Selective impairments of alerting and executive control in HIV-infected patients: evidence from attention network test

Yi-Quan Wang,Sheng Zhu,Kai Wang,Zhi-Hua Shen,Yang Pan,Yong-Guang Wang

doi:10.1186/s12993-017-0129-0

Abstract

BackgroundAttention ability can be subdivided into three functionally independent networks, i.e., alerting network, orienting network, and executive network. Previous literature has documented that deficits in attention are a common consequence of HIV infection. However, the precise nature of deficits of attention in HIV-infected patients is poorly understood. Accordingly, the aim of the study was to identify whether the HIV-infected patients showed a specific attention network deficit or a general attentional impairment.MethodsWe investigated 27 HIV-infected patients and 31 normal controls with the Attention Network Test (ANT).ResultsThe patients exhibited less efficient alerting network and executive network than controls. No significant difference was found in orienting network effect between groups. Our results also indicate a tendency for poorer efficiency on alerting attention and executive attention in patients with CD4 ≤ 200.ConclusionsOur findings suggest that HIV-infected patients exhibited selective impairments of attention network of alerting and executive control. The link between lower CD4 T cell count and poorer attention network function imply the importance of starting antiretroviral therapy earlier to avoid irreversible neurocognitive impairment.

Highlights

Attention ability can be subdivided into three functionally independent networks, i.e., alerting net‐ work, orienting network, and executive network
Unlike the findings of alerting attention and executive attention, our results indicate that HIV-infected patients were sensitive to the spatial cues with normal controls
Consistent with previous literature [43,44,45,46], our results indicate a tendency for poorer efficiency on alerting attention and executive attention in patients with CD4 ≤ 200

Summary

Introduction

Attention ability can be subdivided into three functionally independent networks, i.e., alerting net‐ work, orienting network, and executive network. Previous literature has documented that deficits in attention are a common consequence of HIV infection. The precise nature of deficits of attention in HIV-infected patients is poorly understood. HIV-associated neurocognitive disorders (HAND) are characterized by disabling cognitive, behavioral and motor dysfunction [1], and are a common hallmark of HIV infected individuals. Attention plays the central role in patients’ driving ability [16] and was associated with poor medical adherence [17], the precise nature of deficits in attention for HIV-infected patients is poorly understood [14]. In previous studies of HAND, attentional functioning was routinely investigated by clinical neuropsychological tests.

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