Central Auditory Tests to Track Cognitive Function in People With HIV: Longitudinal Cohort Study.
HIV
auditory
auditory perception
central auditory function
cognition
cognitive dysfunction
cognitive function
longitudinal
monitoring
nervous system
neurocognitive deficit
screening
surveillance
testing
Journal
JMIR formative research
ISSN: 2561-326X
Titre abrégé: JMIR Form Res
Pays: Canada
ID NLM: 101726394
Informations de publication
Date de publication:
09 Feb 2021
09 Feb 2021
Historique:
received:
10
12
2020
accepted:
17
01
2021
revised:
06
01
2021
pubmed:
21
1
2021
medline:
21
1
2021
entrez:
20
1
2021
Statut:
epublish
Résumé
The development of neurocognitive deficits in people infected with HIV is a significant public health problem. Previous cross-sectional studies have shown that performance on central auditory tests (CATs) correlates with cognitive test results in those with HIV, but no longitudinal data exist for confirmation. We have been performing longitudinal assessments of central auditory and cognitive function on a cohort of HIV-positive and HIV-negative individuals in Dar es Salaam, Tanzania to understand how the central auditory system could be used to study and track the progress of central nervous system dysfunction. The goal of the project was to determine if CATs can track the trajectory of cognitive function over time in people diagnosed with HIV. Tests of peripheral and central auditory function as well as cognitive performance were performed on 382 individuals over the course of 3.5 years. Visits were scheduled every 6 months. CATs included tests of auditory temporal processing (gap detection) and speech perception in noise (Hearing in Noise Test and Triple Digit Test). Cognitive tests included the Montreal Cognitive Assessment (MoCA), Test of Variables of Attention (TOVA), and subtests from the Cogstate battery. HIV-positive subjects were divided into groups based on their CAT results at their final visit (bottom 20%, top 20%, middle 60%). Primary analyses focused on the comparison between HIV-positive individuals that performed worse on CATs (bottom 20%) and the overall HIV-positive group (middle 60%). Data were analyzed using linear mixed-effect models with time as the main fixed effect. The group with the worst (bottom 20%) CAT performance showed a difference in trajectory for the MoCA (P=.003), TOVA (P<.048), and Cogstate (P<.046) over the course of the study period compared to the overall HIV-positive group. A battery of three CATs showed a significant difference in cognitive trajectory over a relatively short study period of 3.5 years independent of age (bottom 20% vs HIV-positive group). The results of this study support the ability for CATs to track cognitive function over time, suggesting that central auditory processing can provide a window into central nervous system performance. CATs can be simple to perform, and are relatively insensitive to education and socioeconomic status because they only require repeating sentences, numbers, or detecting gaps in noise. These tests could potentially provide a time-efficient, low-cost method to screen for and monitor cognitive decline in patients with HIV, making them a useful surveillance tool for this major public health problem.
Sections du résumé
BACKGROUND
BACKGROUND
The development of neurocognitive deficits in people infected with HIV is a significant public health problem. Previous cross-sectional studies have shown that performance on central auditory tests (CATs) correlates with cognitive test results in those with HIV, but no longitudinal data exist for confirmation. We have been performing longitudinal assessments of central auditory and cognitive function on a cohort of HIV-positive and HIV-negative individuals in Dar es Salaam, Tanzania to understand how the central auditory system could be used to study and track the progress of central nervous system dysfunction.
OBJECTIVE
OBJECTIVE
The goal of the project was to determine if CATs can track the trajectory of cognitive function over time in people diagnosed with HIV.
METHODS
METHODS
Tests of peripheral and central auditory function as well as cognitive performance were performed on 382 individuals over the course of 3.5 years. Visits were scheduled every 6 months. CATs included tests of auditory temporal processing (gap detection) and speech perception in noise (Hearing in Noise Test and Triple Digit Test). Cognitive tests included the Montreal Cognitive Assessment (MoCA), Test of Variables of Attention (TOVA), and subtests from the Cogstate battery. HIV-positive subjects were divided into groups based on their CAT results at their final visit (bottom 20%, top 20%, middle 60%). Primary analyses focused on the comparison between HIV-positive individuals that performed worse on CATs (bottom 20%) and the overall HIV-positive group (middle 60%). Data were analyzed using linear mixed-effect models with time as the main fixed effect.
RESULTS
RESULTS
The group with the worst (bottom 20%) CAT performance showed a difference in trajectory for the MoCA (P=.003), TOVA (P<.048), and Cogstate (P<.046) over the course of the study period compared to the overall HIV-positive group. A battery of three CATs showed a significant difference in cognitive trajectory over a relatively short study period of 3.5 years independent of age (bottom 20% vs HIV-positive group).
CONCLUSIONS
CONCLUSIONS
The results of this study support the ability for CATs to track cognitive function over time, suggesting that central auditory processing can provide a window into central nervous system performance. CATs can be simple to perform, and are relatively insensitive to education and socioeconomic status because they only require repeating sentences, numbers, or detecting gaps in noise. These tests could potentially provide a time-efficient, low-cost method to screen for and monitor cognitive decline in patients with HIV, making them a useful surveillance tool for this major public health problem.
Identifiants
pubmed: 33470933
pii: v5i2e26406
doi: 10.2196/26406
pmc: PMC7902183
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e26406Subventions
Organisme : FIC NIH HHS
ID : D43 TW009573
Pays : United States
Organisme : NIDCD NIH HHS
ID : R01 DC009972
Pays : United States
Informations de copyright
©Christopher Niemczak, Abigail Fellows, Jonathan Lichtenstein, Travis White-Schwoch, Albert Magohe, Jiang Gui, Jed Wilbur, Odile Clavier, Enica Massawe, Ndeserua Moshi, Michael Boivin, Nina Kraus, Jay Buckey. Originally published in JMIR Formative Research (http://formative.jmir.org), 09.02.2021.
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