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Updated research nosology for HIV-associated neurocognitive disorders

TLDR
This report reviews the collective experience with HIV-associated neurocognitive disorders (HAND), particularly since the advent of highly active antiretroviral treatment, and their definitional criteria; discusses the impact of comorbidities; and suggests inclusion of the term asymptomatic neuroc cognitive impairment to categorize individuals with subclinical impairment.
Abstract
In 1991, the AIDS Task Force of the American Academy of Neurology published nomenclature and research case definitions to guide the diagnosis of neurologic manifestations of HIV-1 infection. Now, 16 years later, the National Institute of Mental Health and the National Institute of Neurological Diseases and Stroke have charged a working group to critically review the adequacy and utility of these definitional criteria and to identify aspects that require updating. This report represents a majority view, and unanimity was not reached on all points. It reviews our collective experience with HIV-associated neurocognitive disorders (HAND), particularly since the advent of highly active antiretroviral treatment, and their definitional criteria; discusses the impact of comorbidities; and suggests inclusion of the term asymptomatic neurocognitive impairment to categorize individuals with subclinical impairment. An algorithm is proposed to assist in standardized diagnostic classification of HAND.

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Journal ArticleDOI

HIV-associated neurocognitive disorder — pathogenesis and prospects for treatment

TL;DR: It is suggested that adjunctive therapies — treatments targeting CNS inflammation and other metabolic processes, including glutamate homeostasis, lipid and energy metabolism — are needed to reverse or improve HAND-related neurological dysfunction.
Journal ArticleDOI

Cognitive dysfunction in HIV patients despite long-standing suppression of viremia.

TL;DR: The prevalence of HANDs without functional repercussion in daily life (asymptomatic neurocognitive impairment) is the most frequent subtype observed in this population, and the HIV dementia scale with a cutoff of 14 points or less seems to provide a useful tool to screen for the presence of Handeds.
References
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Journal ArticleDOI

“Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician

TL;DR: A simplified, scored form of the cognitive mental status examination, the “Mini-Mental State” (MMS) which includes eleven questions, requires only 5-10 min to administer, and is therefore practical to use serially and routinely.

A practical method for grading the cognitive state of patients for the clinician

TL;DR: The Mini-Mental State (MMS) as mentioned in this paper is a simplified version of the standard WAIS with eleven questions and requires only 5-10 min to administer, and is therefore practical to use serially and routinely.
Journal ArticleDOI

Population-based norms for the mini-mental state examination by age and educational level

TL;DR: Results presented should prove to be useful to clinicians who wish to compare an individual patient's MMSE scores with a population reference group and to researchers making plans for new studies in which cognitive status is a variable of interest.
Journal ArticleDOI

The Impact of HIV-Associated Neuropsychological Impairment on Everyday Functioning

TL;DR: Objective, laboratory based functional measures, such as those used here, may compliment NP testing in future studies directed at understanding the impact on life quality of central nervous system disorders and their treatments.
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