Motor dysfunction in HIV-infected patients without clinically detectable central-nervous deficit

Area of Science:

• Neurology
• Infectious Diseases
• Neuroimmunology

Background:

• Human Immunodeficiency Virus (HIV) infection is known to affect the central nervous system (CNS).
• Early detection of subclinical CNS involvement is crucial for managing HIV-associated neurological complications.
• Previous studies have indicated potential motor deficits in HIV-infected individuals.

Purpose of the Study:

• To investigate subclinical motor function abnormalities in HIV-infected patients without evident neurological deficits.
• To compare motor test performance between HIV-infected patients and an age-matched healthy control group.
• To assess the relationship between early functional CNS changes and structural findings on MRI.

Main Methods:

• Fifty HIV-infected patients across all CDC stages, without clinical CNS deficits, were evaluated.
• Exclusion criteria included alcohol/drug abuse, fever, and opportunistic cerebral infections.
• Quantitative motor tests assessed postural tremor, rapid alternating movements (MRAM), and finger extension speed (MRC).
• Results were compared to an age-matched control group; all patients underwent MRI scans.

Main Results:

• No significant differences in tremor peak frequencies were observed between HIV patients and controls.
• Significant slowing was detected in MRAM and MRC rise times among HIV-infected patients.
• Motor test performance in HIV patients resembled that of individuals with manifest basal ganglia diseases.
• All MRI scans of the HIV-infected patients were normal.

Conclusions:

• HIV infection leads to early, subclinical CNS affection, particularly impacting the basal ganglia.
• Quantitative motor function tests can detect these functional abnormalities before structural changes are visible on MRI.
• These findings highlight the importance of sensitive motor assessments in monitoring HIV neurological health.