The main aim of this study was evaluate efficacy of cognitive rehabilitation treatment, in HIV/AIDS patients with ANI and MND, concomitantly treated with HAART. Entry criteria: at least 6 months of HAART with suppressed viral load, stable CD4 count, no comorbidities. 40 patients (29 males, 11 female, median age 50, median CD4 count 595/µl, CDC disease stage: 4 A, 17 B, 19 C) were included in the study and divided into 2 groups: experimental group and control group. The project provided 5 steps: Neuropsychological screening with MMSE, IHDS, 3 Questions Test; Neuropsychological assessment (T0); Cognitive rehabilitation for experimental group, standard of care for controls; Neuropsychological re-test for both groups 3 months from T0 (T1); Follow-up at 6 months from T1 for experimental group (T2). The rehabilitation has provided for a total of 36 sessions in 3 months and implemented with computerized exercise. To test the hypothesized differential improvement between the samples, we compared the results to the Neuropsychological battery tests at T0 and T1 focusing only on pathological scores (score < cut off at T0), with statistical technique repeated measures ANOVA and post-hoc Duncan test surveys. The two samples show discordant clinical evolution: experimental group improved after completing the rehabilitation program, while the control group did not improve. In 6 NP test (p<.05) there is a significant difference between the 2 groups (Graph 1: IHDS; Corsi test; Digit Span; Verbal Span; Rey-Osterrieth complex figure test; F.A.B.). At T1, the scores of the experimental patients to neuropsychological tests are all above the cut-off reference, patients no longer meet the reference criteria for the diagnosis of HAND. The cognitive improvement of the experimental group remained above the cut-off at Follow-up. Although the samples size was small, data show an possible intervention strategy in the treatment of ANI and MND.
Cognitive Rehabilitation Treatment in HIV/AIDS patients with Asymptomatic Neurocognitive Impairment (ANI) and Mild Neurocognitive Disorders (MND)
PIA, Lorenzo;CALCAGNO, Andrea;
2014-01-01
Abstract
The main aim of this study was evaluate efficacy of cognitive rehabilitation treatment, in HIV/AIDS patients with ANI and MND, concomitantly treated with HAART. Entry criteria: at least 6 months of HAART with suppressed viral load, stable CD4 count, no comorbidities. 40 patients (29 males, 11 female, median age 50, median CD4 count 595/µl, CDC disease stage: 4 A, 17 B, 19 C) were included in the study and divided into 2 groups: experimental group and control group. The project provided 5 steps: Neuropsychological screening with MMSE, IHDS, 3 Questions Test; Neuropsychological assessment (T0); Cognitive rehabilitation for experimental group, standard of care for controls; Neuropsychological re-test for both groups 3 months from T0 (T1); Follow-up at 6 months from T1 for experimental group (T2). The rehabilitation has provided for a total of 36 sessions in 3 months and implemented with computerized exercise. To test the hypothesized differential improvement between the samples, we compared the results to the Neuropsychological battery tests at T0 and T1 focusing only on pathological scores (score < cut off at T0), with statistical technique repeated measures ANOVA and post-hoc Duncan test surveys. The two samples show discordant clinical evolution: experimental group improved after completing the rehabilitation program, while the control group did not improve. In 6 NP test (p<.05) there is a significant difference between the 2 groups (Graph 1: IHDS; Corsi test; Digit Span; Verbal Span; Rey-Osterrieth complex figure test; F.A.B.). At T1, the scores of the experimental patients to neuropsychological tests are all above the cut-off reference, patients no longer meet the reference criteria for the diagnosis of HAND. The cognitive improvement of the experimental group remained above the cut-off at Follow-up. Although the samples size was small, data show an possible intervention strategy in the treatment of ANI and MND.
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