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Measuring neurocognitive functioning in HIV infected adults : South African norms and the development of a shortened version of the HNRC International Neurobehavioral Battery
Thesis (PhD)--Stellenbosch University, 2020.
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| Language: | en_ZA |
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Stellenbosch : Stellenbosch University
2020
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| _version_ | 1867613991299186688 |
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| access_status_str | Open Access |
| author | Cilliers, Melanie |
| author2 | Seedat, Soraya, 1966- |
| author_browse | Cilliers, Melanie Seedat, Soraya, 1966- |
| author_facet | Seedat, Soraya, 1966- Cilliers, Melanie |
| author_sort | Cilliers, Melanie |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis (PhD)--Stellenbosch University, 2020. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/109454 |
| institution | Stellenbosch University (South Africa) |
| language | en_ZA |
| last_indexed | 2026-06-10T12:44:55.985Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2020 |
| publishDateRange | 2020 |
| publishDateSort | 2020 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/109454 Measuring neurocognitive functioning in HIV infected adults : South African norms and the development of a shortened version of the HNRC International Neurobehavioral Battery Cilliers, Melanie Seedat, Soraya, 1966- Spies, Georgina Suliman, Sharain Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Psychiatry. Neurocognitive, South Africa Cognition disorders -- South Africa HIV infections -- Complications -- South Africa Brain -- Diseases -- South Africa Neurologic manifestations of general diseases UCTD Thesis (PhD)--Stellenbosch University, 2020. ENGLISH SUMMARY: The human immunodeficiency virus (HIV) is capable of inducing neurological injury, which manifests as a spectrum of neurocognitive (NC) disorders collectively known as HIV-associated neurocognitive disorders (HAND). The HIV Neurobehavioral Research Centre’s International Neurobehavioral Battery (HNRC Battery) is an extensive NC battery that is culturally valid in the South African context and is sensitive to the NC effects of HIV infection. However, its lengthy administration time and a lack of demographically adjusted South African norms makes it impractical in clinical and research settings in South Africa. The current study therefore aimed to (1) develop demographically corrected South African norms for the HNRC Battery and (2) develop a shortened version of the HNRC Battery for use in clinical and research settings in South Africa. The study was divided into three distinct phases. The first phase entailed the development of demographically corrected South African norms for the HNRC Battery using the data from 500 HIVnegative adults. The second phase involved the development of a shortened version of the HNRC Battery by comparing the NC test performances of HIV-positive (n = 103) and HIV-negative (n = 135) participants. The measures that best discriminated between the HIV-positive and HIV-negative groups, that best predicted group inclusion, or that maximised practicality in clinical settings were prioritised in the selection process. In the final phase, the abbreviated HNRC Battery was validated against the original battery. The sensitivity and specificity of the abbreviated HNRC Battery was measured using the data collected from the HIV-positive participants in the second phase (n = 103). Furthermore, the impairment rates of the 103 HIV-positive participants who completed the full HNRC Battery were compared to the impairment rates of 52 HIV-positive participants who only completed the abbreviated battery. Demographically-corrected South African norms were presented for the HNRC Battery. Age, education, ethnicity, gender and NC test administration language were found to be significant predictors of performance. Additionally, the HNRC battery (with an administration time of ±2.5 hours) was shortened to a 28-minute screening battery. Six measures (i. e. the Hopkins Verbal Learning Test – Revised; WAIS-III Symbol Search test; Controlled Oral Word Association – FAS; WMS-III Spatial Span; Grooved Pegboard Test – non-dominant hand; and the Stroop Color-Word Test) that each measured a separate cognitive domain evaluated by the full battery, were selected for the shortened version of the HNRC Battery. Compared to the full HNRC battery, the abbreviated battery showed a good sensitivity (75.0%) and specificity (93.7%). Furthermore, impairment rates identified in an HIV-positive sample who completed the abbreviated HNRC battery (28.9%) were similar to impairment rates found in an HIVpositive- sample who completed the full battery (23.1%). In conclusion, this study provided much-needed NC normative data for the HNRC Battery that can facilitate both clinicians and researchers in identifying NC impairment in the South African context. Furthermore, the newly developed shortened version of the HNRC Battery showed adequate diagnostic accuracy in identifying NC impairment in an HIV-positive South African sample with a significant reduction in administration time, making it more practical in busy clinics. AFRIKAANSE OPSOMMING: Die menslike immuniteitsgebreksvirus (MIV) kan neurologiese afwykings veroorsaak, wat manifesteer as 'n spektrum van neurokognitiewe (NK) versteurings wat saam bekend staan as MIVgeassosieerde neurokognitiewe afwykings (MGNA). Die MIV Neuro-gedrags Navorsingssentrum se Internasionale Neuro-gedrags Battery (HNRC-battery) is 'n uitgebreide NK-battery wat kultureel geldig is in die Suid-Afrikaanse konteks en sensitief is vir die NK-gevolge van MIV-infeksie. Die lang administrasietyd van die battery en 'n gebrek aan demografies aangepaste Suid-Afrikaanse norms maak dit egter onprakties in kliniese en navorsingsomgewings in Suid-Afrika. Die huidige studie het dus ten doel gehad om (1) demografies gekorrigeerde Suid-Afrikaanse norms vir die HNRC-battery te ontwikkel en (2) 'n verkorte siftingsweergawe van die HNRC-battery te ontwikkel vir gebruik in kliniese en navorsingsinstellings in Suid-Afrika. Die studie was in drie verskillende fases verdeel. Die eerste fase het die ontwikkeling van demografies gekorrigeerde Suid-Afrikaanse norms vir die HNRC-battery behels. Norms was ontwikkel vanaf die data van 500 MIV-negatiewe volwassenes. Die tweede fase het die ontwikkeling van 'n verkorte weergawe van die HNRC-battery behels. Die NK-toetsprestasies van MIV-positiewe (n = 103) en MIV-negatiewe (n = 135) deelnemers was vergelyk en die toetsmaatstawwe wat die beste onderskei het tussen die MIV-positiewe en MIV-negatiewe groepe, wat groepsinklusie die beste voorspel het, of wat mees prakties was in ‘n kliniese konteks, was geprioritiseer in die verkortingsproses. In die laaste fase was die verkorte weergawe van die HNRC-battery teen die oorspronklike battery gevalideer. Die sensitiwiteit en spesifisiteit van die verkorte weergawe van die HNRC-battery was gemeet met behulp van die data wat in die tweede fase versamel is van die MIV-positiewe deelnemers (n = 103). Verder was die NK-verswakkingsyfers van die 103 MIV-positiewe deelnemers wat die volledige HNRC-battery voltooi het, vergelyk met die NK-verswakking in ‘n steekproef van 52 MIV-positiewe deelnemers wat slegs die verkorte battery voltooi het. Demografies gekorrigeerde Suid-Afrikaanse norms is ontwikkel vir die HNRC-battery. Ouderdom, opvoeding, etnisiteit, geslag en administrasietaal van die NK battery was beduidende voorspellers van prestasie. Die HNRC-battery (met 'n administrasietyd van ± 2.5 uur) was ook verkort tot 'n 28-minuutskermbattery. Ses maatstawwe (nl. die Hopkins verbale leer-en-vertragingstoets - Hersien; WAIS-III Simboolsoekopdrag; Gekontroleerde mondelinge woordassosiasie – FAS; WMS-III Ruimtelikespan opdrag; Gegroefde gaatjiesbord-toets – nie-dominante hand; en die Stroop kleurwoordtoets) wat elkeen 'n aparte kognitiewe domein meet, was uit die volledige battery gekies vir die verkorte weergawe van die HNRC-battery. In vergelyking met die volledige HNRC-battery, het die verkorte battery 'n goeie sensitiwiteit (75.0%) en spesifisiteit (93.7%) getoon. Verder was die NK-verswakkingsyfers wat geidentifiseer is in 'n MIV-positiewe steekproef wat die verkorte HNRC-battery voltooi het (28.9%) soortgelyk aan die in 'n MIV-positiewe steekproef wat die volledige battery voltooi het (23.1%). Ten slotte het hierdie studie noodsaaklike normatiewe data van die HNRC-battery ontwikkel wat beide klinici en navorsers kan help om NK-verswakking in MIV-positiewe Suid-Afrikaners te identifiseer. Verder het die nuut ontwikkelde verkorte weergawe van die HNRC-battery voldoende diagnostiese akkuraatheid getoon in die identifisering van NK-verswakking in 'n MIV-positiewe Suid-Afrikaanse steekproef. Terselfdetyd is die administrasietyd van die battery aansienlik verkort, wat dit meer prakties maak in besige klinieke. Doctorate 2020-12-04T08:42:55Z 2021-02-01T07:55:51Z 2020-12-04T08:42:55Z 2021-02-01T07:55:51Z 2020-12 Thesis http://hdl.handle.net/10019.1/109454 en_ZA Stellenbosch University 287 pages : illustrations, includes annexures application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Neurocognitive, South Africa Cognition disorders -- South Africa HIV infections -- Complications -- South Africa Brain -- Diseases -- South Africa Neurologic manifestations of general diseases UCTD Cilliers, Melanie Measuring neurocognitive functioning in HIV infected adults : South African norms and the development of a shortened version of the HNRC International Neurobehavioral Battery |
| title | Measuring neurocognitive functioning in HIV infected adults : South African norms and the development of a shortened version of the HNRC International Neurobehavioral Battery |
| title_full | Measuring neurocognitive functioning in HIV infected adults : South African norms and the development of a shortened version of the HNRC International Neurobehavioral Battery |
| title_fullStr | Measuring neurocognitive functioning in HIV infected adults : South African norms and the development of a shortened version of the HNRC International Neurobehavioral Battery |
| title_full_unstemmed | Measuring neurocognitive functioning in HIV infected adults : South African norms and the development of a shortened version of the HNRC International Neurobehavioral Battery |
| title_short | Measuring neurocognitive functioning in HIV infected adults : South African norms and the development of a shortened version of the HNRC International Neurobehavioral Battery |
| title_sort | measuring neurocognitive functioning in hiv infected adults south african norms and the development of a shortened version of the hnrc international neurobehavioral battery |
| topic | Neurocognitive, South Africa Cognition disorders -- South Africa HIV infections -- Complications -- South Africa Brain -- Diseases -- South Africa Neurologic manifestations of general diseases UCTD |
| url | http://hdl.handle.net/10019.1/109454 |
| work_keys_str_mv | AT cilliersmelanie measuringneurocognitivefunctioninginhivinfectedadultssouthafricannormsandthedevelopmentofashortenedversionofthehnrcinternationalneurobehavioralbattery |