Does antiretroviral therapy improve HIV-associated cognitive impairment? A quantitative review of the literature.

The development of antiretroviral therapy (ART) has dramatically improved survival for those living with human immunodeficiency virus (HIV), but whether ART improves cognitive functioning remains unclear. The aim of the present review was to examine systematically the extent to which ART improves cognition among individuals with HIV using meta-analytic methods. Twenty-three studies were included in the quantitative review.

Specificity of verbal learning impairment and recovery in a marijuana-dependent male: the effects of sustained marijuana abstinence.

Introduction: We present the case of a young adult in treatment for marijuana dependence, with recurrent depression and a history of possible traumatic brain injury, complaining of concentration, memory, and initiation problems.

Methods: The patient was assessed longitudinally during treatment with a brief neuropsychological battery, as well as measures of marijuana use and mood.

Results: Testing at treatment baseline revealed performance that was generally in the high average range or higher on measures of reaction time and attention, with a selective impairment in verbal learning (borderline to extremely low range).

On becoming a peer reviewer for a neuropsychology journal.

The peer-review process is an invaluable service provided by the professional community, and it provides the critical foundation for the advancement of science. However, there is remarkably little systematic guidance for individuals who wish to become part of this process. This paper, written from the perspective of reviewers and editors with varying levels of experience, provides general guidelines and advice for new reviewers in neuropsychology, as well as outlining benefits of participation in this process.

Functional consequences of HIV-associated neuropsychological impairment.

This review focuses on the "real world" implications of infection with HIV/AIDS from a neuropsychological perspective. Relevant literature is reviewed which examines the relationships between HIV-associated neuropsychological impairment and employment, driving, medication adherence, mood, fatigue, and interpersonal functioning. Specifically, the relative contributions of medical, cognitive, psychosocial, and psychiatric issues on whether someone with HIV/AIDS will be able to return to work, adhere to a complicated medication regimen, or safely drive a vehicle will be discussed.

Decision-making in long-term cocaine users: Effects of a cash monetary contingency on Gambling task performance.

Background: The Iowa Gambling task, which typically incorporates hypothetical monetary earnings and losses for performance, has been widely used to measure decision-making in substance abusers. We examined the effects of a cash monetary contingency on Gambling task performance in cocaine abusers and control participants.

Methods: Twenty-two long-term cocaine smokers who met DSM-IV criteria for cocaine dependence and 24 non-cocaine-using control participants completed this study.

Acute effects of smoked marijuana on decision making, as assessed by a modified gambling task, in experienced marijuana users.

The impact of regular marijuana use on executive cognitive abilities, including decision making, is not well understood. While cross-sectional studies have suggested that substance abusers exhibit impaired decision making, as assessed by the Iowa Gambling Task, the direct role of marijuana use in the Gambling Task performance of marijuana smokers has not been well defined. In this report, we present data on performance on a modified Gambling Task in experienced marijuana users after they had smoked marijuana under controlled laboratory conditions.

Neuropsychiatric predictors of return to work in HIV/AIDS.

This study followed 118 HIV+ individuals who had taken steps to return to work to determine facilitators or barriers in returning to work. Over the two-year study period, 52% of the participants obtained employment. Memory function served as the most potent predictor of obtaining employment.

Detection of inadequate effort on the California Verbal Learning Test-Second edition: forced choice recognition and critical item analysis.

The Forced Choice Recognition (FCR) and the Critical Item Analysis (CIA) indices of the California Verbal Learning Test-II (CVLT-II) have been identified by the CVLT-II test developers as potentially useful, brief screening indicators of effort in neuropsychological assessment. This retrospective study analyzes performance on these measures in three groups: (1) clinically referred individuals; (2) forensically referred individuals not suspected of inadequate effort; and (3) forensically referred individuals whose performance on freestanding tests of effort suggested inadequate effort. Performances on FCR were analyzed for their relation to actual memory impairment and with regard to concrete and abstract distractor endorsement.

Functional ("psychogenic") amnesia.

Patients who present with severely impaired memory functioning without a discernable neurological cause typically have experienced one or more severely stressful life events. These patients, who are described as having "psychogenic" or "dissociative" amnesia, typically differ from patients with the neurologic amnestic syndrome in that memory for their personal life histories is much more severely affected than is their ability to learn and retain new information; that is, they have isolated retrograde amnesia. Recent cognitive and brain imaging research has begun to reveal some of the cerebral mechanisms underlying functional amnesia, but this disorder remains best conceptualized as a relatively rare form of illness-simulating behavior rather than a disease.

Cognitive function of older patients receiving adjuvant chemotherapy for breast cancer: a pilot prospective longitudinal study.

Objectives: To report on the longitudinal cognitive functioning of older women receiving adjuvant chemotherapy for breast cancer.

Design: Neuropsychological and functional status testing were performed before chemotherapy and 6 months after chemotherapy.

Setting: Cancer center.

Components of depression in HIV-1 infection: their differential relationship to neurocognitive performance.

Both depression and neurocognitive compromise are commonly observed among persons infected with the Human Immunodeficiency Virus (HIV). To date, the majority of studies have failed to find a consistent relationship between mood and cognition among HIV-seropositive (HIV+) individuals, suggesting that these constructs are independent of one another. However, depression is a multi-dimensional syndrome and its measurement often utilizes multi-factorial instruments containing cognitive, affective, somatic, and motivational components.

Effect of adjuvant breast cancer chemotherapy on cognitive function from the older patient's perspective.

Purpose: This longitudinal prospective study describes the older breast cancer patient's perception of the cognitive impact of adjuvant chemotherapy.

Methods: A total of 50 patients > or =age 65 with stage I to III breast cancer enrolled in this IRB-approved prospective study. Of the 50, 3 refused postchemotherapy testing and 2 had a cerebrovascular accident (CVA) during therapy, leaving 45 evaluable patients.

Neurocognitive function in clinically stable men with bipolar I disorder or schizophrenia and normal control subjects.

Background: Patients with bipolar disorder and schizophrenia have been shown to have neurocognitive deficits when compared with control subjects. The degree and pattern of impairment between psychiatric groups have rarely been compared, especially when subjects are psychiatrically stable.

Methods: Using a standard neurocognitive battery, we compared euthymic outpatients with bipolar disorder (n = 40), stable patients with schizophrenia (n = 20), and subjects with no psychiatric disorder (n = 22).

Forensic evaluation of trauma syndromes in children.

There are significant differences between a clinical evaluation and a forensic evaluation [289-291]. These differences must be kept solidly in mind in performing the evaluation. The forensic evaluator needs to assess the validity of complaints, including the possibility of malingering and the child's ability to describe symptoms accurately, the connection between the symptoms and a given incident, and the potential long-term sequelae of a trauma.

Executive dysfunction in geriatric depression.

Objective: The purpose of this study was to characterize the neuropsychological presentation of geriatric depression and to determine whether depression-related executive dysfunction is more pronounced during advanced age.

Method: The attention and executive functioning of 40 adults with major depression were compared with those of 40 healthy comparison subjects; 20 subjects were 20-60 years old, and 20 were > or =61 years. It was hypothesized that depressed subjects, regardless of age, would perform more poorly than comparison subjects on both attention and executive tasks but that the older depressed adults would evidence significantly greater impairment on executive measures.