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Impairments in memory and hippocampal function in HIV-positive vs HIV-negative women

A preliminary study

From the Departments of Psychiatry (P.M.M., D.M.L., D.F., P.P., F.G., E.M.), Psychology (P.M.M., L.H.R.), and Neurology (D.M.L., E.M.), University of Illinois at Chicago; and Departments of Medicine, Stroger Hospital and Rush University (M.H.C.) and The Core Center (K.W.), Bureau of Health Services of Cook County, Chicago, IL.

Address correspondence and reprint requests to Dr. Pauline M. Maki, University of Illinois at Chicago, Department of Psychiatry (MC 913), 912 S Wood St, Chicago, IL 60612 pmaki{at}psych.uic.edu.

Objective: Neurocognitive studies of HIV typically target executive functions dependent on frontostriatal circuitry. The integrity of medial temporal systems has received considerably less attention despite high hippocampal viral load. Studies also predominately involve HIV+ men, though HIV+ women may be at increased risk for cognitive dysfunction due to the high prevalence of psychosocial/mental health problems and lower educational attainment. Our aim was to conduct a preliminary investigation of episodic memory and its neural correlates in HIV-infected and at-risk uninfected women.

Methods: Participants included 54 HIV+ and 12 HIV– women (mean age = 43 years; 86% African American) recruited from the Chicago site of the Women's Interagency HIV Study. Participants completed standardized tests of verbal and visual episodic memory, working memory, and executive function. A subset of 11 women also underwent functional MRI during a delayed verbal episodic memory task.

Results: HIV serostatus predicted significantly lower immediate and delayed verbal episodic memory, working memory, and visual memory. Preliminary neuroimaging findings revealed group differences in bilateral hippocampal function, with HIV+ women showing decreased activation during encoding and increased activation during delayed recognition. These alterations correlated with worse episodic verbal memory.

Conclusions: Verbal episodic memory deficits are evident in HIV+ women and may be associated with hippocampal dysfunction at both encoding and retrieval.

Abbreviations: ARV = antiretroviral therapy; CES-D = Center for Epidemiologic Studies–Depression Scale; fMRI = functional MRI; HAART = highly active antiretroviral therapy; HCV = hepatitis C virus antibody; HVLT = Hopkins Verbal Learning Task; ROI = region of interest; TE = echo time; TR = repetition time; WIHS = Women's Interagency HIV Study; WRAT-R = Wide Range Achievement Test–Revised.

Supplemental data at www.neurology.org.

Support information is provided at the end of the article.

Disclosure: The authors report no disclosures.

Disclaimer: The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the NIH, the University of Illinois at Chicago, Stroger Hospital, or the Cook County Bureau of Health Services.

Received September 25, 2008. Accepted in final form February 11, 2009.