There have been many advances in HIV treatment in the past few decades. This has led to a longer average life span for people living with HIV, but can also lead to longer periods of impairment. Among the many negative outcomes of HIV is neurocognitive impairment. In fact, almost half of those with HIV will have some level of neurocognitive impairment. People with the most significant deficits could experience motor function issues or behavior problems as well as cognitive challenges. This level of dysfunction is known as HAND: HIV-associated neurocognitive disorder. When individuals have HAND, they may be unable to process their emotions or accurately perceive the emotions of those around them, which can cause strain in social interactions. Facial expressions are often a person’s first clue to someone’s emotional state. To ensure harmonious social encounters, it is important to be able to effectively interpret the expressions of others. Lucette A. Cysique of the Neurology Department at St. Vincent’s Hospital in Australia wanted to find out if this type of emotional recognition function was diminished in individuals with HIV.
In a recent study, Cysique assessed 25 HIV-negative and 85 HIV-positive individuals for neurological functioning, behavioral patterns, daily activity independence, and overall psychiatric state. She then recorded their responses to facial cues, including happy, sad, angry, fearful, and neutral faces. Cysique looked specifically at how depression, apathy, and dependence on others contributed to their responses. She found that the HIV-positive individuals who did not have HAND had minimal deficits in emotional processing abilities. However, those with HAND had significant difficulty processing the emotional states of the cues. In particular, it took them longer to identify negative facial expressions, such as anger, sadness, and fear. Also, all of the participants had trouble assessing the levels of happiness exhibited in the happy faces, but this was especially challenging for the participants with HAND. She did not find evidence to support any link between depression, independence, and apathy in emotional processing deficits.
Cysique believes that her findings give new insight into the neurocognitive degeneration that can occur as HIV advances. Evidence of this is the fact only expression identification is impaired in all HIV-positive participants, but speed of identification is reduced significantly in those with HAND. “This result indicates that the mild reduction observed in the entire group may reflect early abnormalities that are amplified with the development of clinically meaningful forms of cognitive impairment,” Cysique said, adding that she hopes future work will extend her findings by using larger sample sizes and including additional facial expressions not included in this research.
Lane, Tammy A., Danielle M. Moore, Jennifer Batchelor, Bruce J. Brew, and Lucette A. Cysique. Facial emotional processing in HIV infection: Relation to neurocognitive and neuropsychiatric status. Neuropsychology 26.6 (2012): 713-22. Print.
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