Background: Human immunodeficiency virus (HIV) infection can affect areas of the brain that control thinking ability. These same areas of the brain also control the sense of smell. HIV infection is common in people with substance use disorder (SUD). SUD also affects thinking ability. Researchers want to learn more about the connection between the sense of smell and decision-making ability in people with HIV, SUD, or both. Objective: To test the sense of smell in people with HIV and/or SUD and how they make choices based on odors. Eligibility: People aged 18 to 65 years with any of these: (1) HIV, (2) SUD, (3) both HIV and SUD, or (4) neither SUD nor HIV. Design: Participants will have 2 visits. Each visit will last 3 to 5 hours. In visit 1, participants will have a blood draw and a saliva swab. They will answer questions about their health, sleep habits, food intake, and substance use. They will have smell tests: They will smell scented sticks and answer questions about them. They will be blindfolded for some tests. They will perform tasks on a computer. They will look at pictures and smell pleasant food odors, such as chocolate cake or pizza. Smells will be delivered using a nasal mask. Their sniffing and breathing will be measured. They may also be exposed to odor-free air. They will eat food that corresponds to one of the food odors they smelled. In visit 2, participants will do a saliva swab and a different computer task that involves odors. They will also have tests of their attention and memory. Participants may opt to have an imaging scan of the brain.
Study Description: Cognitive impairments persist in people living with Human Immunodeficiency Virus (HIV) despite anti-retroviral therapy (ART). However, these impairments remain under-characterized and it is not clear whether they include deficits in model-based control of behavior. HIV is common in people with substance use disorder (SUD) but the combined impact of HIV and SUD on cognition remains unclear. The olfactory system is uniquely vulnerable to neurodegeneration and overlaps with brain regions involved in decision making. This study will investigate olfactory function and model-based behavior in people living with HIV and SUD, and relate these measures to biomarkers of neurodegeneration. Objectives: The primary objective of this protocol is to compare olfactory function and performance on behavioral tasks assessing model-based behavior between people living with and without HIV, and between people with and without SUD. Secondary objectives of this protocol are to compare blood-based and MRI0-based biomarkers of neurodegeneration between people living with and without HIV, and between people with and without SUD. Endpoints: Primary: * Olfactory function (Sniffin Sticks Threshold, Discrimination, and Identification tests) * Behavior on tasks assessing model-based behavior (outcome devaluation and sensory preconditioning) Secondary: * Blood-based biomarker of neurodegeneration (Neurofilament Light Chain \[NfL\]) * MRI-based biomarker of neurodegeneration (Magnetic Resonance Imaging)
Study Type
OBSERVATIONAL
Enrollment
120
National Institute on Drug Abuse
Baltimore, Maryland, United States
Olfactory function
Sniffin Sticks Threshold, Discrimination, and Identification tests
Time frame: Visit 1
Model-based decision making
Model-based decision making as assessed in an outcome devaluation task (visit 1) and sensory preconditioning task (visit 2)
Time frame: Visit 1 & 2
Neurofilament Light Chain
Plasma levels of neurofilament light chain \[NfL\]
Time frame: Visit 1
MRI
MRI-based biomarkers of neurodegeneration
Time frame: Visit 2 (optional)
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