cognition disorders; executive function; functional ability; helper T lymphocyte; human subject; leukocyte count; memory disorders; neuropathology; neuropsychological tests; patient oriented research; prefrontal lobe /cortex; therapy compliance; virus load

DESCRIPTION (provided by applicant): Despite considerable scientific progress over the past 15 years, notable limitations persist in the theoretical and clinical significance of memory assessment in persons with HIV-1 infection. The overarching aim of this revised multidisciplinary project is to provide a conceptually-driven approach to delineating the impact of HIV-1 infection on prospective memory (ProM). ProM is a unique aspect of episodic memory sensitive to fronto-striatal damage that encompasses the complex processes of forming, monitoring, and executing future intentions vis-a-vis ongoing distractions. Consideration of ProM can enhance prediction of- and interventions related to - instrumental activities of daily living (lADLs). It is therefore surprising that ProM has not been evaluated in HIV-1, especially given the fronto-striatal neuropathogenesis of HIV-1-associated memory deficits and their impact on lADLs. Accordingly, this revised research application is guided by the following specific aims: 1) to clarify the nature, extent, and disease correlates of ProM impairment in HIV-1 infection; 2) to delineate the cognitive mechanisms of ProM impairment in HIV-1 using both clinical and experimental measures; and 3) to assess the efficacy of ProM in predicting lADLs (e.g., medication adherence) in HIV-1. We will recruit 200 HIV+ participants and 50 demographically comparable controls to evaluate the following primary hypotheses: 1) HIV-1 infection is associated with deficient executive control of encoding and retrieval within ProM; 2) ProM impairment is associated with advanced HIV-1 disease (e.g., viral load); and 3) ProM provides incremental validity relative to traditional cognitive tests in predicting lADLs, including medication adherence. This study promises to produce important conceptual and practical innovations regarding the nature and clinical assessment of HIV-associated cognitive disorders, and may ultimately facilitate the development of ProM-based interventions to minimize the impact of cognitive disorders on persons with HIV-1 infection, caregivers, and the health care system.

描述（由申请人提供）：尽管过去 15 年取得了相当大的科学进步，但 HIV-1 感染者记忆评估的理论和临床意义仍然存在明显的局限性。这个修订后的多学科项目的总体目标是提供一种概念驱动的方法来描述 HIV-1 感染对前瞻记忆 (ProM) 的影响。 ProM 是情景记忆的一个独特方面，对额纹状体损伤敏感，涵盖形成、监控和执行未来意图（相对于持续干扰）的复杂过程。考虑 ProM 可以增强对日常生活工具性活动 (LADL) 的预测和相关干预。因此，令人惊讶的是，ProM 尚未在 HIV-1 中进行评估，特别是考虑到 HIV-1 相关记忆缺陷的额纹状体神经发病机制及其对 IADL 的影响。因此，本修订后的研究申请以以下具体目标为指导：1）阐明 HIV-1 感染中 ProM 损伤的性质、程度和疾病相关性； 2) 使用临床和实验措施来描述 HIV-1 ProM 损伤的认知机制； 3) 评估 ProM 在预测 HIV-1 的 IADL（例如药物依从性）方面的功效。我们将招募 200 名 HIV+ 参与者和 50 名人口统计学可比较的对照来评估以下主要假设：1）HIV-1 感染与 ProM 内编码和检索的执行控制缺陷有关； 2) ProM 损伤与晚期 HIV-1 疾病（例如病毒载量）相关； 3) ProM 在预测 LADL（包括药物依从性）方面提供了相对于传统认知测试的增量有效性。这项研究有望在 HIV 相关认知障碍的性质和临床评估方面产生重要的概念和实践创新，并可能最终促进基于 ProM 的干预措施的开发，以尽量减少认知障碍对 HIV-1 感染者、护理人员的影响和医疗保健系统。