This is a competing renewal application for Years 11-15 of R01 DA12828, "Cognitive Neuropsychology of HIV and Drug Abuse," an ongoing program of theory driven research to investigate the unique and additive effects of HIV and substance dependence on selected neurocognitive functions with neuroanatomical and functional significance for neuroAIDS research. During the current cycle we successfully demonstrated selective deficits among HIV+ drug users in measures of learning and executive functions critically dependent on basal ganglia and prefrontal cortex integrity. Our study findings provided unique evidence of significantly different patterns of neurocognitive performance among HIV+ male and female SDIs. Neurocognition among HIV+ women is significantly understudied and essentially no studies have compared neurocognitive performance of HIV+ men and women directly. Such studies are urgently needed for cocaine dependent HIV+ women, since cocaine dependence strongly and uniquely predicts morbidity and mortality among women living with HIV/AIDS and women are significantly more vulnerable to stimulant addiction compared with men. This renewal application will move forward by 1) comparing episodic memory and executive performance of HIV+ male and female cocaine dependent individuals 2)investigating potential interactive effects of severity of cocaine dependence with sex and serostatus on neurocognition;and 3) conducting an exploratory study of neurocognitive and hormonal fluctuation across the menstrual cycle as a prudent first step toward investigating potential female specific mechanisms of HIV-associated neurocognitive impairment among cocaine users. This application is uniquely positioned to acquire extensive knowledge directly relevant to neurobehavioral components of HIV disease management, cognitive strategies for enhancement of memory, cognitive recovery with continued abstinence from drugs and sex-appropriate relapse prevention strategies. Finally this application addresses research topics of high scientific priority for NIDA and will increase representation of women in studies of drug abuse.
Results from this study will characterize sex differences in memory and executive skills among HIV+ individuals with a history of cocaine dependence. These functions are frequently impaired among individuals with HIV-associated neurocognitive disorder (HAND) and also key components of addictive behavior. This new knowledge will facilitate design of sex-specific cognitive remediation and enhancement techniques for improving memory and executive functions among HIV+ substance dependent individuals;apply knowledge of sex differences in learning, memory and executive functions as potential improvements in sex-specific strategies of relapse prevention;and provide new knowledge of the effects of sex steroid hormones on neurocognitive function to fine tune somatic, social and behavioral interventions for cocaine dependent HIV+ women through the menstrual transition.
|Albert, Steven M; Martin, Eileen M (2014) HIV and the neuropsychology of everyday life. Neurology 82:2046-7|
|Martin, Eileen M; DeHaan, Samantha; Vassileva, Jasmin et al. (2013) Decision making among HIV+ drug using men who have sex with men: a preliminary report from the Chicago Multicenter AIDS Cohort Study. J Clin Exp Neuropsychol 35:573-83|
|Wilson, Michael J; Martin-Engel, Lindsay; Vassileva, Jasmin et al. (2013) An investigation of the effects of antiretroviral central nervous system penetration effectiveness on procedural learning in HIV+ drug users. J Clin Exp Neuropsychol 35:915-25|
|Paxton, Jessica L; Vassileva, Jasmin; Gonzalez, Raul et al. (2012) Neurocognitive performance in drug-dependent males and females with posttraumatic stress disorder symptoms. J Clin Exp Neuropsychol 34:521-30|
|Gonzalez, Raul; Schuster, Randi M; Vassileva, Jasmin et al. (2011) Impact of HIV and a history of marijuana dependence on procedural learning among individuals with a history of substance dependence. J Clin Exp Neuropsychol 33:735-52|
|Martin, Eileen; Gonzalez, Raul; Vassileva, Jasmin et al. (2011) HIV+ men and women show different performance patterns on procedural learning tasks. J Clin Exp Neuropsychol 33:112-20|
|Hilsabeck, Robin C; Martin, Eileen M (2010) Women and advancement in neuropsychology: real-life lessons learned. Clin Neuropsychol 24:481-92|
|Gonzalez, Raul; Wardle, Margaret; Jacobus, Joanna et al. (2010) Influence of procedural learning on Iowa Gambling Task performance among HIV+ individuals with history of substance dependence. Arch Clin Neuropsychol 25:28-38|
|Martin-Thormeyer, Eileen M; Paul, Robert H (2009) Drug abuse and hepatitis C infection as comorbid features of HIV associated neurocognitive disorder: neurocognitive and neuroimaging features. Neuropsychol Rev 19:215-31|
|Gonzalez, Raul; Jacobus, Joanna; Amatya, Anup K et al. (2008) Deficits in complex motor functions, despite no evidence of procedural learning deficits, among HIV+ individuals with history of substance dependence. Neuropsychology 22:776-86|
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