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Thippabhotla S, Adeyemo B, Cooley SA, Roman J, Metcalf N, Boerwinkle A, Wisch J, Paul R, Ances BM. Comparison of Resting State Functional Connectivity in Persons With and Without HIV: A Cross-sectional Study. J Infect Dis 2023; 228:751-758. [PMID: 37228129 PMCID: PMC10503955 DOI: 10.1093/infdis/jiad180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 05/15/2023] [Accepted: 05/24/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND This study examined the effects of human immunodeficiency virus (HIV) on resting state functional connectivity (RSFC) in a large cohort of people with HIV (PWH) and healthy controls without HIV (PWoH). Within PWH analyses focused on the effects of viral suppression and cognitive impairment on RSFC. METHODS A total of 316 PWH on stable combination antiretroviral therapy and 209 demographically matched PWoH were scanned at a single institution. Effects of the virus were examined by grouping PWH by detectable (viral load > 20 copies/mL; VLD) and undetectable (VLU) viral loads and as being cognitively impaired (CI) (Global Deficit Score ≥ 0.5) or cognitively normal (CN). Regression analysis, object oriented data analysis, and spring embedded graph models were applied to RSFC measures from 298 established brain regions of interest comprising 13 brain networks to examine group differences. RESULTS No significant RSFC differences were observed between PWH and PWoH. Within PWH, there were no significant differences in RSFC between VLD and VLU subgroups and CI and CN subgroups. CONCLUSIONS There were no significant effects of HIV on RSFC in our relatively large cohort of PWH and PWoH. Future studies could increase the sample size and combine with other imaging modalities.
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Affiliation(s)
| | - Babatunde Adeyemo
- School of Medicine, Washington University in St Louis, St Louis, Missouri, USA
| | - Sarah A Cooley
- School of Medicine, Washington University in St Louis, St Louis, Missouri, USA
| | - June Roman
- School of Medicine, Washington University in St Louis, St Louis, Missouri, USA
| | - Nicholas Metcalf
- School of Medicine, Washington University in St Louis, St Louis, Missouri, USA
| | - Anna Boerwinkle
- School of Medicine, Washington University in St Louis, St Louis, Missouri, USA
| | - Julie Wisch
- School of Medicine, Washington University in St Louis, St Louis, Missouri, USA
| | - Robert Paul
- University of Missouri-St Louis, St Louis, Missouri, USA
| | - Beau M Ances
- School of Medicine, Washington University in St Louis, St Louis, Missouri, USA
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2
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Chaganti J, Gates TM, Brew BJ. Reversible large-scale network disruption correlates with neurocognitive improvement in HIV-associated minor neurocognitive disorder with combined anti-retroviral therapy intensification: a prospective longitudinal resting-state functional magnetic resonance imaging study. Neurol Sci 2023; 44:3261-3269. [PMID: 37052787 DOI: 10.1007/s10072-023-06783-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 03/23/2023] [Indexed: 04/14/2023]
Abstract
OBJECTIVE HIV-associated neurocognitive disorder (HAND) affects multiple cognitive domains and currently, the neuropsychological testing is the gold standard to identify these deficits. The aim of this longitudinal 12-month pilot study is to determine the effect of intensified combination antiretroviral therapy (cART) on rs-fMRI in virally suppressed (both in CSF and blood) patients with active HAND (those who have progressive neurocognitive impairment) and correlated with neurocognitive function tests. METHODS In this pilot study, we have evaluated sixteen patients with active HAND with viral suppression in both blood and CSF to study the effect of cART on functional connectivity. Participants underwent rs-fMRI at the baseline (time point-1 (TP-1) and 12-month visits (time point-2 (TP-2)). Connectivity in the five major networks was measured at TP-1 and TP-2 using the seed-based approach. All the participants underwent a five-domain neuropsychological battery at TP-1 and TP-2. Neurocognitive scores (NC) as well as blood and CSF markers were correlated with functional connectivity (FC). RESULTS There was a significant increase in the FC between the two time points within the executive, salience, default mode, dorsal attention, and visual networks at voxel level threshold of p < 0.001 and cluster level threshold of p < 0.05 and corrected for false detection rate (FDR). The neurocognitive scores were positively correlated with all the networks at similar cluster and voxel level thresholds. CONCLUSIONS These results indicate that rs-fMRI can be potentially used as one of the biomarkers for treatment efficacy in HAND.
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Affiliation(s)
- Joga Chaganti
- Department of Medical Imaging, St Vincent's Hospital, Sydney, Australia.
| | - Thomas M Gates
- Center for Applied Medical Research Program, St Vincent's Hospital, Sydney, Australia
| | - Bruce J Brew
- Department of Neurology, Head Neuroscience Program and Peter Duncan Neuroscience Centre for Applied Medical Research, St Vincent's Hospital, University of New South Wales, Sydney, Australia
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3
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Lew BJ, McCusker MC, O'Neill J, Bares SH, Wilson TW, Doucet GE. Resting state network connectivity alterations in HIV: Parallels with aging. Hum Brain Mapp 2023; 44:4679-4691. [PMID: 37417797 PMCID: PMC10400792 DOI: 10.1002/hbm.26409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 05/10/2023] [Accepted: 06/12/2023] [Indexed: 07/08/2023] Open
Abstract
The increasing incidence of age-related comorbidities in people with HIV (PWH) has led to accelerated aging theories. Functional neuroimaging research, including functional connectivity (FC) using resting-state functional magnetic resonance imaging (rs-fMRI), has identified neural aberrations related to HIV infection. Yet little is known about the relationship between aging and resting-state FC in PWH. This study included 86 virally suppressed PWH and 99 demographically matched controls spanning 22-72 years old who underwent rs-fMRI. The independent and interactive effects of HIV and aging on FC were investigated both within- and between-network using a 7-network atlas. The relationship between HIV-related cognitive deficits and FC was also examined. We also conducted network-based statistical analyses using a brain anatomical atlas (n = 512 regions) to ensure similar results across independent approaches. We found independent effects of age and HIV in between-network FC. The age-related increases in FC were widespread, while PWH displayed further increases above and beyond aging, particularly between-network FC of the default-mode and executive control networks. The results were overall similar using the regional approach. Since both HIV infection and aging are associated with independent increases in between-network FC, HIV infection may be associated with a reorganization of the major brain networks and their functional interactions in a manner similar to aging.
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Affiliation(s)
- Brandon J. Lew
- Institute for Human NeuroscienceBoys Town National Research HospitalOmahaNebraskaUSA
- College of MedicineUniversity of Nebraska Medical Center (UNMC)OmahaNebraskaUSA
| | - Marie C. McCusker
- Institute for Human NeuroscienceBoys Town National Research HospitalOmahaNebraskaUSA
- Interdepartmental Neuroscience ProgramYale University School of MedicineNew HavenConnecticutUSA
| | - Jennifer O'Neill
- Department of Internal Medicine, Division of Infectious DiseasesUNMCOmahaNebraskaUSA
| | - Sara H. Bares
- Department of Internal Medicine, Division of Infectious DiseasesUNMCOmahaNebraskaUSA
| | - Tony W. Wilson
- Institute for Human NeuroscienceBoys Town National Research HospitalOmahaNebraskaUSA
- College of MedicineUniversity of Nebraska Medical Center (UNMC)OmahaNebraskaUSA
- Department of Pharmacology & NeuroscienceCreighton UniversityOmahaNebraskaUSA
| | - Gaelle E. Doucet
- Institute for Human NeuroscienceBoys Town National Research HospitalOmahaNebraskaUSA
- Department of Pharmacology & NeuroscienceCreighton UniversityOmahaNebraskaUSA
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4
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Channer B, Matt SM, Nickoloff-Bybel EA, Pappa V, Agarwal Y, Wickman J, Gaskill PJ. Dopamine, Immunity, and Disease. Pharmacol Rev 2023; 75:62-158. [PMID: 36757901 PMCID: PMC9832385 DOI: 10.1124/pharmrev.122.000618] [Citation(s) in RCA: 51] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 08/02/2022] [Accepted: 08/04/2022] [Indexed: 12/14/2022] Open
Abstract
The neurotransmitter dopamine is a key factor in central nervous system (CNS) function, regulating many processes including reward, movement, and cognition. Dopamine also regulates critical functions in peripheral organs, such as blood pressure, renal activity, and intestinal motility. Beyond these functions, a growing body of evidence indicates that dopamine is an important immunoregulatory factor. Most types of immune cells express dopamine receptors and other dopaminergic proteins, and many immune cells take up, produce, store, and/or release dopamine, suggesting that dopaminergic immunomodulation is important for immune function. Targeting these pathways could be a promising avenue for the treatment of inflammation and disease, but despite increasing research in this area, data on the specific effects of dopamine on many immune cells and disease processes remain inconsistent and poorly understood. Therefore, this review integrates the current knowledge of the role of dopamine in immune cell function and inflammatory signaling across systems. We also discuss the current understanding of dopaminergic regulation of immune signaling in the CNS and peripheral tissues, highlighting the role of dopaminergic immunomodulation in diseases such as Parkinson's disease, several neuropsychiatric conditions, neurologic human immunodeficiency virus, inflammatory bowel disease, rheumatoid arthritis, and others. Careful consideration is given to the influence of experimental design on results, and we note a number of areas in need of further research. Overall, this review integrates our knowledge of dopaminergic immunology at the cellular, tissue, and disease level and prompts the development of therapeutics and strategies targeted toward ameliorating disease through dopaminergic regulation of immunity. SIGNIFICANCE STATEMENT: Canonically, dopamine is recognized as a neurotransmitter involved in the regulation of movement, cognition, and reward. However, dopamine also acts as an immune modulator in the central nervous system and periphery. This review comprehensively assesses the current knowledge of dopaminergic immunomodulation and the role of dopamine in disease pathogenesis at the cellular and tissue level. This will provide broad access to this information across fields, identify areas in need of further investigation, and drive the development of dopaminergic therapeutic strategies.
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Affiliation(s)
- Breana Channer
- Department of Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, Pennsylvania (B.C., S.M.M., E.A.N-B., Y.A., J.W., P.J.G.); and The Children's Hospital of Philadelphia Research Institute, Philadelphia, Pennsylvania (V.P.)
| | - Stephanie M Matt
- Department of Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, Pennsylvania (B.C., S.M.M., E.A.N-B., Y.A., J.W., P.J.G.); and The Children's Hospital of Philadelphia Research Institute, Philadelphia, Pennsylvania (V.P.)
| | - Emily A Nickoloff-Bybel
- Department of Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, Pennsylvania (B.C., S.M.M., E.A.N-B., Y.A., J.W., P.J.G.); and The Children's Hospital of Philadelphia Research Institute, Philadelphia, Pennsylvania (V.P.)
| | - Vasiliki Pappa
- Department of Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, Pennsylvania (B.C., S.M.M., E.A.N-B., Y.A., J.W., P.J.G.); and The Children's Hospital of Philadelphia Research Institute, Philadelphia, Pennsylvania (V.P.)
| | - Yash Agarwal
- Department of Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, Pennsylvania (B.C., S.M.M., E.A.N-B., Y.A., J.W., P.J.G.); and The Children's Hospital of Philadelphia Research Institute, Philadelphia, Pennsylvania (V.P.)
| | - Jason Wickman
- Department of Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, Pennsylvania (B.C., S.M.M., E.A.N-B., Y.A., J.W., P.J.G.); and The Children's Hospital of Philadelphia Research Institute, Philadelphia, Pennsylvania (V.P.)
| | - Peter J Gaskill
- Department of Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, Pennsylvania (B.C., S.M.M., E.A.N-B., Y.A., J.W., P.J.G.); and The Children's Hospital of Philadelphia Research Institute, Philadelphia, Pennsylvania (V.P.)
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5
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Hall SA, Bell RP, Davis SW, Towe SL, Ikner TP, Meade CS. Human immunodeficiency virus-related decreases in corpus callosal integrity and corresponding increases in functional connectivity. Hum Brain Mapp 2021; 42:4958-4972. [PMID: 34382273 PMCID: PMC8449114 DOI: 10.1002/hbm.25592] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/25/2021] [Accepted: 07/06/2021] [Indexed: 12/15/2022] Open
Abstract
People living with human immunodeficiency virus (PLWH) often have neurocognitive impairment. However, findings on HIV-related differences in brain network function underlying these impairments are inconsistent. One principle frequently absent from these reports is that brain function is largely emergent from brain structure. PLWH commonly have degraded white matter; we hypothesized that functional communities connected by degraded white matter tracts would show abnormal functional connectivity. We measured white matter integrity in 69 PLWH and 67 controls using fractional anisotropy (FA) in 24 intracerebral white matter tracts. Then, among tracts with degraded FA, we identified gray matter regions connected to these tracts and measured their functional connectivity during rest. Finally, we identified cognitive impairment related to these structural and functional connectivity systems. We found HIV-related decreased FA in the corpus callosum body (CCb), which coordinates activity between the left and right hemispheres, and corresponding increases in functional connectivity. Finally, we found that individuals with impaired cognitive functioning have lower CCb FA and higher CCb functional connectivity. This result clarifies the functional relevance of the corpus callosum in HIV and provides a framework in which abnormal brain function can be understood in the context of abnormal brain structure, which may both contribute to cognitive impairment.
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Affiliation(s)
- Shana A. Hall
- Department of Psychiatry and Behavioral SciencesDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Ryan P. Bell
- Department of Psychiatry and Behavioral SciencesDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Simon W. Davis
- Department of NeurologyDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Sheri L. Towe
- Department of Psychiatry and Behavioral SciencesDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Taylor P. Ikner
- Department of Psychiatry and Behavioral SciencesDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Christina S. Meade
- Department of Psychiatry and Behavioral SciencesDuke University School of MedicineDurhamNorth CarolinaUSA
- Brain Imaging and Analysis CenterDuke University Medical CenterDurhamNorth CarolinaUSA
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6
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Fernandez Cruz AL, Chen CM, Sanford R, Collins DL, Brouillette MJ, Mayo NE, Fellows LK. Multimodal neuroimaging markers of variation in cognitive ability in older HIV+ men. PLoS One 2021; 16:e0243670. [PMID: 34314416 PMCID: PMC8315526 DOI: 10.1371/journal.pone.0243670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 07/12/2021] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE This study used converging methods to examine the neural substrates of cognitive ability in middle-aged and older men with well-controlled HIV infection. METHODS Seventy-six HIV+ men on antiretroviral treatment completed an auditory oddball task and an inhibitory control (Simon) task while time-locked high-density EEG was acquired; 66 had usable EEG data from one or both tasks; structural MRI was available for 43. We investigated relationships between task-evoked EEG responses, cognitive ability and immunocompromise. We also explored the structural correlates of these EEG markers in the sub-sample with complete EEG and MRI data (N = 27). RESULTS EEG activity was associated with cognitive ability at later (P300) but not earlier stages of both tasks. Only the oddball task P300 was reliably associated with HIV severity (nadir CD4). Source localization confirmed that the tasks engaged partially distinct circuits. Thalamus volume correlated with oddball task P300 amplitude, while globus pallidus volume was related to the P300 in both tasks. INTERPRETATION This is the first study to use task-evoked EEG to identify neural correlates of individual differences in cognition in men living with well-controlled HIV infection, and to explore the structural basis of the EEG markers. We found that EEG responses evoked by the oddball task are more reliably related to cognitive performance than those evoked by the Simon task. We also provide preliminary evidence for a subcortical contribution to the effects of HIV infection severity on P300 amplitudes. These results suggest brain mechanisms and candidate biomarkers for individual differences in cognition in HIV.
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Affiliation(s)
- Ana Lucia Fernandez Cruz
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Chien-Ming Chen
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Ryan Sanford
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - D. Louis Collins
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | | | - Nancy E. Mayo
- School of Physical and Occupational Therapy, Division of Clinical Epidemiology, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Lesley K. Fellows
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
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7
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Minosse S, Picchi E, Di Giuliano F, Sarmati L, Teti E, Pistolese CA, Lanzafame S, Di Ciò F, Guerrisi M, Andreoni M, Floris R, Toschi N, Garaci F. Functional brain network reorganization in HIV infection. J Neuroimaging 2021; 31:796-808. [PMID: 33900655 DOI: 10.1111/jon.12861] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/15/2021] [Accepted: 03/15/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND AND PURPOSE To investigate the reorganization of the central nervous system provided by resting state-functional MRI (rs-fMRI), graph-theoretical analysis, and a newly developed functional brain network disruption index in patients with human immunodeficiency virus (HIV) infection. METHODS Forty HIV-positive patients without neurological impairment and 20 age- and sex-matched healthy controls underwent rs-fMRI at 3T; blood sampling was obtained the same day to evaluate biochemical variables (absolute, relative, and nadir CD4 T-lymphocytes value and plasmatic HIV-RNA). From fMRI data, disruption indices, as well as global and local graph theoretical measures, were estimated and examined for group differences (HIV vs. controls) as well as for associations with biochemical variables (HIV only). Finally, all data (global and local graph-theoretical measures, disruption indices, and biochemical variables) were tested for putative differences across three patient groups based on the duration of combined antiretroviral therapy (cART). RESULTS Brain function of HIV patients appeared to be deeply reorganized as compared to normal controls. The disruption index showed significant negative association with relative CD4 values, and a positive significant association between plasmatic HIV-RNA and local graph-theoretical metrics in the left lingual gyrus and the right lobule IV and V of right cerebellar hemisphere was also observed. Finally, a differential distribution of HIV clinical biomarkers and several brain metrics was observed across cART duration groups. CONCLUSION Our study demonstrates that rs-fMRI combined with advanced graph theoretical analysis and disruption indices is able to detect early and subtle functional changes of brain networks in HIV patients.
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Affiliation(s)
- Silvia Minosse
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Eliseo Picchi
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Francesca Di Giuliano
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Loredana Sarmati
- Clinical Infectious Diseases, Tor Vergata University, Rome, Italy
| | - Elisabetta Teti
- Clinical Infectious Diseases, Tor Vergata University, Rome, Italy
| | - Chiara Adriana Pistolese
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Simona Lanzafame
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Francesco Di Ciò
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Maria Guerrisi
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Massimo Andreoni
- Clinical Infectious Diseases, Tor Vergata University, Rome, Italy
| | - Roberto Floris
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Nicola Toschi
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.,Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, Boston, Massachusetts, USA
| | - Francesco Garaci
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.,San Raffaele Cassino, Frosinone, Italy
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8
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Anteraper SA, Gopinath K, Hoch MJ, Waldrop-Valverde D, Franklin D, Letendre SL, Whitfield-Gabrieli S, Anderson AM. A comprehensive data-driven analysis framework for detecting impairments in brain function networks with resting state fMRI in HIV-infected individuals on cART. J Neurovirol 2021; 27:239-248. [PMID: 33666883 DOI: 10.1007/s13365-021-00943-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 12/14/2020] [Accepted: 01/12/2021] [Indexed: 10/22/2022]
Abstract
Central nervous system (CNS) sequelae continue to be common in HIV-infected individuals despite combination antiretroviral therapy (cART). These sequelae include HIV-associated neurocognitive disorder (HAND) and virologic persistence in the CNS. Resting state functional magnetic resonance imaging (rsfMRI) is a widely used tool to examine the integrity of brain function and pathology. In this study, we examined 16 HIV-positive (HIV+) subjects and 12 age, sex, and race matched HIV seronegative controls (HIV-) whole-brain high-resolution rsfMRI along with a battery of neurocognitive tests. A comprehensive data-driven analysis of rsfMRI revealed impaired functional connectivity, with very large effect sizes in executive function, language, and multisensory processing networks in HIV+ subjects. These results indicate the potential of high-resolution rsfMRI in combination with advanced data analysis techniques to yield biomarkers of neural impairment in HIV.
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Affiliation(s)
| | | | | | | | - Donald Franklin
- University of California At San Diego School of Medicine, La Jolla, San Diego, CA, USA
| | - Scott L Letendre
- University of California At San Diego School of Medicine, La Jolla, San Diego, CA, USA
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9
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Sarma MK, Pal A, Keller MA, Welikson T, Ventura J, Michalik DE, Nielsen-Saines K, Deville J, Kovacs A, Operskalski E, Church JA, Macey PM, Biswal B, Thomas MA. White matter of perinatally HIV infected older youths shows low frequency fluctuations that may reflect glial cycling. Sci Rep 2021; 11:3086. [PMID: 33542389 PMCID: PMC7862588 DOI: 10.1038/s41598-021-82587-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 01/12/2021] [Indexed: 12/15/2022] Open
Abstract
In perinatally HIV-infected (PHIV) children, neurodevelopment occurs in the presence of HIV-infection, and even with combination antiretroviral therapy (cART) the brain can be a reservoir for latent HIV. Consequently, patients often demonstrate long-term cognitive deficits and developmental delay, which may be reflected in altered functional brain activity. Our objective was to examine brain function in PHIV on cART by quantifying the amplitude of low frequency fluctuations (ALFF) and regional homogeneity (ReHo). Further, we studied ALFF and ReHo changes with neuropsychological performance and measures of immune health including CD4 count and viral loads in the HIV-infected youths. We found higher ALFF and ReHo in cerebral white matter in the medial orbital lobe for PHIV (N = 11, age mean ± sd = 22.5 ± 2.9 years) compared to controls (N = 16, age = 22.5 ± 3.0 years), with age and gender as co-variates. Bilateral cerebral white matter showed increased spontaneous regional activity in PHIV compared to healthy controls. No brain regions showed lower ALFF or ReHo in PHIV compared to controls. Higher log10 viral load was associated with higher ALFF and ReHo in PHIV in bilateral cerebral white matter and right cerebral white matter respectively after masking the outcomes intrinsic to the brain regions that showed significantly higher ALFF and ReHo in the PHIV compared to the control. Reductions in social cognition and abstract thinking in PHIV were correlated with higher ALFF at the left cerebral white matter in the left medial orbital gyrus and higher ReHo at the right cerebral white matter in the PHIV patients. Although neuroinflammation and associated neuro repair were not directly measured, the findings support their potential role in PHIV impacting neurodevelopment and cognition.
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Affiliation(s)
- Manoj K Sarma
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, Los Angeles, CA, 90095-1721, USA
| | - Amrita Pal
- UCLA School of Nursing, University of California, Los Angeles, Los Angeles, CA, USA
| | - Margaret A Keller
- Pediatrics, Harbor-UCLA Medical Center, Torrance, CA, USA.,The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Tamara Welikson
- Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Joseph Ventura
- Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - David E Michalik
- Infectious Diseases-Pediatrics, Miller Children's Hospital of Long Beach, Long Beach, CA, USA
| | | | - Jaime Deville
- David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Andrea Kovacs
- Keck School of Medicine of University of Southern California, Los Angeles, CA, USA.,Los Angeles+USC Medical Center, Los Angeles, CA, USA
| | - Eva Operskalski
- Keck School of Medicine of University of Southern California, Los Angeles, CA, USA.,Los Angeles+USC Medical Center, Los Angeles, CA, USA
| | - Joseph A Church
- Pediatrics, Keck School of Medicine of University of Southern California, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Paul M Macey
- UCLA School of Nursing, University of California, Los Angeles, Los Angeles, CA, USA
| | - Bharat Biswal
- Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, USA
| | - M Albert Thomas
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, Los Angeles, CA, 90095-1721, USA.
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10
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Nass SR, Hahn YK, McLane VD, Varshneya NB, Damaj MI, Knapp PE, Hauser KF. Chronic HIV-1 Tat exposure alters anterior cingulate cortico-basal ganglia-thalamocortical synaptic circuitry, associated behavioral control, and immune regulation in male mice. Brain Behav Immun Health 2020; 5:100077. [PMID: 33083793 PMCID: PMC7571616 DOI: 10.1016/j.bbih.2020.100077] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 04/25/2020] [Indexed: 12/28/2022] Open
Abstract
HIV-1 selectively disrupts neuronal integrity within specific brain regions, reflecting differences in viral tropism and/or the regional differences in the vulnerability of distinct neuronal subpopulations within the CNS. Deficits in prefrontal cortex (PFC)-mediated executive function and the resultant loss of behavioral control are a particularly debilitating consequence of neuroHIV. To explore how HIV-1 disrupts executive function, we investigated the effects of 48 h, 2 and/or 8 weeks of HIV-1 Tat exposure on behavioral control, synaptic connectivity, and neuroimmune function in the anterior cingulate cortex (ACC) and associated cortico-basal ganglia (BG)-thalamocortical circuitry in adult, Tat transgenic male mice. HIV-1 Tat exposure increased novelty-exploration in response to novel food, flavor, and environmental stimuli, suggesting that Tat triggers increased novelty-exploration in situations of competing motivation (e.g., drive to feed or explore vs. fear of novel, brightly lit open areas). Furthermore, Tat induced adaptability in response to an environmental stressor and pre-attentive filtering deficits. The behavioral insufficiencies coincided with decreases in the inhibitory pre- and post-synaptic proteins, synaptotagmin 2 and gephyrin, respectively, in the ACC, and alterations in specific pro- and anti-inflammatory cytokines out of 23 assayed. The interaction of Tat exposure and the resultant time-dependent, selective alterations in CCL4, CXCL1, IL-12p40, and IL-17A levels in the PFC predicted significant decreases in adaptability. Tat decreased dendritic spine density and cortical VGLUT1 inputs, while increasing IL-1β, IL-6, CCL5, and CCL11 in the striatum. Alternatively, IL-1α, CCL5, and IL-13 were decreased in the mediodorsal thalamus despite the absence of synaptic changes. Thus, HIV-1 Tat appears to uniquely and systematically disrupt immune regulation and the inhibitory and excitatory synaptic balance throughout the ACC-BG-thalamocortical circuitry resulting in a loss of behavioral control.
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Affiliation(s)
- Sara R. Nass
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Medical College of Virginia (MCV) Campus, Richmond, P.O. Box 980613, VA, 23298-0613, USA
| | - Yun K. Hahn
- Department of Anatomy and Neurobiology, Virginia Commonwealth University, Medical College of Virginia (MCV) Campus, P.O. Box 980709, Richmond, VA, 23298-0709, USA
| | - Virginia D. McLane
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Medical College of Virginia (MCV) Campus, Richmond, P.O. Box 980613, VA, 23298-0613, USA
| | - Neil B. Varshneya
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Medical College of Virginia (MCV) Campus, Richmond, P.O. Box 980613, VA, 23298-0613, USA
| | - M. Imad Damaj
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Medical College of Virginia (MCV) Campus, Richmond, P.O. Box 980613, VA, 23298-0613, USA
| | - Pamela E. Knapp
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Medical College of Virginia (MCV) Campus, Richmond, P.O. Box 980613, VA, 23298-0613, USA
- Department of Anatomy and Neurobiology, Virginia Commonwealth University, Medical College of Virginia (MCV) Campus, P.O. Box 980709, Richmond, VA, 23298-0709, USA
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Medical College of Virginia (MCV) Campus, P.O. Box 980059, Richmond, VA, 23298-0059, USA
| | - Kurt F. Hauser
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Medical College of Virginia (MCV) Campus, Richmond, P.O. Box 980613, VA, 23298-0613, USA
- Department of Anatomy and Neurobiology, Virginia Commonwealth University, Medical College of Virginia (MCV) Campus, P.O. Box 980709, Richmond, VA, 23298-0709, USA
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Medical College of Virginia (MCV) Campus, P.O. Box 980059, Richmond, VA, 23298-0059, USA
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11
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Philippi CL, Reyna L, Nedderman L, Chan P, Samboju V, Chang K, Phanuphak N, Ratnaratorn N, Hellmuth J, Benjapornpong K, Dumrongpisutikul N, Pothisri M, Robb ML, Ananworanich J, Spudich S, Valcour V, Paul R. Resting-state neural signatures of depressive symptoms in acute HIV. J Neurovirol 2020; 26:226-240. [PMID: 31989446 PMCID: PMC7261250 DOI: 10.1007/s13365-020-00826-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 09/23/2019] [Accepted: 01/16/2020] [Indexed: 02/07/2023]
Abstract
Depressive symptoms are often elevated in acute and chronic HIV. Previous neuroimaging research identifies abnormalities in emotion-related brain regions in depression without HIV, including the anterior cingulate cortex (ACC) and amygdala. However, no studies have examined the neural signatures of depressive symptoms in acute HIV infection (AHI). Seed-based voxelwise resting-state functional connectivity (rsFC) for affective seed regions of interest (pregenual ACC, subgenual ACC [sgACC], bilateral amygdala) was computed for 74 Thai males with AHI and 30 Thai HIV-uninfected controls. Group analyses compared rsFC of ACC and amygdala seed regions between AHI and uninfected control groups. Within the AHI group, voxelwise regression analyses investigated the relationship between depressive symptoms and rsFC for these affective seed regions. Group analyses revealed alterations in rsFC of the amygdala in AHI versus uninfected controls. Depressive symptoms associated with decreased rsFC between ACC regions and posterior cingulate/precuneus, medial temporal, and lateral parietal regions in AHI. Symptoms of depression also correlated to increased rsFC between ACC regions and lateral prefrontal cortex, sgACC, and cerebellum in AHI. Similar to the ACC, depressive symptoms associated with decreased rsFC between amygdala and precuneus. Of blood biomarkers, only HIV RNA inversely correlated with rsFC between posterior sgACC and left uncus. We found that depressive symptoms in AHI associate with altered rsFC of ACC and amygdala regions previously implicated in depression. Longitudinal research in this cohort will be necessary to determine whether these early alterations in rsFC of affective network regions are related to persistent depressive symptoms after combination antiretroviral therapy.
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Affiliation(s)
- Carissa L Philippi
- Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO, USA.
| | - Leah Reyna
- Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO, USA
| | - Laura Nedderman
- Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO, USA
| | - Phillip Chan
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - Vishal Samboju
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Kevin Chang
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | | | | | - Joanna Hellmuth
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | | | | | - Mantana Pothisri
- Department of Radiology, Chulalongkorn University Medical Center, Bangkok, Thailand
| | - Merlin L Robb
- U.S. Military HIV Research Program, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Jintanat Ananworanich
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
- U.S. Military HIV Research Program, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
- Department of Global Health, The University of Amsterdam, Amsterdam, The Netherlands
| | - Serena Spudich
- Department of Neurology, Yale University, New Haven, CT, USA
| | - Victor Valcour
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Robert Paul
- Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO, USA
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12
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HIV-related decreased brain activity during a semantic memory task is reflected in spontaneous brain functional connectivity. HEALTH PSYCHOLOGY REPORT 2020. [DOI: 10.5114/hpr.2020.94720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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13
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Dopaminergic impact of cART and anti-depressants on HIV neuropathogenesis in older adults. Brain Res 2019; 1723:146398. [PMID: 31442412 DOI: 10.1016/j.brainres.2019.146398] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 08/09/2019] [Accepted: 08/19/2019] [Indexed: 01/21/2023]
Abstract
The success of combination antiretroviral therapy (cART) has transformed HIV infection into a chronic condition, resulting in an increase in the number of older, cART-treated adults living with HIV. This has increased the incidence of age-related, non-AIDS comorbidities in this population. One of the most common comorbidities is depression, which is also associated with cognitive impairment and a number of neuropathologies. In older people living with HIV, treating these overlapping disorders is complex, often creating pill burden or adverse drug-drug interactions that can exacerbate these neurologic disorders. Depression, NeuroHIV and many of the neuropsychiatric therapeutics used to treat them impact the dopaminergic system, suggesting that dopaminergic dysfunction may be a common factor in the development of these disorders. Further, changes in dopamine can influence the development of inflammation and the regulation of immune function, which are also implicated in the progression of NeuroHIV and depression. Little is known about the optimal clinical management of drug-drug interactions between cART drugs and antidepressants, particularly in regard to dopamine in older people living with HIV. This review will discuss those interactions, first examining the etiology of NeuroHIV and depression in older adults, then discussing the interrelated effects of dopamine and inflammation on these disorders, and finally reviewing the activity and interactions of cART drugs and antidepressants on each of these factors. Developing better strategies to manage these comorbidities is critical to the health of the aging, HIV-infected population, as the older population may be particularly vulnerable to drug-drug interactions affecting dopamine.
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14
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Abstract
Neurologic involvement of HIV remains an important concern for patients, physicians, and investigators. Catastrophic decline is rarely seen in patients on combination antiretroviral therapy (cART); however, neurological decline remains a critical clinical challenge. In this issue of the JCI, Spudich and associates investigated the status of HIV in the cerebral spinal fluid (CSF) and revealed ongoing presence of HIV in the nervous system. Surprisingly, even in the face of optimal treatment, including suppressed HIV RNA, almost half of the patients investigated showed cell-associated HIV (CA-HIV) DNA in the CSF. Spudich et al. find that persistence of HIV in CSF cells is associated with lower performance on neurocognitive testing. These findings emphasize the need to consider a viral-associated mechanism as playing a significant and potentially ongoing role in HIV-associated neurocognitive disorder (HAND).
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15
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Diagnostic and prognostic biomarkers for HAND. J Neurovirol 2019; 25:686-701. [PMID: 30607890 DOI: 10.1007/s13365-018-0705-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 11/13/2018] [Accepted: 11/16/2018] [Indexed: 02/06/2023]
Abstract
In 2007, the nosology for HIV-1-associated neurocognitive disorders (HAND) was updated to a primarily neurocognitive disorder. However, currently available diagnostic tools lack the sensitivity and specificity needed for an accurate diagnosis for HAND. Scientists and clinicians, therefore, have been on a quest for an innovative biomarker to diagnose (i.e., diagnostic biomarker) and/or predict (i.e., prognostic biomarker) the progression of HAND in the post-combination antiretroviral therapy (cART) era. The present review examined the utility and challenges of four proposed biomarkers, including neurofilament light (NFL) chain concentration, amyloid (i.e., sAPPα, sAPPβ, amyloid β) and tau proteins (i.e., total tau, phosphorylated tau), resting-state functional magnetic resonance imaging (fMRI), and prepulse inhibition (PPI). Although significant genotypic differences have been observed in NFL chain concentration, sAPPα, sAPPβ, amyloid β, total tau, phosphorylated tau, and resting-state fMRI, inconsistencies and/or assessment limitations (e.g., invasive procedures, lack of disease specificity, cost) challenge their utility as a diagnostic and/or prognostic biomarker for milder forms of neurocognitive impairment (NCI) in the post-cART era. However, critical evaluation of the literature supports the utility of PPI as a powerful diagnostic biomarker with high accuracy (i.e., 86.7-97.1%), sensitivity (i.e., 89.3-100%), and specificity (i.e., 79.5-94.1%). Additionally, the inclusion of multiple CSF and/or plasma markers, rather than a single protein, may provide a more sensitive diagnostic biomarker for HAND; however, a pressing need for additional research remains. Most notably, PPI may serve as a prognostic biomarker for milder forms of NCI, evidenced by its ability to predict later NCI in higher-order cognitive domains with regression coefficients (i.e., r) greater than 0.8. Thus, PPI heralds an opportunity for the development of a brief, noninvasive diagnostic and promising prognostic biomarker for milder forms of NCI in the post-cART era.
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16
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Li R, Wang W, Wang Y, Peters S, Zhang X, Li H. Effects of early HIV infection and combination antiretroviral therapy on intrinsic brain activity: a cross-sectional resting-state fMRI study. Neuropsychiatr Dis Treat 2019; 15:883-894. [PMID: 31114203 PMCID: PMC6497505 DOI: 10.2147/ndt.s195562] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 03/06/2019] [Indexed: 12/16/2022] Open
Abstract
Objective: To investigate effects of early HIV infection and combination antiretroviral therapy (cART) on intrinsic brain activity by using amplitude of low-frequency fluctuation (ALFF) analysis. Patients and methods: Forty-nine HIV patients, including 26 with cART (HIV+/cART+) and 23 treatment-naïve (HIV+/cART-), and 25 matched healthy controls (HCs) underwent resting-state functional magnetic resonance imaging examination. ALFF values were compared by using one-way ANOVA tests with Analysis of Functional NeuroImages (AFNI)'s 3dClustSim correction (voxel p<0.005, α<0.05). In addition, the ALFF values of brain regions that showed significant differences among the three groups were correlated with clinical and neuropsychological variables in both groups of patients by using Spearman correlation analysis. Results: ANOVA analysis showed that statistic difference of ALFF values among three groups was located in the occipital cortex. Post hoc analysis showed a decrease in occipital ALFF value in HIV patients compared to HC, but showed no difference of occipital ALFF between HIV+/cART+ and HIV+/cART-. Additionally, compared with HC, HIV+/cART+ exhibited higher ALFF in the right caudate and frontoparietal cortex, and HIV+/cART- showed higher ALFF in the bilateral caudate. HIV+/cART+ demonstrated higher ALFF values in auditory cortex than HIV+/cART-. Moreover, ALFF values in the right occipital cortex were positively associated with CD4+/CD8+ ratio and executive function in HIV+/cART-. Conclusion: Early HIV-infected individuals presented reduced spontaneous brain activity in the occipital cortex. cART appeared to be ineffective in halting the HIV-induced neurodegeneration but might delay the progression of neural dysfunction to some extent. ALFF might be a potential biomarker in monitoring the effects of HIV and cART on brain function.
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Affiliation(s)
- Ruili Li
- Department of Radiology, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, People's Republic of China
| | - Wei Wang
- Department of Radiology, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, People's Republic of China
| | - Yuanyuan Wang
- Department of Radiology, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, People's Republic of China
| | - Sönke Peters
- Clinic for Radiology and Neuroradiology, University Hospital of Schleswig-Holstein, Kiel 24105, Germany
| | - Xiaodong Zhang
- Department of Radiology, Tianjin First Central Hospital, Tianjin, 300192, People's Republic of China
| | - Hongjun Li
- Department of Radiology, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, People's Republic of China
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17
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Zhao J, Chen F, Ren M, Li L, Li A, Jing B, Li H. Low-frequency fluctuation characteristics in rhesus macaques with SIV infection: a resting-state fMRI study. J Neurovirol 2018; 25:141-149. [PMID: 30478797 DOI: 10.1007/s13365-018-0694-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 10/16/2018] [Accepted: 10/25/2018] [Indexed: 12/18/2022]
Abstract
Simian immunodeficiency virus (SIV)-infected macaque is a widely used model to study human immunodeficiency virus. The purpose of the study is to discover the amplitude of low-frequency fluctuation (ALFF) and fractional ALFF (fALFF) changes in SIV-infected macaques. Seven rhesus macaques were involved in the longitudinal MRI scans: (1) baseline (healthy state); (2) SIV infection stage (12 weeks after SIV inoculation). ALFF and fALFF were subsequently computed and compared to ascertain the changes caused by SIV infection. Whole-brain correlation analysis was further used to explore the possible associations between ALFF/fALFF values and immune status parameters (CD4+ T cell counts, CD4/CD8 ratio and virus load). Compared with the baseline, macaques in SIV infection stage displayed strengthened ALFF values in left precuneus, postcentral gyrus, and temporal gyrus, and weakened ALFF values in orbital gyrus and inferior temporal gyrus. Meanwhile, increased fALFF values were found in left superior frontal gyrus, right precentral gyrus, and superior temporal gyrus, while decreased fALFF values existed in left hippocampus, left caudate, and right inferior frontal gyrus. Furthermore, ALFF and fALFF values in several brain regions showed significant relationships with CD4+ T cell counts, CD4/CD8 ratio, and plasma virus load. Our findings could promote the understanding of neuroAIDS caused by HIV infection, which may provide supplementary evidences for the future therapy study in SIV model.
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Affiliation(s)
- Jing Zhao
- Department of Radiology, Beijing Youan Hospital, Capital Medical University, No.8, Xi Tou Tiao, You An MenWai, Feng Tai District, Beijing, 100069, China
| | - Feng Chen
- Department of Radiology, Beijing Youan Hospital, Capital Medical University, No.8, Xi Tou Tiao, You An MenWai, Feng Tai District, Beijing, 100069, China
| | - Meiji Ren
- Department of Radiology, Beijing Youan Hospital, Capital Medical University, No.8, Xi Tou Tiao, You An MenWai, Feng Tai District, Beijing, 100069, China
| | - Li Li
- Department of Radiology, Beijing Youan Hospital, Capital Medical University, No.8, Xi Tou Tiao, You An MenWai, Feng Tai District, Beijing, 100069, China
| | - Aixin Li
- Department of Infectious Diseases, Beijing Youan Hospital, Capital Medical University, No.8, Xi Tou Tiao, You An Men Wai, Feng Tai District, Beijing, 10069, China
| | - Bin Jing
- School of Biomedical Engineering, Capital Medical University, No.10, Xi Tou Tiao, You An Men Wai, Feng Tai District, Beijing, 100069, China.
| | - Hongjun Li
- Department of Radiology, Beijing Youan Hospital, Capital Medical University, No.8, Xi Tou Tiao, You An MenWai, Feng Tai District, Beijing, 100069, China.
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18
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Yadav SK, Gupta RK, Hashem S, Bhat AA, Garg RK, Venkatesh V, Gupta PK, Singh AK, Chaturvedi S, Ahmed SN, Azeem MW, Haris M. Changes in resting-state functional brain activity are associated with waning cognitive functions in HIV-infected children. NEUROIMAGE-CLINICAL 2018; 20:1204-1210. [PMID: 30391858 PMCID: PMC6224323 DOI: 10.1016/j.nicl.2018.10.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 10/22/2018] [Accepted: 10/26/2018] [Indexed: 01/13/2023]
Abstract
Delayed brain development in perinatally HIV-infected children may affect the functional brain activity and subsequently cognitive function. The current study evaluated the functional brain activity in HIV-infected children by quantifying the amplitude of low frequency fluctuations (ALFF) and functional connectivity (FC). Additionally, correlation of ALFF and FC with cognitive measures was performed. Twenty-six HIV-infected children and 20 control children underwent neuropsychological (NP) assessment and resting-state functional magnetic resonance imaging (rs-fMRI). ALFF and FC maps were generated and group differences were analyzed using two-sample t-test. Furthermore, ALFF and FC showing significant group differences were correlated with NP scores using Pearson's correlation. Significantly lower ALFF in the left middle temporal gyrus, precentral and post central gyrus was observed in HIV-infected children compared to controls. FC was significantly reduced in the right inferior parietal, vermis, middle temporal and left postcentral regions, and significantly increased in the right precuneus, superior parietal and left middle frontal regions in HIV-infected children as compared to control. HIV-infected children showed significantly lower NP scores in various domains including closure, exclusion, memory, verbal meaning, quantity and hidden figure than controls. These waning cognitive functions were significantly associated with changes in ALFF and FC in HIV-infected children. The findings suggest that abnormal ALFF and FC may responsible for cognitive deficits in HIV-infected children. ALFF and FC in association with cognitive evaluation may provide a clinical biomarker to evaluate functional brain activity and to plan neurocognitive intervention in HIV-infected children undergoing standard treatment.
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Affiliation(s)
- Santosh K Yadav
- Division of Translational Medicine, Research Branch, Sidra Medicine, Doha, Qatar.
| | - Rakesh K Gupta
- Department of Radiology and Imaging, Fortis Memorial Research Institute, Gurgaon, India
| | - Sheema Hashem
- Division of Translational Medicine, Research Branch, Sidra Medicine, Doha, Qatar
| | - Ajaz A Bhat
- Division of Translational Medicine, Research Branch, Sidra Medicine, Doha, Qatar
| | - Ravindra K Garg
- Department of Neurology, King George Medical University, Lucknow, India
| | - Vimala Venkatesh
- Department of Microbiology, King George Medical University, Lucknow, India
| | - Pradeep K Gupta
- Department of Radiology and Imaging, Fortis Memorial Research Institute, Gurgaon, India
| | - Alok K Singh
- Department of Neurology, King George Medical University, Lucknow, India
| | - Saurabh Chaturvedi
- Department of Pediatric Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Sabha Nisar Ahmed
- Division of Translational Medicine, Research Branch, Sidra Medicine, Doha, Qatar
| | - Muhammad W Azeem
- Department of Psychiatry, Sidra Medicine/Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Mohammad Haris
- Division of Translational Medicine, Research Branch, Sidra Medicine, Doha, Qatar; Laboratory Animal Research Center, Qatar University, Doha, Qatar
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19
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Toich JTF, Taylor PA, Holmes MJ, Gohel S, Cotton MF, Dobbels E, Laughton B, Little F, van der Kouwe AJW, Biswal B, Meintjes EM. Functional Connectivity Alterations between Networks and Associations with Infant Immune Health within Networks in HIV Infected Children on Early Treatment: A Study at 7 Years. Front Hum Neurosci 2018; 11:635. [PMID: 29375341 PMCID: PMC5768628 DOI: 10.3389/fnhum.2017.00635] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 12/12/2017] [Indexed: 12/22/2022] Open
Abstract
Although HIV has been shown to impact brain connectivity in adults and youth, it is not yet known to what extent long-term early antiretroviral therapy (ART) may alter these effects, especially during rapid brain development in early childhood. Using both independent component analysis (ICA) and seed-based correlation analysis (SCA), we examine the effects of HIV infection in conjunction with early ART on resting state functional connectivity (FC) in 7 year old children. HIV infected (HIV+) children were from the Children with HIV Early Antiretroviral Therapy (CHER) trial and all initiated ART before 18 months; uninfected children were recruited from an interlinking vaccine trial. To better understand the effects of current and early immune health on the developing brain, we also investigated among HIV+ children the association of FC at 7 years with CD4 count and CD4%, both in infancy (6–8 weeks) and at scan. Although we found no differences within any ICA-generated resting state networks (RSNs) between HIV+ and uninfected children (27 HIV+, 18 uninfected), whole brain connectivity to seeds located at RSN connectivity peaks revealed several loci of FC differences, predominantly from seeds in midline regions (posterior cingulate cortex, paracentral lobule, cuneus, and anterior cingulate). Reduced long-range connectivity and increased short-range connectivity suggest developmental delay. Within the HIV+ children, clinical measures at age 7 years were not associated with FC values in any of the RSNs; however, poor immune health during infancy was associated with localized FC increases in the somatosensory, salience and basal ganglia networks. Together these findings suggest that HIV may affect brain development from its earliest stages and persist into childhood, despite early ART.
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Affiliation(s)
- Jadrana T F Toich
- MRC/UCT Medical Imaging Research Unit, Division of Biomedical Engineering, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Paul A Taylor
- MRC/UCT Medical Imaging Research Unit, Division of Biomedical Engineering, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,African Institute for Mathematical Sciences, Muizenberg, South Africa.,Scientific and Statistical Computing Core, National Institutes of Health, Bethesda, MD, United States
| | - Martha J Holmes
- MRC/UCT Medical Imaging Research Unit, Division of Biomedical Engineering, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Suril Gohel
- Department of Health Informatics, School of Health Professions, Rutgers University, Newark, NJ, United States
| | - Mark F Cotton
- Family Clinical Research Unit, Department of Paediatrics and Child Health, Stellenbosch University, Stellenbosch, South Africa
| | - Els Dobbels
- Family Clinical Research Unit, Department of Paediatrics and Child Health, Stellenbosch University, Stellenbosch, South Africa
| | - Barbara Laughton
- Family Clinical Research Unit, Department of Paediatrics and Child Health, Stellenbosch University, Stellenbosch, South Africa
| | - Francesca Little
- Department of Statistical Sciences, University of Cape Town, Cape Town, South Africa
| | | | - Bharat Biswal
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, United States
| | - Ernesta M Meintjes
- MRC/UCT Medical Imaging Research Unit, Division of Biomedical Engineering, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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20
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Zhuang Y, Qiu X, Wang L, Ma Q, Mapstone M, Luque A, Weber M, Tivarus M, Miller E, Arduino RC, Zhong J, Schifitto G. Combination antiretroviral therapy improves cognitive performance and functional connectivity in treatment-naïve HIV-infected individuals. J Neurovirol 2017; 23:704-712. [PMID: 28791662 PMCID: PMC5655604 DOI: 10.1007/s13365-017-0553-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 05/20/2017] [Accepted: 07/10/2017] [Indexed: 11/28/2022]
Abstract
Our study aimed to investigate the short-term effect of combination antiretroviral therapy (cART) on cognitive performance and functional and structural connectivity and their relationship to plasma levels of antiretroviral (ARV) drugs. Seventeen ARV treatment-naïve HIV-infected individuals (baseline mean CD4 cell count, 479 ± 48 cells/mm3) were age matched with 17 HIV-uninfected individuals. All subjects underwent a detailed neurocognitive and functional assessment and magnetic resonance imaging. HIV-infected subjects were scanned before starting cART and 12 weeks after initiation of treatment. Uninfected subjects were assessed once at baseline. Functional connectivity (FC) was assessed within the default mode network while structural connectivity was assessed by voxel-wise analysis using tract-based spatial statistics (TBSS) and probabilistic tractography within the DMN. Tenofovir and emtricitabine blood concentration were measured at week 12 of cART. Prior to cART, HIV-infected individuals had significantly lower cognitive performance than control subjects as measured by the total Z-score from the neuropsychological tests assessing six cognitive domains (p = 0.020). After 12 weeks of cART treatment, there remained only a weak cognitive difference between HIV-infected and HIV-uninfected subjects (p = 0.057). Mean FC was lower in HIV-infected individuals compared with those uninfected (p = 0.008), but FC differences became non-significant after treatment (p = 0.197). There were no differences in DTI metrics between HIV-infected and HIV-uninfected individuals using the TBSS approach and limited evidence of decreased structural connectivity within the DMN in HIV-infected individuals. Tenofovir and emtricitabine plasma concentrations did not correlate with either cognitive performance or imaging metrics. CONCLUSIONS Twelve weeks of cART improves cognitive performance and functional connectivity in ARV treatment-naïve HIV-infected individuals with relatively preserved immune function. Longer periods of observation are necessary to assess whether this effect is maintained.
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Affiliation(s)
- Yuchuan Zhuang
- Department of Electrical and Computer Engineering, University of Rochester, Rochester, NY, USA
| | - Xing Qiu
- Department of Biostatistics and Computational Biology, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY, USA
| | - Lu Wang
- Department of Biostatistics and Computational Biology, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY, USA
| | - Qing Ma
- Department of Pharmacy Practice, University at Buffalo, Buffalo, NY, USA
| | - Mark Mapstone
- Department of Neurology, University of California, Irvine School of Medicine, Irvine, CA, USA
| | - Amneris Luque
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Miriam Weber
- Department of Neurology, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY, USA
| | - Madalina Tivarus
- Department of Imaging Sciences, School of Medicine and Dentistry, University of Rochester Medical Center, 601 Elmwood Ave, Box 673, Rochester, NY, 14642, USA
| | - Eric Miller
- Department of Psychiatry and Bio-behavioral Sciences, University of California, Los Angeles, CA, USA
| | - Roberto C Arduino
- Division of Infectious Diseases, Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Jianhui Zhong
- Department of Imaging Sciences, School of Medicine and Dentistry, University of Rochester Medical Center, 601 Elmwood Ave, Box 673, Rochester, NY, 14642, USA
| | - Giovanni Schifitto
- Department of Neurology, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY, USA. .,Department of Imaging Sciences, School of Medicine and Dentistry, University of Rochester Medical Center, 601 Elmwood Ave, Box 673, Rochester, NY, 14642, USA.
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