TMARC Pilot Studies - Completed

Assessment & Remediation of Real-world Functions in METH & HIV Using Virtual Reality (Iudicello)

Agency: TMARC
PI: Iudicello, Jennifer, Ph.D.

Abstract

Among persons living with HIV and METH, neurocognitive deficits (e.g., executive dysfunction) are associated with poorer real-world outcomes, including medication non-adherence. Yet there are growing concerns regarding the extent to which the current armamentarium of functional tasks fully capture the intricacies of the cognitive and functional demands of daily life in the modern era, which may have important diagnostic and treatment implications. Thus, this Pilot study aims to determine the impact of METH and HIV on novel, user-friendly virtual reality measures of everyday functioning capacity, which may better capture the demands of successful daily functioning. We plan to assess 80 well-characterized TMARC participants stratified by HIV and METH across four study groups (HIV-/METH-, HIV-/METH+, HIV+/METH-, HIV+/METH+), and hypothesize that HIV and METH will be associated with poorer functioning on these virtual reality tasks, which will correlate with executive dysfunction (e.g., decision-making, impulsivity). We also hypothesize that these novel measures will be more sensitive in detecting METH and HIV-related disability than traditional performance-based measures of functional capacity. The ultimate clinical value of developing novel virtual reality assessments is enhanced by parallel development of targeted cognitive and behavioral remediation strategies for HIV and METH, which is a grossly underdeveloped area of investigation. Thus, this study will also apply the principles of Goal Management Training (GMT) to improve performance on a computerized web-based virtual reality task that is sensitive to HIV-associated neurocognitive disorders (HAND). GMT is a structured manualized rehabilitation protocol that trains individuals on aspects of goal-directed behavior (e.g., goal assessment and monitoring) and has shown to improve executive deficits in traumatic brain injury. This Pilot study, which will work closely with the Behavioral Assessment and Medical Core, represents a critical first step in an emerging program of research that will facilitate technological advances in the diagnosis and treatment of HIV-associated functional problems among substance abusers.

Sponsored by NIH/NIDA P50DA026306

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