The brain basis of executive dysfunction in older people living with HIV
Bibliographic record
Abstract
Executive dysfunction can occur in people with human immunodeficiency virus (HIV), even with well-controlled infection. The brain basis of this impairment, and its relationship with other aspects of cognitive dysfunction remain unclear. The underlying pathophysiology is also unknown, with potential contributions from direct HIV infection, comorbidities common in those with HIV, and aging effects as people live longer with the virus. Here, we assessed executive function with the Simon task, collecting behavioral and EEG data in 84 older people living with HIV, treated with combination antiretroviral therapy and without frank dementia, drawn from the Positive Brain Health Now cohort. We asked whether poorer performance reflected impulsive responding or impaired control. We also tested whether these measures related to overall cognitive ability, measured by a brief neuropsychological battery, and to clinical variables, including age, HIV infection severity and cardiovascular risk. We found that poor performers on the Simon task showed a general processing slowing pattern, and that performance correlated with global cognitive ability, arguing for diffuse brain injury rather than localized cortical or sub-cortical dysfunction. Poor performers also had smaller amplitude event-related potentials (ERP). The severity of initial HIV infection or current HIV control did not predict Simon task impairment, but those with more cardiovascular risk factors performed more poorly and showed smaller amplitude ERP. This study supports the hypothesis that executive dysfunction in older people with systemically-controlled HIV infection is one facet of diffuse brain dysfunction. This relates more to age and other cardiovascular risk factors than to ongoing HIV effects in these cART-treated patients, arguing that preventing or treating cognitive dysfunction will require shifting the focus to comorbidities with a negative impact on the brain.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".