N400 event-related potential reduction indexes: early central nervous system impairment in HIV.

We examined event-related potential (ERP) measures of priming in a lexical decision task in which two-thirds of the words were presented as sequential antonym pairs. HIV-1+ subjects were divided into cognitively normal and cognitively impaired subgroups on the basis of a neuropsychological battery. Cognitively impaired HIV-1+ subjects showed reduced priming, associated with reduced N400 ERP component amplitudes, suggesting that the processing of linguistic stimuli in these patients may involve reduced activation of semantic networks. Cognitively normal HIV-1+ subjects showed a reduction in N400 amplitude, but no reduction in performance, suggesting that some reduction in neural signal may occur earlier in the course of HIV-1 central nervous system disease than behavioral priming deficit. As the known neurological deficit in HIV-1 disease is primarily in the basal ganglia and periventricular white matter, we propose that a functional disconnection of subcortical and frontal structures from posterior cortical structures underlies this reduction in semantic activation.