Sakthivelayutham, S (2011) A Study of P300 Evaluation in Asymptomatic HIV infected Patients. Masters thesis, Madras Medical College, Chennai.
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Abstract
The HIV/AIDS epidemic is a major global public health crisis with an estimated 40 million adults and children living with HIV infection. HIV Associated Neurocognitive Disorders (HAND) is characterized by cognitive, behavioral, and motor dysfunction and occurs in 10-15% of HIVseropositive individuals with advanced infection in the US .The frequency of HAND is largely unknown in resource-limited countries, although preliminary surveys suggest a relatively high frequency of cognitive dysfunction. If a similar proportion were to be seen on a global scale, then HIV dementia would be the most common cause of dementia worldwide in patients under the age of 40 years. Despite the availability of HAART, HIVrelated neurological disorders continue to represent substantial personal, economic and societal burdens. Frequently a set of patients show subclinical neurocognitive impairment, which does not fulfill the criteria for HIV Associated Dementia proposed by the American Academy of Neurology (AAN). These patients do not exhibit recognizable functional restriction in Daily activities and may be missed in conventional screening and Neuropsychological testing. But they progress to frank dementia eventually unless it is identified earlier and checked by effective Anti Retroviral Therapy. Early recognition of subclinical neurocognitive impairment is essential to prevent the transformation to frank dementia which is associated with significant morbidity and mortality. The diagnosis of neurocognitive impairment is dependent upon a clinical history and a detailed Neuropsychological testing which is time consuming, language and education dependent, and often not available in developing countries. 1. P-300 evaluation is an useful neurophysiological tool in detecting subclinical neurocognitive impairment in a proportion of asymptomatic HIV positive patients. 2. Abnormal P3 latency prolongation was noted in 26% of asymptomatic HIV patients in the study, which is an indicator of subclinical cognitive impairment. 3. In addition to P3 latency prolongation, the early subcortical N1, P2, and N2 latencies were also prolonged in a proportion of patients, reiterating the point that HIV dementia is basically a subcortical variety. 4. Early detection of subclinical neurocognitive impairment will help in intensifying Anti Retroviral Therapy which may modify or halt the progression of dementia in HIV patients. 5. P-300, neurophysiological testing may be complementary to neuropsychological screening tests, like HIV dementia scale, as patients who failed to show significant abnormalities in HDS score had abnormalities during P-300 evaluation. 6. CD4 cell count is inversely correlated with P-300 latency. However, this is a small study and large scale studies need to be done to confirm this observation.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | P300 Evaluation ; Asymptomatic ; HIV ; infected Patients. |
| Subjects: | MEDICAL > Neurology |
| Depositing User: | Kambaraman B |
| Date Deposited: | 28 Jun 2017 11:56 |
| Last Modified: | 28 Jun 2017 11:56 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/584 |
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