Implications of HAM/TSP functional incapacity in the quality of life.

OBJECTIVE: To identify the functional status and quality of life of HAM/TSP patients. METHOD: We evaluated prospectively 30 HAM/TSP patients (20 females) seen in the Neuroinfection Clinic of the HUGG. The functional capacity was analyzed by the functional independence measure (FIM), the expanded disability status (EDSS) scale and the Osame's motor disability score (OMDS). The quality of life was assessed by the Short-Form Health Survey 36 (SF-36)TM. RESULTS: All patients need assistance device. The FIM, OMDS and EDSS scores classified 70%, 67% and 67% of the patients as dependent, respectively. The lowest scores of the SF-36 survey were found in the domains related to the physical health (D1, D2), role-emotional functioning (D7) and social functioning (D6). CONCLUSION: Our data suggest that the HAM/TSP physical impairment has an impact in the emotional and social issues, considering the limitation in the daily activities.

Implications of HAM/TSP functional incapacity in the quality of life / Implicações da incapacidade funcional na qualidade de vida de pacientes com HAM/TSP

OBJECTIVE: To identify the functional status and quality of life of HAM/TSP patients. METHOD: We evaluated prospectively 30 HAM/TSP patients (20 females) seen in the Neuroinfection Clinic of the HUGG. The functional capacity was analyzed by the functional independence measure (FIM), the expanded disability status (EDSS) scale and the Osame's motor disability score (OMDS). The quality of life was assed by the Short-Form Health Survey 36 (SF-36)TM. RESULTS: All patients need assistance device. The FIM, OMDS and EDSS scores classified 70 percent, 67 percent and 67 percent of the patients as dependent, respectively. The lowest scores of the SF-36 survey were found in the domains related to the physical health (D1, D2), role-emotional functioning (D7) and social functioning (D6). CONCLUSION: Our data suggest that the HAM/TSP physical impairment has an impact in the emotional and social issues, considering the limitation in the daily activities.

OBJETIVO: Avaliar a capacidade funcional e sua interferência na qualidade de vida de pacientes com HAM/TSP. MÉTODO: Foram analisados prospectivamente 30 casos (20 mulheres) de HAM/TSP, atendidos no Ambulatório de Neuroinfecção do HUGG. As escalas para avaliação da capacidade funcional consistiram em: medida de independência funcional (FIM), escala de incapacidade expandida (EDSS) e pontuação da incapacidade motora de Osame (OMDS). A qualidade de vida foi analisada pelo Short-Form 36 Health Survey (SF-36)TM. RESULTADOS: Todos os pacientes necessitavam de assistência para deambular. As escalas FIM, OMDS e EDDS classificaram 70 por cento, 67 por cento e 67 por cento dos pacientes como dependentes, respectivamente. A avaliação pelo SF-36 demonstrou menores escores nos domínios físico (D1, D2), emocional (D7) e social (D6). CONCLUSÃO: Os achados sugerem que a limitação nas atividades diárias decorrentes do envolvimento físico comprometem aspectos emocionais e sociais na HAM/TSP.

Cognitive slowing in cognitive-motordisorder associated to type 1 humanimmunodeficiency virus: tr and P300

Introduction. Reaction time (RT) deficit exhibited by HIV-1 asymptomatic seropositive individuals cannot alwaysbe explained by the effect of a cognitive slowing single factor.Evidence exists that decisional and peripheral componentsof RT may have differential slowing.Objectives. To assess the hypothesis of a cognitive slowing single factor as the main responsible for RT slowingin these subjects. Methodology. Thirty two (32) HIV-1 neurologically asymptomatic seropositive individuals were compared to 29 seronegative controls in two discriminative reaction time tasks (DRT) having increased cognitive difficulty but equal motorresponse demands. P300 component of the event-related potential was recorded simultaneously. RT, PPI, errors, and P300 latency were assessed using ANOVA. Results: Seropositives were slower than controls in RT,made more errors and showed delayed latencies of P300 in both tasks. However, while the increase of RT from the easier to the more difficult task was additive, the increase of P300 latencies was multiplicative. Conclusions. These results reveal differences in patternsof slowing between central and motor information processing mechanisms. Such results suggest that a singlecommon factor is not enough to explain cognitive slowing in HIV-1 seropositive subjects(AU)

Introducción. Los déficit de tiempo de reacción (TR) en los sujetos infectados por el virus de inmunodeficienciahumana tipo 1 (VIH-1) en las etapas iniciales de la infección no parecen siempre comprensibles por la acciónde un factor general de enlentecimiento cognitivo. Existen evidencias que indican que los componentes dela decisión y periféricos del TR pueden lentificarse diferencialmente.Objetivos. Evaluar la acción de un factor general de enlentecimiento cognitivo como causa principal de incrementodel TR en estos sujetos. Métodos. Treinta y dos sujetos seropositivos al VIH-1 neurológicamente asintomáticos fueron comparados con 29 controles seronegativos en dos tareas de tiempo de reacción discriminativo (TRD) de dificultad creciente, perocon iguales demandas de respuesta. Simultáneamente se registró el componente P300 del potencial evocadopor las tareas. El TR, el IPP, los errores y la latencia del componente P300 fueron comparados mediante ANOVA.Resultados. Los seropositivos fueron más lentos, cometieron más errores y exhibieron latencias más prolongadasque los controles, pero mientras que el incremento del TR entre tareas fue aditivo, el de latencia de P300 fuemultiplicativo. Conclusiones. Los resultados revelan una disociaciónen el patrón de enlentecimiento de los mecanismos centrales y los de producción de respuesta. Tales resultadossugieren que un factor general no es suficiente paraexplicar el enlentecimiento cognitivo de estos(AU)

Cognitive slowing in cognitive-motor disorder associated to type 1 human immunodeficiency virus: TR and P300.

INTRODUCTION: Reaction time (RT) deficit exhibited by HIV-1 asymptomatic seropositive individuals cannot always be explained by the effect of a cognitive slowing single factor. Evidence exists that decisional and peripheral components of RT may have differential slowing. OBJECTIVES: To assess the hypothesis of a cognitive slowing single factor as the main responsible for RT slowing in these subjects. METHODOLOGY: Thirty two (32) HIV-1 neurologically asymptomatic seropositive individuals were compared to 29 seronegative controls in two discriminative reaction time tasks (DRT) having increased cognitive difficulty but equal motor response demands. P300 component of the event-related potential was recorded simultaneously. RT, PPI, errors, and P300 latency were assessed using ANOVA. RESULTS: Seropositives were slower than controls in RT, made more errors and showed delayed latencies of P300 in both tasks. However, while the increase of RT from the easier to the more difficult task was additive, the increase of P300 latencies was multiplicative. CONCLUSIONS: These results reveal differences in patterns of slowing between central and motor information processing mechanisms. Such results suggest that a single common factor is not enough to explain cognitive slowing in HIV-1 seropositive subjects.