International neurocognitive normative study: neurocognitive comparison data in diverse resource-limited settings: AIDS Clinical Trials Group A5271.

Journal: Journal of neurovirology

Volume: 22

Issue: 4

Year of Publication: 2018

Affiliated Institutions:  Department of Neurology, University of North Carolina, Physician Office Building, Manning Drive, Chapel Hill, NC, -, USA. kevinr@neurology.unc.edu. Harvard University, Boston, MA, USA. University of Washington, Seattle, WA, USA. Northwestern University, Chicago, IL, USA. University of Zimbabwe, Harare, Zimbabwe. Johns Hopkins University, Baltimore, MD, USA. Fiocruz, Rio De Janeiro, Brazil. University of Colorado Denver, Aurora, CO, USA. Frontier Science, Buffalo, NY, USA. Queen Elizabeth, Blantyre, Malawi. Chiang Mai University, Chiang Mai, Thailand. NARI, Pune, India. YRGCARE, Chennai, India. Asociacion Civil Impacta Salud y Educacion, Lima, Peru. UNC Project, Lilongwe, Malawi. University of the Witwatersrand, Johannesburg, South Africa. Social Scientific Systems, Silver Springs, MD, USA. University of KwaZulu-Natal, Durban, South Africa.

Abstract summary 

Infrastructure for conducting neurological research in resource-limited settings (RLS) is limited. The lack of neurological and neuropsychological (NP) assessment and normative data needed for clinical interpretation impedes research and clinical care. Here, we report on ACTG 5271, which provided neurological training of clinical site personnel and collected neurocognitive normative comparison data in diverse settings. At ten sites in seven RLS countries, we provided training for NP assessments. We collected normative comparison data on HIV- participants from Brazil (n = 240), India (n = 480), Malawi (n = 481), Peru (n = 239), South Africa (480), Thailand (n = 240), and Zimbabwe (n = 240). Participants had a negative HIV test within 30 days before standardized NP exams were administered at baseline and 770 at 6 months. Participants were enrolled in eight strata, gender (female and male), education (<10 and ≥10 years), and age (<35 and ≥35 years). Of 2400 enrolled, 770 completed the 6-month follow-up. As expected, significant between-country differences were evident in all the neurocognitive test scores (p < 0.0001). There was variation between the age, gender, and education strata on the neurocognitive tests. Age and education were important variables for all tests; older participants had poorer performance, and those with higher education had better performance. Women had better performance on verbal learning/memory and speed of processing tests, while men performed better on motor tests. This study provides the necessary neurocognitive normative data needed to build infrastructure for future neurological and neurocognitive studies in diverse RLS. These normative data are a much-needed resource for both clinicians and researchers.

Authors & Co-authors:  Robertson K K Jiang H H Evans S R SR Marra C M CM Berzins B B Hakim J J Sacktor N N Silva M Tulius MT Campbell T B TB Nair A A Schouten J J Kumwenda J J Supparatpinyo K K Tripathy S S Kumarasamy N N la Rosa A A Montano S S Mwafongo A A Firnhaber C C Sanne I I Naini L L Amod F F Walawander A A

Study Outcome 

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Statistics
Citations :  Antinori A, Arendt G, Becker JT, Brew BJ, Byrd DA, Cherner M, et al. Wojna VE. Updated research nosology for HIV-associated neurocognitive disorders. Neurology. 2007;69(18):1789–1799. doi: 10.1212/01.WNL.0000287431.88658.8b.
Authors :  25
Identifiers
Doi : 10.1007/s13365-015-0415-2
SSN : 1538-2443
Study Population
Men,Women
Mesh Terms
Adult
Other Terms
Cognitive impairment;Neurocognitive assessment;Neuropsychological functioning;Normative comparison data;Resource limited
Study Design
Cross Sectional Study
Study Approach
Country of Study
Zimbabwe
Publication Country
United States