Electroencephelographic (EEG) & mini mental state examination (MMSE) findings among HIV positive patients

Abstract

Objective: To study the role of Folstein’s Mini Mental State Examination (MMSE) and the Electroencephalogram (EEG) in the clinical evaluation of patients at risk of cognitive impairment in HIV disease. Methods: Eighty HIV-positive patients were categorized into 2 groups according to their current immune status (HIV or AIDS). Group 1 consists of asymptomatic HIV-seropositive individuals (HIV) with CD4 counts above 200 cells/ml3, and group 2 consists of individuals with Acquired Immunodeficiency Syndrome (AIDS) with CD4 counts below 200 cells/ml3. Thirty six were males and 44 were females, ranging between the age of 18-60 years. The patients were recruited from The Bay Hospital, Richards Bay, Kwa-Zulu Natal, South Africa. Demographically, 99% of the patients selected were Black and 1% Caucasian. For the detection of cognitive impairment in each patient, MMSE and EEG were performed. The EEG findings were then correlated with results of MMSE, immunosuppression, opportunistic infections, medication (Highly Active Antiretroviral Therapy) and disease classification. Results: MMSE was significantly associated with the EEG results (p=0.008), immunosuppression (p=0.016), opportunistic infections (p=0.018), and disease classification (p=0.030). EEG did not associate with immunosuppression (p=0.838), opportunistic infections (p=0.074), and disease classification (p=0.259). Neither the MMSE nor the EEG was associated with HAART intake. The mean MMSE score for the AIDS group was 24, marginally less than that of the matched HIV group scoring 27. Twenty one of all patients had a score less than 24, indicative of dementia. EEG was abnormal in 16 patients and borderline in 8 cases. Conclusion: MMSE may be a sensitive test in detecting cognitive impairment and monitoring its course in AIDS/HIV. EEG abnormalities may indicate a risk of HIV cognitive impairment in otherwise stable individuals.