A pilot study of the effects of internet-based cognitive stimulation on neuropsychological function in HIV disease.

Abstract

Mild cognitive deficits associated with HIV disease can affect activities of daily living, so interventions that reduce them may have a long-term effect on quality of life. We evaluated the feasibility of a cognitive stimulation program (CSP) to improve neuropsychological test performance in HIV disease. Sixty volunteers (30 HIV-infected) participated. The primary outcome was the change in neuropsychological test performance as indexed by the Global Impairment Rating; secondary outcomes included mood (Brief Symptom Inventory subscales) and quality of life rating (Medical Outcomes Survey-HIV) scales. Fifty-two participants completed all 24 weeks of the study, and 54% of the participants in the CSP group successfully used the system via internet access from their home or other location. There was a significant interaction between usage and study visit such that the participants who used the program most frequently showed significantly greater improvements in cognitive functioning (F(3, 46.4 = 3.26, p = 0.030); none of the secondary outcomes were affected by the dose of CSP. We found it possible to complete an internet-based CSP in HIV-infected individuals; ease of internet access was a key component for success. Participants who used the program most showed improvements in cognitive function over the 24-week period, suggesting that a larger clinical trial of CSP may be warranted.