Neuropsychiatric disturbance is associated with executive dysfunction in HIV-1 infection

Prominent apathy and/or irritability are frequently observed among individu als infected with the human immunodeficiency virus (HIV). Although these sy mptoms often occur as part of a mood disorder, compelling evidence suggests that they may occur independently of depression in neurologic disease/diso rder. The current study examined the prevalence of both apathy and irritabi lity among a sample of HIV-infected individuals and explored the degree to which these neuropsychiatric (NP) phenomena were associated with performanc e on neurocognitive measures thought to be sensitive to the potential CNS e ffects of HIV-1. Clinician-administered rating scales assessing apathy and irritability were administered to 65 MV-seropositive (HIV+) and 21 hIV-sero negative (HIV-) participants who also completed a dual-cask reaction time p aradigm and the Stroop task. NP disturbance was significantly more prevalen t among HIV+ participants compared with HIV- controls and was associated wi th specific neurocognitive deficits suggestive of executive dysfunction. Re lative to both HIV- controls and to neuropsychiatrically intact HIV+ partic ipants, those HIV+ individuals with evidence of prominent apathy and/or irr itability showed deficits in dual-task, but not single-task, performance an d on the interference condition of the Stroop. Unexpectedly NP disturbance did not show a robust relationship with HIV disease stage. These results su ggest that the presence of prominent apathy and/or irritability among HIVindividuals may signify greater HIV-associated CNS involvement. In HIV/AIDS , the disruption of frontal-subcortical circuits may be a common mechanism causing both executive dysfunction and NP disturbance.