Neural dynamics of selective attention deficits in HIV-associated neurocognitive disorder

ObjectiveTo identify the neural markers of attention dysfunction in patients with HIV-associated neurocognitive disorder (HAND).MethodsSixty participants, including 40 HIV-infected adults (half with HAND) and 20 demographically matched controls performed a visual selective attention task while undergoing high-density magnetoencephalography. Neuronal activity related to selective attention processing was quantified and compared across the 3 groups, and correlated with neuropsychological measures of attention and executive function. Spontaneous neural activity was also extracted from these attention-related cortical areas and examined with respect to HAND status.ResultsHIV-infected participants with and without HAND exhibited behavioral selective attention deficits on the magnetoencephalography task, as indicated by an increased flanker effect. Neuronal measures of flanker interference activity in the alpha and theta range revealed differential dynamics in attention-related brain areas across the 3 groups, especially in those with HAND. In addition, theta range flanker interference activity in the left inferior frontal and dorsolateral prefrontal cortex was associated with executive function and attention composite scores, respectively. Progressively stronger spontaneous alpha and theta activity was also found in unimpaired HIV-infected and HAND participants relative to controls across brain regions implicated in different components of attention processing.ConclusionsBehavioral and neuronal metrics of selective attention performance distinguish participants with HAND from controls and unimpaired HIV-infected participants. These metrics, along with measures of local spontaneous neural activity, may hold promise as early markers of cognitive decline in participants with HIV infection and be useful prognostic indicators for HAND.

Improving Wayfinding for Older Users With Selective Attention Deficits

Older adults experience difficulties with navigating their environments and may need to rely on signs more heavily than younger adults. However, older adults also experience difficulties with focusing their visual attention, which suggests that signs need to be designed with the goal of making it as easy as possible to attend to them. This article discusses some design principles that may be especially important to compensate for declining attentional focus. These principles include distinctiveness, consistent appearance and location, standardized images, simplicity, isolation from other elements of the environment, and reassurance about the current route.