Early central nervous system response to HIV infection: sleep distortion and cognitive-motor decrements.

Important note: Information in this article was accurate in 1996. The state of the art may have changed since the publication date.

Early central nervous system response to HIV infection: sleep distortion and cognitive-motor decrements.

AIDS. 1995 Sep;9(9):1043-50. Unique Identifier : AIDSLINE MED/96085719
White JL; Darko DF; Brown SJ; Miller JC; Hayduk R; Kelly T; Mitler MM; Department of Neuropharmacology, Scripps Research Institute, La; Jolla, California, USA.

Abstract: OBJECTIVE: To repeat and extend findings suggesting that sleep disturbance, excessive daytime sleepiness, and degraded cognitive-motor abilities may be early markers of central nervous system (CNS) involvement in HIV infection. DESIGN: A controlled, cross-sectional, prospective analysis. SETTING: Clinical research center at a teaching hospital and a military health research center. SUBJECTS: Twenty-three HIV-positive (mean CD4+ count, 387 +/- 162 x 10(6)/l) and 13 seronegative men who were Naval personnel or participants of the University of California, San Diego HIV Neurobehavioral Research Center. MAIN OUTCOME MEASURES: Nocturnal and daytime sleep electroencephalogram, electromyogram, and electrocardiogram. Simple and complex cognitive-motor performance assessed via computerized tasks. RESULTS: Comparison of sleep parameters based on HIV status, length of time infected, zidovudine use, and CD4+ count indicated that CD4+ T cells > 400 x 10(6)/l were associated with a distortion in nocturnal sleep characterized by increased stages 3 and 4 non-rapid eye movement (i.e., slow-wave) sleep in the latter portion of the night and reduced nocturnal awakenings. HIV-positive patients were no sleepier in the daytime than controls. Cognitive-motor performance revealed deficits in both accuracy and efficiency for HIV-positive patients. CONCLUSION: Asymptomatic HIV-positive patients with CD4+ counts > 400 x 10(6)/l demonstrate a statistically significant increase in slow-wave sleep during the latter portion of the night and less arousability. CD4+ lymphocyte count in the early phases of HIV infection appears to differentiate between various levels of HIV disease progression with respect to certain CNS measurements of nocturnal sleep and cognitive-motor performance. Sleep structure distortion remains one of the earliest and most consistently replicable physiological signs of HIV infection. This distortion may provide a link to immune function, disease progression, and cognitive-motor disability in HIV infection.

Keywords: Adult Arousal/PHYSIOLOGY AIDS Dementia Complex/*DIAGNOSIS/PHYSIOPATHOLOGY Brain/PHYSIOPATHOLOGY Circadian Rhythm/PHYSIOLOGY Cognition Disorders/*DIAGNOSIS/PHYSIOPATHOLOGY Cross-Sectional Studies CD4 Lymphocyte Count Human HIV Seropositivity/DIAGNOSIS/PHYSIOPATHOLOGY Male Middle Age *Neuropsychological Tests Prospective Studies Psychomotor Disorders/*DIAGNOSIS/PHYSIOPATHOLOGY Reaction Time/PHYSIOLOGY Sleep Disorders/*DIAGNOSIS/PHYSIOPATHOLOGY Sleep Stages/PHYSIOLOGY Support, U.S. Gov't, Non-P.H.S. Support, U.S. Gov't, P.H.S. Wakefulness/PHYSIOLOGY JOURNAL ARTICLE
960430
M9640869

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