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Semantic Clustering Inefficiency in HIV-Associated Dementia

Received July 7, 2005; revised December 13, 2005; accepted January 19, 2006. Mr. Gongvatana is affiliated with the University of California, San Diego, and San Diego State University, California. Dr. Woods is affiliated with the Department of Psychiatry, HIV Neurobehavioral Research Center, San Diego, California. Dr. Taylor is affiliated with the VA San Diego Healthcare System, and the University of California, San Diego, California. Mr. Vigil and Dr. Grant are affiliated with the University of California, San Diego, the VA San Deigo Health Care System, and the Naval Medical Center, San Diego, California. Address correspondence to Dr. Woods, HIV Neurobehavioral Research Center, Department of Psychiatry, University of California, San Diego, 150 West Washington Street, 2nd Floor, San Diego, CA 92103; spwoods{at}ucsd.edu (e-mail).

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Although HIV is detectable throughout the CNS, its preferential disruption of fronto-basal ganglia systems is thought to underlie the neurobehavioral syndrome of HIV-associated dementia. Semantic clustering, a measure of organizational strategy during learning and retrieval, is commonly impaired in patients with frontal systems dysfunction, but has not previously been evaluated in HIV-associated dementia. The current study examined semantic and serial clustering strategies on a list-learning task in 15 individuals with HIV-associated dementia, 44 HIV-infected individuals without dementia, and 24 healthy comparison subjects. Results indicated a stepwise decline in the use of semantic, but not serial, clustering with increasing severity of HIV-associated cognitive disorder. Findings suggest that HIV-associated dementia is associated with inefficient use of higher-level encoding and retrieval strategies, perhaps mediated by a disruption of fronto-basal ganglia systems.

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