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J Neuropsychiatry Clin Neurosci 1992; 4:270-279
Copyright © 1992 by American Neuropsychiatric Association
Progressive slowing of reaction time and increasing cerebrospinal fluid concentrations of quinolinic acid in HIV-infected individuals
A Martin, MP Heyes, AM Salazar, DL Kampen, J Williams, WA Law, ME Coats and SP Markey
Laboratory of Clinical Science, National Institute of Mental Health, Bethesda, MD 20892.
Neuropsychological functioning and cerebrospinal fluid concentrations of an
endogenous neurotoxin, quinolinic acid (QUIN) were evaluated in 52
HIV-positive individuals (71% without constitutional symptoms) and 33
HIV-seronegative controls (including 15 psychiatric patients with
adjustment disorders). Although the HIV-positive subjects did not differ
from controls on standard neuropsychological tests, simple and choice
reactions times (RT) were slow at initial evaluation (P less than 0.01) and
became progressively slower at 6-month re-evaluation (P less than 0.05).
Cerebrospinal fluid (CSF) QUIN was elevated at initial evaluation and
increased during the 6-month interval (P less than 0.05). Moreover, during
this 6-month interval, progressive slowing of RT was highly correlated with
increasing levels of CSF QUIN (r = 0.85, df = 15, P less than 0.0001) but
not with changes in mood, constitutional symptoms, or CD4 cell count. These
findings suggest that RT may provide a sensitive behavioral measure of
relatively early central nervous system involvement in HIV-infected
individuals and that QUIN may play an important role in the pathogenesis of
HIV-related neurological dysfunction.
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