This study will folllow 16 people at St. Michael’s Hospital in Toronto. It will compare cognitive remediation group therapy (CRGT) to standard HIV group therapy (control group) to determine if there’s enough of a difference in these approaches to merit a larger study. We will be keeping an eye on this one for you and will update you with any findings of note.

Meditation and other mind-body practices are one of the few things proven to help with HAND.

From their Conclusion: “However, mindfulness, a combination of least three relaxation techniques and cognitive behavioral strategies, and yoga show encouraging results in decreasing physical and psychological symptoms and improving quality of life and health in people living with HIV.”

Study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6560810/

I am including this under treatment because the study has to do with a potential one.

The FOXO3 protein is directly responsible for the death of neuronal cells in the brain. It is activated by a particular protein (Tat: Trans-activator of transcription) produced by the virus’ lifecycle. From their conclusion:
In summary, our work reveals for the first time that FOXO3 can be activated by HIV-1 Tat.. We considered that FOXO3-dependent neural apoptosis may play a role in the pathogenesis of HAND. Hence, we provide here a further understanding of the HAND pathogenesis mechanism and the FOXO3 may be the potential promising target for the therapy of HAND.

Jargon: apoptosis means cell death. pathogenesis means “what causes a disease.”

Study: https://www.frontiersin.org/articles/10.3389/fnins.2019.00044/full

This study showed that the brain amyloid burden does not differ in virally suppressed people with HAND. Elevated amyloid levels have been shown to lead to both strokes and Alzheimer’s-like brain deterioration, so it was a question of whether the similarly symptomatic HAND and Alzheimer’s had similar biomarkers. According to this study, they do not.

Study: https://nn.neurology.org/content/7/4/e739.abstract

An intriguing study from 2019 shows that there is a notable cerebrospinal fluid difference between those with and without HAND. There aren’t many current diagnostic tools that can show the causal agent for HAND symptoms, so this is a good thing to have.

Study: https://www.nature.com/articles/s41598-019-45418-2#Sec2

This one hits a few issues. First, the study was done in the context of people who have their virus suppressed so this relates to those who have controlled its effect on their immune system in general. In that group, they found a correlation between HAND and a disruption in specific areas of the blood brain barrier. They conclude that this disruption is caused by HIV already in the brain and that the disruption formed after the damage to the brain was already done.

Study: https://journals.lww.com/aidsonline/Abstract/2019/10010/Imaging_correlates_of_the_blood_brain_barrier.4.aspx

There’s no notable difference in HAND among those with a vitamin D deficiency and those with normal levels. We’re not saying stop getting your D, we’re just saying it’s not a factor here.

Abstract: https://link.springer.com/article/10.1007/s13365-018-00719-6