Biomedical subjects

C H Hinkin

Publications and source records attributed to C H Hinkin.

At least 19 recordsLinked to original sources

PubMed2000

Neuropsychiatric disturbance is associated with executive dysfunction in HIV-1 infection.

Prominent apathy and/or irritability are frequently observed among individuals infected with the human immunodeficiency virus (HIV). Although these symptoms often occur as part of a mood disorder, compelling evidence suggests that they may occur independently of depression in neurologic disease/disorder. The current study examined the prevalence of both apathy and irritability among a sample of HIV-infected individuals and explored the degree to which these neuropsychiatric (NP) phenomena were associated with performance on neuro-cognitive measures thought to be sensitive to the potential CNS effects of HIV-1. Clinician-administered rating scales assessing apathy and irritability were administered to 65 HIV-seropositive (HIV+) and 21 HIV-seronegative (HIV-) participants who also completed a dual-task reaction time paradigm and the Stroop task. NP disturbance was significantly more prevalent among HIV+ participants compared with HIV- controls and was associated with specific neuro-cognitive deficits suggestive of executive dysfunction. Relative to both HIV- controls and to neuro-psychiatrically intact HIV+ participants, those HIV+ individuals with evidence of prominent apathy and/or irritability showed deficits in dual-task, but not single-task, performance and on the interference condition of the Stroop. Unexpectedly, NP disturbance did not show a robust relationship with HIV disease stage. These results suggest that the presence of prominent apathy and/or irritability among HIV+ individuals may signify greater HIV-associated CNS involvement. In HIV/AIDS, the disruption of frontal-subcortical circuits may be a common mechanism causing both executive dysfunction and NP disturbance.

AIDS Dementia Complex↗

PubMed2000

Dual task performance in HIV-1 infection.

Fifty HIV-infected individuals and 20 uninfected controls participated in an investigation of dual task performance in HIV-1 infection. Participants first engaged in a simple auditory reaction time (RT) task followed by a visual choice RT task (single task condition), and then they simultaneously engaged in both tasks (dual task condition). Under single task conditions, the HIV+ participants did not significantly differ from controls on either simple or choice RT (though a trend was evident on single task choice RT). In contrast, under dual task conditions the HIV+ group's performance decrement, relative to controls, was significantly greater on both simple and choice RT. This dual task decrement was also significantly associated with slower performance on the interference condition of the Stroop. Patients with AIDS tended to have greater dual task decrements than did the pre-AIDS group, though this fell short of statistical significance. These results suggest that HIV-1 infection leads to deficits in divided attention and the simultaneous processing of competing stimuli, deficits which have been linked to disruption of the anterior attentional system.

AIDS Dementia Complex↗

PubMed2000

Pedophilia and temporal lobe disturbances.

Paraphilias may occur with brain disease, but the nature of this relationship is unclear. The authors report 2 patients with late-life homosexual pedophilia. The first met criteria for frontotemporal dementia; the second had bilateral hippocampal sclerosis. Both were professional men with recent increases in sexual behavior. In both, 18-fluorodeoxyglucose positron emission tomography revealed prominent right temporal lobe hypometabolism. These cases and the literature suggest that bilateral anterior temporal disease affecting right more than left temporal lobe can increase sexual interest. A predisposition to pedophilia may be unmasked by hypersexuality from brain disease. These observations have potential implications for all neurologically based paraphilias.

Aged↗

PubMed1999

Declarative and procedural memory functioning in abstinent cocaine abusers.

BACKGROUND: We determined the nature and recovery of procedural and declarative memory functioning in a cocaine-abusing cohort in the 45-day period following use. METHODS: Thirty-seven cocaine abusers and 27 control subjects were administered the following memory and mood measures: California Verbal Learning Test, recall of the Rey-Osterrieth Complex Figure Test, Pursuit Rotor Task, and Profile of Mood States at 4 visits (within 72 hours of admission and at 10, 21, and 45 days following abstinence). RESULTS: Analysis of performance on the Rey-Osterrieth Complex Figure Test revealed that both groups improved in their recall over repeated administrations, though the control group recalled significantly more of the information than cocaine subjects during the 45-day interval. Results for the California Verbal Learning Test indicated improved learning for both subject groups over time, but no group x time interaction. On the Pursuit Rotor Task, cocaine abusers improved their performance at a faster rate than controls at visit 1. At day 45 (visit 4), cocaine abusers again showed improvement on the Pursuit Rotor Task, whereas controls demonstrated a relative plateau in rate of learning. CONCLUSIONS: This study documented a lasting detrimental effect on a sensitive nonverbal declarative memory task in cocaine-dependent subjects following abstinence of 45 days. In contrast, abstinence from cocaine during this 45-day period was associated with sustained improvement on a motor learning test in the cocaine abusers relative to controls.

Adult↗

PubMed1999

Computerized and traditional stroop task dysfunction in HIV-1 infection.

Controlled processing, response inhibition, and set adoption were examined in 51 HIV-1 infected participants and 21 uninfected controls who were administered a vocal reaction time (RT) version of the Stroop task (Stroop-RT; J. R. Stroop, 1935) as well as the traditional 100 item paper-and-pencil version. Response set expectancies on the Stroop-RT were manipulated by presenting 50% of trials in homogenous blocks and randomly varying the stimulus type during the remaining trials. As hypothesized, HIV seropositive (HIV+) participants were significantly slower than HIV seronegative controls on both versions of the Stroop. Significant interference effects were apparent on the paper-and-pencil version of the Stroop, but were not as prominent on the Stroop-RT. The HIV+ participants did profit from the blocking manipulation on the Stroop-RT, suggesting that set adoption is retained in HIV infection. These data suggest that HIV infection may result in deficient response inhibition, possibly secondary to frontostriatal dysfunction and dopaminergic alterations.

Adult↗

PubMed1998

Depression predicts procedural but not episodic memory in HIV-1 infection.

Forty-three homosexual/bisexual males with HIV-1 infection participated in a study that sought to determine: (1) whether increased levels of self-reported depressive symptomatology were associated with poorer performance on episodic or procedural memory tasks, (2) the relative strength of association between the affective/cognitive or somatic symptoms of depression and memory deficits and level of immunosuppression, and (3) whether increased depression or neuropsychological deficits are associated with degree of immunosuppression. Linear regression analyses revealed that increased affective/cognitive symptomatology was correlated with poorer performance on a procedural memory task, but was not correlated with performance on an episodic memory task or degree of immunosuppression. In contrast, somatic symptoms showed the strongest association with level of immunosuppression, but were not correlated with performance on the memory tasks. These findings underscore the complex interplay between neuropsychiatric and neuropsychological symptomatology in HIV-1 infection.

Adult↗

PubMed1998

Apathy, depression, and cognitive performance in HIV-1 infection.

The authors examined the relationship between apathy, depression, and cognitive performance in 48 HIV-1-seropositive and 21 seronegative (control) subjects, using reaction time (RT) and working memory tasks. Apathy, but not depression, was associated with working memory deficits among HIV-seropositive subjects. The cognitive-affective component of the Beck Depression Inventory (BDI), but not apathy, was associated with slowing and decreased accuracy on a choice RT task. The BDI cognitive-affective component was more closely associated than the BDI somatic component with both RT slowing and apathy. Results suggest that prominent symptoms of apathy, independent of depression, may be an important indicator of CNS involvement in HIV infection. Total BDI scores showed a less consistent relationship with neurocognitive performance, suggesting that somatic symptomatology is diagnostically ambiguous among HIV-infected subjects.

AIDS Dementia Complex↗

PubMed1998

Executive dysfunction in Alzheimer's disease: association with neuropsychiatric symptoms and functional impairment.

Relationships between measures of executive skills and neuropsychiatric and functional status were examined in a group of 31 patients with Alzheimer's disease. Deficits in four executive skills tests were significantly associated with the Agitation/Disinhibition factor score and Total Neuropsychiatric score on the Neurobehavioral Rating Scale, as well as the Activities subscore on the Blessed Dementia Scale. The majority of these associations remained significant after covariance for Mini-Mental State Examination scores. Executive dysfunction is associated with clinically relevant neuropsychiatric symptoms and functional impairment in Alzheimer's disease. These associations may be independent of other cognitive deficits such as memory, language, and visuospatial skills, and may not be appreciated on routine clinical evaluations. Executive skills deficits, neuropsychiatric symptoms, and functional disability may emerge from shared neurobiological mechanisms.

Aged↗

PubMed1997

Concurrent validity of the Neurobehavioral Cognitive Status Exam subtests.

The Neurobehavioral Cognitive Status Exam (NCSE) is a screening measure that assesses numerous neuropsychological (NP) domains. Fifty-four patients completed the NCSE and common NP tests assessing similar abilities. Most subtest screens (brief items that determine whether additional testing should occur) exhibited low false negative rates, but high false positive rates, based upon performance on the follow-up metric items. Each subtest was significantly correlated with the associated NP test. However, using performance on the NP tests as the 'gold standard', the NCSE subtests classified impaired and unimpaired patients at a much lower than expected rate. The latter results draw into question the efficacy of the NCSE subtests in delineating domain-specific cognitive functioning.

Attention↗

PubMed1997

Subjective complaints versus actual cognitive deficits in predominantly symptomatic HIV-1 seropositive individuals.

The relationship of self-reported cognitive, motor, and affective complaints to actual neuropsychological functioning was explored in a cohort of predominantly symptomatic HIV-1 seropositive individuals. Ninety-two symptomatic HIV-1 infected subjects were questioned about complaints common in HIV infection and were assessed with a comprehensive neuropsychological test battery. No relationship was found between subjective complaints and cognitive functioning, yet a significant relationship was found between self-reported difficulties and formal measures of affect and mood. Failure to show a relationship between self-reported cognitive status and actual neuropsychological functioning in this cohort suggests that complaints of cognitive decline may be attributable to emotional factors.

Adult↗

PubMed1997

EEG power correlates with subcortical metabolic activity in AIDS.

The authors studied the relationship between brain metabolic activity and quantitative electroencephalographic power in AIDS. Basal ganglia and thalamic metabolic activity, measured with positron emission tomography, correlated positively with EEG power in the 6-10-Hz band across most head regions. Metabolic activity of anatomically defined cortical regions did not correlate with EEG power recorded over each region. These results support previously reported associations between abnormalities in subcortical metabolic activity and EEG activity. The lack of correlation between cortical metabolic activity and EEG activity suggests that previously observed abnormalities in EEG activity are primarily subcortical in origin.

Acquired Immunodeficiency Syndrome↗

PubMed1996

Actual versus self-reported cognitive dysfunction in HIV-1 infection: memory-metamemory dissociations.

The relationship between subjective awareness and objective neuropsychological status in HIV-1 infection remains unclear. Forty-six HIV-1 seropositive males were administered a battery of neuropsychological measures assessing episodic memory, metacognition, and depression. Results of ANOVA revealed a dissociation between subjects' self-complaint of neuropsychological impairment and objective performance, with subjects who denied cognitive impairment performing worse on memory testing. Three subgroups were identified: A group whose self-reported cognitive impairment exceeded deficits demonstrated on memory testing (37% of subjects); a group who denied impairment but evidenced deficits on memory testing (26% of subjects); and a group whose self-appraisal was consistent with performance (37% of subjects). These data suggest that self-report of cognitive dysfunction among HIV-1 infected subjects is frequently at variance with objective neuropsychological testing and that diminished awareness of decline among medically symptomatic HIV-1 infected subjects can be identified.

Acquired Immunodeficiency Syndrome↗

PubMed1995

Cortical abnormalities associated with subcortical lesions in vascular dementia. Clinical and position emission tomographic findings.

OBJECTIVE: To examine the effects of subcortical lesions on cortical metabolic rate and clinical symptoms in patients with vascular dementia. METHOD: Eleven elderly patients with vascular dementia who demonstrated no lesion involving the cerebral cortex on magnetic resonance imaging underwent 18F-fluorodeoxyglucose positron emission tomography to assess global cortical metabolism and metabolic activity in each cortical lobe. Subcortical lesions on magnetic resonance imaging (periventricular hyperintensities, deep white matter hyperintensities, and subcortical lacunar infarcts) were measured using a graded scale of severity. Cognitive and noncognitive symptoms were assessed with the Neurobehavioral Rating Scale. RESULTS: Reduced cortical metabolism was generally associated with the severity of subcortical pathologic changes, but there was substantial heterogeneity in the relationship between subcortical lesions and cortical metabolic activity. Mean global cortical metabolism was lower in patients with periventricular hyperintensities in anterior subcortical regions than in those without such lesions. The metabolic rate in the frontal cortex was lower in patients with a lacunar infarct of the basal ganglia or thalamus than in those without. Neurobehavioral Rating Scale total score, the Verbal Output Disturbance factor score, and the Anxiety/Depression factor score were correlated with the severity of white matter lesions. CONCLUSIONS: Cortical metabolic dysfunction is related to ischemic subcortical lesions in patients with vascular dementia. Metabolism in the frontal cortex may be particularly dependent on pathologic alterations of subcortical nuclei. Anxiety, depression, and the overall severity of neuropsychiatric symptoms in vascular dementia are associated with the extent of white matter ischemia.

Adolescent↗

PubMed1995

Cerebral metabolic change in patients with AIDS: report of a six-month follow-up using positron-emission tomography.

The authors examined change in cerebral metabolic function over time by using PET in HIV-infected individuals diagnosed with AIDS. Ten subjects with AIDS received [18F]2-fluoro-2-deoxy-D-glucose PET scans and completed a comprehensive neuropsychological battery. The scan and test battery were repeated after 6 months. Over time, the subjects showed increased relative basal ganglia metabolism as well as increased parietal lobe metabolism. There were no statistically significant changes in neuropsychological performance. These results suggest that PET may be more sensitive than traditional neuropsychological evaluation to subtle central nervous system changes in AIDS.

AIDS Dementia Complex↗

PubMed1995

The relationship between psychiatric symptoms and regional cortical metabolism in Alzheimer's disease.

Cognitive and noncognitive psychiatric symptoms were systematically evaluated in 21 patients with Alzheimer's disease by using the Neurobehavioral Rating Scale. Regional cerebral metabolic activity was measured in each patient by [18F]fluorodeoxyglucose PET. Significant correlations emerged between global cortical metabolic activity and the Agitation/Disinhibition factor score, Cognition factor score, and total score. Relationships between noncognitive symptoms and metabolic activity were regionally specific, with significant correlations between Agitation/Disinhibition factor score and metabolism in the frontal and temporal lobes, between Psychosis factor score and metabolism in the frontal lobe, and between Anxiety/Depression factor score and metabolism in the parietal lobe. These results suggest that psychiatric symptoms are fundamental expressions of the cortical dysfunction of Alzheimer's disease.

Adult↗

PubMed1995

Psychological symptomatology in spouses and adult children of alcoholics: an examination of the hypothesized personality characteristics of codependency.

The concept of codependency has been advanced to explain certain psychological traits purported to be characteristic of spouses and adult children of alcoholics. To test the validity of this hypothesized syndrome, 97 female subjects living with either an alcoholic (SA), a psychiatric patient (SP), or dentistry patient (SD) were studied; approximately 50% of subjects had a positive family history (FH+) for alcoholism. All subjects were administered an extensive battery of psychological tests. The results revealed significantly greater levels of psychological symptomatology among the SA and FH+ subjects, in part consistent with the hypothesized symptomatology of codependency.

Adult↗

PubMed1994

Frequencies of MMPI-168 code types among asymptomatic and symptomatic HIV-1 seropositive gay men.

Welsh codes of Minnesota Multiphasic Personality Inventory-168 (MMPI-168) profiles were calculated for 151 HIV-1 seropositive gay men and 27 gay seronegative controls. Although 99% of seropositives' profiles were clinically elevated, the profile configurations among subjects were varied. These data document the presence of considerable emotional distress among HIV-infected individuals, yet the heterogeneity of codes encountered argues against generalizations of seropositive subjects based upon mean MMPI profiles.

Adult↗

PubMed1994

The relationship between age and cognitive impairment in HIV-1 infection: findings from the Multicenter AIDS Cohort Study and a clinical cohort.

Previous studies have identified age as a risk factor for many neurologic disorders, and a "cerebral reserve" factor has been postulated to explain these findings. This study examined whether age represents a risk factor for HIV-1-related neuropsychological dysfunction. Subjects for study 1 were primarily asymptomatic seropositive (n = 1,066) and seronegative (n = 1,004) nonelderly male community volunteers who completed neuropsychological and reaction time measures. Data analyses revealed a significant effect for age on reaction time and timed neuropsychological measures, but no interaction between age and serostatus. Study 2, employing a similar neuropsychological battery, consisted of 76 seropositive men (29 over age 55) recruited from community outpatient clinics and 47 seronegative controls. We found serostatus and age to have main effects on a number of measures, but a trend for an effect of age-serostatus interaction on only one measure.

AIDS Dementia Complex↗