Cognitive Neuropsychology of HIV and Drug Abuse

HIV 和药物滥用的认知神经心理学

• 批准号: 8412832
• 负责人: Eileen Martin
• 金额: $ 62.49万
• 依托单位: RUSH UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-08-20 至 2017-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8412832
• 关键词: AIDS neuropathy; AIDS/HIV problem; Addictive Behavior; Address; Automobile Driving; Basal Ganglia; Behavior Therapy; Brain region; Cocaine; Cocaine Dependence; Cocaine Users; Cognitive; Cognitive remediation; Crack Cocaine; Decision Making; Disease; Disease Management; Drug abuse; Drug user; Employment; Episodic memory; Estradiol; Female; Gonadal Steroid Hormones; HIV; HIV Infections; Hippocampus (Brain); Hormonal; Impaired cognition; Impairment; Individual; Knowledge; Learning; Life; Link; Literature; Measures; Memory; Menstrual cycle; Morbidity - disease rate; National Institute of Drug Abuse; Neurocognition; Neurocognitive; Neuropsychology; Pattern; Performance; Personal Financing; Phase; Positioning Attribute; Prefrontal Cortex; Prevention strategy; Progesterone; Psychostimulant dependence; Recording of previous events; Reporting; Research; Safety; Sampling; Seminal; Severities; Sex Characteristics; Short-Term Memory; Substance Addiction; Techniques; Testing; Virus; Woman; cognitive enhancement; cognitive recovery; design; disorder later incidence prevention; drug abstinence; executive function; improved; male; men; mortality; neurobehavioral; programs; proliferative phase Menstrual cycle; sex; skills; social; theories

DESCRIPTION (provided by applicant): This is a competing renewal application for Years 11-15 of R01 DA12828, "Cognitive Neuropsychology of HIV and Drug Abuse," an ongoing program of theory driven research to investigate the unique and additive effects of HIV and substance dependence on selected neurocognitive functions with neuroanatomical and functional significance for neuroAIDS research. During the current cycle we successfully demonstrated selective deficits among HIV+ drug users in measures of learning and executive functions critically dependent on basal ganglia and prefrontal cortex integrity. Our study findings provided unique evidence of significantly different patterns of neurocognitive performance among HIV+ male and female SDIs. Neurocognition among HIV+ women is significantly understudied and essentially no studies have compared neurocognitive performance of HIV+ men and women directly. Such studies are urgently needed for cocaine dependent HIV+ women, since cocaine dependence strongly and uniquely predicts morbidity and mortality among women living with HIV/AIDS and women are significantly more vulnerable to stimulant addiction compared with men. This renewal application will move forward by 1) comparing episodic memory and executive performance of HIV+ male and female cocaine dependent individuals 2)investigating potential interactive effects of severity of cocaine dependence with sex and serostatus on neurocognition; and 3) conducting an exploratory study of neurocognitive and hormonal fluctuation across the menstrual cycle as a prudent first step toward investigating potential female specific mechanisms of HIV-associated neurocognitive impairment among cocaine users. This application is uniquely positioned to acquire extensive knowledge directly relevant to neurobehavioral components of HIV disease management, cognitive strategies for enhancement of memory, cognitive recovery with continued abstinence from drugs and sex-appropriate relapse prevention strategies. Finally this application addresses research topics of high scientific priority for NIDA and will increase representation of women in studies of drug abuse. PUBLIC HEALTH RELEVANCE: Results from this study will characterize sex differences in memory and executive skills among HIV+ individuals with a history of cocaine dependence. These functions are frequently impaired among individuals with HIV-associated neurocognitive disorder (HAND) and also key components of addictive behavior. This new knowledge will facilitate design of sex-specific cognitive remediation and enhancement techniques for improving memory and executive functions among HIV+ substance dependent individuals; apply knowledge of sex differences in learning, memory and executive functions as potential improvements in sex-specific strategies of relapse prevention; and provide new knowledge of the effects of sex steroid hormones on neurocognitive function to fine tune somatic, social and behavioral interventions for cocaine dependent HIV+ women through the menstrual transition.

描述（由申请人提供）：这是R01 DA12828 11 - 15年的竞争性更新应用，“ HIV和药物滥用的认知神经心理学”，这是一项正在进行的理论驱动研究计划，以研究HIV和毒品依赖对神经植物的神经认知功能的独特和添加性效应，对神经植物的功能依赖Neurowoestic和功能性研究。在当前周期中，我们成功地证明了HIV+药物使用者之间的选择性缺陷，在学习和执行功能的衡量标准中，主要取决于基底神经节和前额叶皮层完整性。我们的研究发现提供了独特的证据，表明艾滋病毒+男性和女性SDI中神经认知性能的明显不同。艾滋病毒+女性之间的神经认知已被显着研究，基本上没有研究直接比较了艾滋病毒+男性和女性的神经认知表现。可卡因依赖性的HIV+女性迫切需要此类研究，因为与男性相比，可卡因的依赖性强烈，独特地预测了患有艾滋病毒/艾滋病和妇女的女性的艾滋病毒/艾滋病和妇女的发病率和死亡率更容易受到刺激成瘾的影响。这种更新应用将通过1）比较艾滋病毒+男性和女性可卡因依赖性个体的发作性记忆和执行表现2）研究可卡因依赖性严重程度与性别和血统对神经认知的潜在互动效应； 3）对月经周期进行神经认知和激素波动进行探索性研究，这是研究可卡因使用者中与HIV相关神经认知障碍的潜在女性特定机制的审慎第一步。该应用具有独特的位置，可以获取与HIV疾病管理的神经行为成分，增强记忆的认知策略，认知能力恢复，持续戒毒对药物的持续戒酒和性别适当的相关性预防策略直接相关的广泛知识。最后，该申请介绍了NIDA高科学优先级的研究主题，并将增加妇女在药物滥用研究中的代表性。 公共卫生相关性：这项研究的结果将表征具有可卡因依赖史的艾滋病毒+个人的记忆和执行技能的性别差异。这些功能在患有HIV相关的神经认知障碍（Hand）的个体中经常受到损害，也是成瘾行为的关键组成部分。这些新知识将促进特定性别的认知补救和增强技术的设计，以改善艾滋病毒+物质依赖性人的记忆和执行功能；在学习，记忆和执行功能中应用性别差异的知识作为预防复发的性别特定策略的潜在改善；并提供有关性类固醇激素对神经认知功能的影响的新知识，可通过月经过渡对可卡因依赖性HIV+女性进行微调，社会和行为干预。