Characteristics of Motor Dysfunction in Longstanding Human Immunodeficiency Virus
Abstract Background Cognitive dysfunction in human immunodeficiency virus (HIV) has decreased, but milder forms of HIV-associated neurocognitive disorders (HAND) persist along with motor dysfunction. The HIV Motor Scale (HMS) is a validated tool that captures motor abnormalities on routine neurologi...
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creator | Robinson-Papp, Jessica Gensler, Gary Navis, Allison Sherman, Seth Ellis, Ronald J Gelman, Benjamin B Kolson, Dennis L Letendre, Scott L Singer, Elyse J Valdes-Sueiras, Miguel Morgello, Susan |
description | Abstract
Background
Cognitive dysfunction in human immunodeficiency virus (HIV) has decreased, but milder forms of HIV-associated neurocognitive disorders (HAND) persist along with motor dysfunction. The HIV Motor Scale (HMS) is a validated tool that captures motor abnormalities on routine neurologic examination and which is associated with cognitive impairment in HIV. In this study, we applied a modified HMS (MHMS) to a nationwide cohort of people with longstanding HIV to characterize and understand the factors contributing to motor dysfunction.
Methods
The National NeuroAIDS Tissue Consortium is a nationwide longitudinal cohort study. Participants undergo regular assessments including neurological examination, neuropsychological testing, and immunovirologic data collection. Data from examinations were used to calculate the MHMS score, which was then correlated with history of AIDS-related central nervous system (CNS) disorders (ARCD; eg, prior CNS opportunistic infection), cerebrovascular disease (CVD), and HAND.
Results
Sixty-nine percent of participants showed an abnormality on the MHMS, with 27% classified as severe. Results did not vary based on demographic or immunologic variables. The most common abnormalities seen were gait (54%), followed by coordination (39%) and strength (25%), and these commonly co-occurred. CVD (P = .02), history of ARCD (P = .001), and HAND (P = .001) were all associated with higher (ie, worse) HMS in univariate analyses; CVD and ARCD persisted in multivariate analyses. CVD was also marginally associated with symptomatic HAND.
Conclusions
Complex motor dysfunction remains common in HIV and is associated with CVD, ARCD, and to a lesser extent, HAND. Future studies are needed to understand the longitudinal trajectory of HIV-associated motor dysfunction, its neural substrates, and impact on quality of life.
Motor dysfunction, especially gait impairment, is common in longstanding human immunodeficiency virus (HIV); it is associated with cerebrovascular disease, a prior history of an AIDS-related central nervous system disorder, and to a lesser extent, a diagnosis of HIV-associated neurocognitive disorder. |
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Background
Cognitive dysfunction in human immunodeficiency virus (HIV) has decreased, but milder forms of HIV-associated neurocognitive disorders (HAND) persist along with motor dysfunction. The HIV Motor Scale (HMS) is a validated tool that captures motor abnormalities on routine neurologic examination and which is associated with cognitive impairment in HIV. In this study, we applied a modified HMS (MHMS) to a nationwide cohort of people with longstanding HIV to characterize and understand the factors contributing to motor dysfunction.
Methods
The National NeuroAIDS Tissue Consortium is a nationwide longitudinal cohort study. Participants undergo regular assessments including neurological examination, neuropsychological testing, and immunovirologic data collection. Data from examinations were used to calculate the MHMS score, which was then correlated with history of AIDS-related central nervous system (CNS) disorders (ARCD; eg, prior CNS opportunistic infection), cerebrovascular disease (CVD), and HAND.
Results
Sixty-nine percent of participants showed an abnormality on the MHMS, with 27% classified as severe. Results did not vary based on demographic or immunologic variables. The most common abnormalities seen were gait (54%), followed by coordination (39%) and strength (25%), and these commonly co-occurred. CVD (P = .02), history of ARCD (P = .001), and HAND (P = .001) were all associated with higher (ie, worse) HMS in univariate analyses; CVD and ARCD persisted in multivariate analyses. CVD was also marginally associated with symptomatic HAND.
Conclusions
Complex motor dysfunction remains common in HIV and is associated with CVD, ARCD, and to a lesser extent, HAND. Future studies are needed to understand the longitudinal trajectory of HIV-associated motor dysfunction, its neural substrates, and impact on quality of life.
Motor dysfunction, especially gait impairment, is common in longstanding human immunodeficiency virus (HIV); it is associated with cerebrovascular disease, a prior history of an AIDS-related central nervous system disorder, and to a lesser extent, a diagnosis of HIV-associated neurocognitive disorder.</description><identifier>ISSN: 1058-4838</identifier><identifier>EISSN: 1537-6591</identifier><identifier>DOI: 10.1093/cid/ciz986</identifier><identifier>PMID: 31587032</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>AIDS Dementia Complex - diagnosis ; AIDS Dementia Complex - epidemiology ; and Commentaries ; HIV ; HIV Infections - complications ; Humans ; Longitudinal Studies ; Quality of Life</subject><ispartof>Clinical infectious diseases, 2020-09, Vol.71 (6), p.1532-1538</ispartof><rights>The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com. 2019</rights><rights>The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c408t-36b5c3a4c06453d81f40d5266f1f044566c109be6bad17208c0cce9dbd8b7f1b3</citedby><cites>FETCH-LOGICAL-c408t-36b5c3a4c06453d81f40d5266f1f044566c109be6bad17208c0cce9dbd8b7f1b3</cites><orcidid>0000-0001-9397-8873</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,1584,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31587032$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Robinson-Papp, Jessica</creatorcontrib><creatorcontrib>Gensler, Gary</creatorcontrib><creatorcontrib>Navis, Allison</creatorcontrib><creatorcontrib>Sherman, Seth</creatorcontrib><creatorcontrib>Ellis, Ronald J</creatorcontrib><creatorcontrib>Gelman, Benjamin B</creatorcontrib><creatorcontrib>Kolson, Dennis L</creatorcontrib><creatorcontrib>Letendre, Scott L</creatorcontrib><creatorcontrib>Singer, Elyse J</creatorcontrib><creatorcontrib>Valdes-Sueiras, Miguel</creatorcontrib><creatorcontrib>Morgello, Susan</creatorcontrib><title>Characteristics of Motor Dysfunction in Longstanding Human Immunodeficiency Virus</title><title>Clinical infectious diseases</title><addtitle>Clin Infect Dis</addtitle><description>Abstract
Background
Cognitive dysfunction in human immunodeficiency virus (HIV) has decreased, but milder forms of HIV-associated neurocognitive disorders (HAND) persist along with motor dysfunction. The HIV Motor Scale (HMS) is a validated tool that captures motor abnormalities on routine neurologic examination and which is associated with cognitive impairment in HIV. In this study, we applied a modified HMS (MHMS) to a nationwide cohort of people with longstanding HIV to characterize and understand the factors contributing to motor dysfunction.
Methods
The National NeuroAIDS Tissue Consortium is a nationwide longitudinal cohort study. Participants undergo regular assessments including neurological examination, neuropsychological testing, and immunovirologic data collection. Data from examinations were used to calculate the MHMS score, which was then correlated with history of AIDS-related central nervous system (CNS) disorders (ARCD; eg, prior CNS opportunistic infection), cerebrovascular disease (CVD), and HAND.
Results
Sixty-nine percent of participants showed an abnormality on the MHMS, with 27% classified as severe. Results did not vary based on demographic or immunologic variables. The most common abnormalities seen were gait (54%), followed by coordination (39%) and strength (25%), and these commonly co-occurred. CVD (P = .02), history of ARCD (P = .001), and HAND (P = .001) were all associated with higher (ie, worse) HMS in univariate analyses; CVD and ARCD persisted in multivariate analyses. CVD was also marginally associated with symptomatic HAND.
Conclusions
Complex motor dysfunction remains common in HIV and is associated with CVD, ARCD, and to a lesser extent, HAND. Future studies are needed to understand the longitudinal trajectory of HIV-associated motor dysfunction, its neural substrates, and impact on quality of life.
Motor dysfunction, especially gait impairment, is common in longstanding human immunodeficiency virus (HIV); it is associated with cerebrovascular disease, a prior history of an AIDS-related central nervous system disorder, and to a lesser extent, a diagnosis of HIV-associated neurocognitive disorder.</description><subject>AIDS Dementia Complex - diagnosis</subject><subject>AIDS Dementia Complex - epidemiology</subject><subject>and Commentaries</subject><subject>HIV</subject><subject>HIV Infections - complications</subject><subject>Humans</subject><subject>Longitudinal Studies</subject><subject>Quality of Life</subject><issn>1058-4838</issn><issn>1537-6591</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kctKxDAUhoMoOo5ufADpRhChmjSXphtBxtvAiAjqNqS5jJFpMiatMD69lY6iGxeHc-B8_OfyA3CA4CmCFT5TTvfxUXG2AUaI4jJntEKbfQ0pzwnHfAfspvQKIUIc0m2wgxHlJcTFCDxMXmSUqjXRpdaplAWb3YU2xOxylWznVeuCz5zPZsHPUyu9dn6e3XaN9Nm0aToftLFOOePVKnt2sUt7YMvKRTL76zwGT9dXj5PbfHZ_M51czHJFIG9zzGqqsCQKMkKx5sgSqGnBmEUWEkIZU_1xtWG11KgsIFdQKVPpWvO6tKjGY3A-6C67ujFaGd9GuRDL6BoZVyJIJ_52vHsR8_AuSsIZ72eOwfFaIIa3zqRWNC4ps1hIb0KXRIEh4hUiuOjRkwFVMaQUjf0Zg6D48kD0HojBgx4-_L3YD_r99B44GoDQLf8T-gQsw5IQ</recordid><startdate>20200912</startdate><enddate>20200912</enddate><creator>Robinson-Papp, Jessica</creator><creator>Gensler, Gary</creator><creator>Navis, Allison</creator><creator>Sherman, Seth</creator><creator>Ellis, Ronald J</creator><creator>Gelman, Benjamin B</creator><creator>Kolson, Dennis L</creator><creator>Letendre, Scott L</creator><creator>Singer, Elyse J</creator><creator>Valdes-Sueiras, Miguel</creator><creator>Morgello, Susan</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-9397-8873</orcidid></search><sort><creationdate>20200912</creationdate><title>Characteristics of Motor Dysfunction in Longstanding Human Immunodeficiency Virus</title><author>Robinson-Papp, Jessica ; Gensler, Gary ; Navis, Allison ; Sherman, Seth ; Ellis, Ronald J ; Gelman, Benjamin B ; Kolson, Dennis L ; Letendre, Scott L ; Singer, Elyse J ; Valdes-Sueiras, Miguel ; Morgello, Susan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c408t-36b5c3a4c06453d81f40d5266f1f044566c109be6bad17208c0cce9dbd8b7f1b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>AIDS Dementia Complex - diagnosis</topic><topic>AIDS Dementia Complex - epidemiology</topic><topic>and Commentaries</topic><topic>HIV</topic><topic>HIV Infections - complications</topic><topic>Humans</topic><topic>Longitudinal Studies</topic><topic>Quality of Life</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Robinson-Papp, Jessica</creatorcontrib><creatorcontrib>Gensler, Gary</creatorcontrib><creatorcontrib>Navis, Allison</creatorcontrib><creatorcontrib>Sherman, Seth</creatorcontrib><creatorcontrib>Ellis, Ronald J</creatorcontrib><creatorcontrib>Gelman, Benjamin B</creatorcontrib><creatorcontrib>Kolson, Dennis L</creatorcontrib><creatorcontrib>Letendre, Scott L</creatorcontrib><creatorcontrib>Singer, Elyse J</creatorcontrib><creatorcontrib>Valdes-Sueiras, Miguel</creatorcontrib><creatorcontrib>Morgello, Susan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Robinson-Papp, Jessica</au><au>Gensler, Gary</au><au>Navis, Allison</au><au>Sherman, Seth</au><au>Ellis, Ronald J</au><au>Gelman, Benjamin B</au><au>Kolson, Dennis L</au><au>Letendre, Scott L</au><au>Singer, Elyse J</au><au>Valdes-Sueiras, Miguel</au><au>Morgello, Susan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Characteristics of Motor Dysfunction in Longstanding Human Immunodeficiency Virus</atitle><jtitle>Clinical infectious diseases</jtitle><addtitle>Clin Infect Dis</addtitle><date>2020-09-12</date><risdate>2020</risdate><volume>71</volume><issue>6</issue><spage>1532</spage><epage>1538</epage><pages>1532-1538</pages><issn>1058-4838</issn><eissn>1537-6591</eissn><abstract>Abstract
Background
Cognitive dysfunction in human immunodeficiency virus (HIV) has decreased, but milder forms of HIV-associated neurocognitive disorders (HAND) persist along with motor dysfunction. The HIV Motor Scale (HMS) is a validated tool that captures motor abnormalities on routine neurologic examination and which is associated with cognitive impairment in HIV. In this study, we applied a modified HMS (MHMS) to a nationwide cohort of people with longstanding HIV to characterize and understand the factors contributing to motor dysfunction.
Methods
The National NeuroAIDS Tissue Consortium is a nationwide longitudinal cohort study. Participants undergo regular assessments including neurological examination, neuropsychological testing, and immunovirologic data collection. Data from examinations were used to calculate the MHMS score, which was then correlated with history of AIDS-related central nervous system (CNS) disorders (ARCD; eg, prior CNS opportunistic infection), cerebrovascular disease (CVD), and HAND.
Results
Sixty-nine percent of participants showed an abnormality on the MHMS, with 27% classified as severe. Results did not vary based on demographic or immunologic variables. The most common abnormalities seen were gait (54%), followed by coordination (39%) and strength (25%), and these commonly co-occurred. CVD (P = .02), history of ARCD (P = .001), and HAND (P = .001) were all associated with higher (ie, worse) HMS in univariate analyses; CVD and ARCD persisted in multivariate analyses. CVD was also marginally associated with symptomatic HAND.
Conclusions
Complex motor dysfunction remains common in HIV and is associated with CVD, ARCD, and to a lesser extent, HAND. Future studies are needed to understand the longitudinal trajectory of HIV-associated motor dysfunction, its neural substrates, and impact on quality of life.
Motor dysfunction, especially gait impairment, is common in longstanding human immunodeficiency virus (HIV); it is associated with cerebrovascular disease, a prior history of an AIDS-related central nervous system disorder, and to a lesser extent, a diagnosis of HIV-associated neurocognitive disorder.</abstract><cop>US</cop><pub>Oxford University Press</pub><pmid>31587032</pmid><doi>10.1093/cid/ciz986</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-9397-8873</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | AIDS Dementia Complex - diagnosis AIDS Dementia Complex - epidemiology and Commentaries HIV HIV Infections - complications Humans Longitudinal Studies Quality of Life |
title | Characteristics of Motor Dysfunction in Longstanding Human Immunodeficiency Virus |
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