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McGuire JL, Grinspan JB, Jordan-Sciutto KL. Update on Central Nervous System Effects of HIV in Adolescents and Young Adults. Curr HIV/AIDS Rep 2023; 20:19-28. [PMID: 36809477 PMCID: PMC10695667 DOI: 10.1007/s11904-023-00651-3] [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] [Accepted: 01/15/2023] [Indexed: 02/23/2023]
Abstract
PURPOSE OF REVIEW : Behaviorally acquired (non-perinatal) HIV infection during adolescence and young adulthood occurs in the midst of key brain developmental processes such as frontal lobe neuronal pruning and myelination of white matter, but we know little about the effects of new infection and therapy on the developing brain. RECENT FINDINGS Adolescents and young adults account for a disproportionately high fraction of new HIV infections each year. Limited data exist regarding neurocognitive performance in this age group, but suggest impairment is at least as prevalent as in older adults, despite lower viremia, higher CD4 + T cell counts, and shorter durations of infection in adolescents/young adults. Neuroimaging and neuropathologic studies specific to this population are underway. The full impact of HIV on brain growth and development in youth with behaviorally acquired HIV has yet to be determined; it must be investigated further to develop future targeted treatment and mitigation strategies.
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Affiliation(s)
- Jennifer L McGuire
- Division of Neurology, Children's Hospital of Philadelphia, 3501 Civic Center Blvd, Philadelphia, PA, 19104, USA.
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
| | - Judith B Grinspan
- Division of Neurology, Children's Hospital of Philadelphia, 3501 Civic Center Blvd, Philadelphia, PA, 19104, USA
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Kelly L Jordan-Sciutto
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
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2
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Monick AJ, Joyce MR, Chugh N, Creighton JA, Morgan OP, Strain EC, Marvel CL. Characterization of basal ganglia volume changes in the context of HIV and polysubstance use. Sci Rep 2022; 12:4357. [PMID: 35288604 PMCID: PMC8921181 DOI: 10.1038/s41598-022-08364-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 03/04/2022] [Indexed: 11/10/2022] Open
Abstract
HIV and psychoactive substances can impact the integrity of the basal ganglia (BG), a neural substrate of cognition, motor control, and reward-seeking behaviors. This study assessed BG gray matter (GM) volume as a function of polysubstance (stimulant and opioid) use and HIV status. We hypothesized that comorbid polysubstance use and HIV seropositivity would alter BG GM volume differently than would polysubstance use or HIV status alone. We collected structural MRI scans, substance use history, and HIV diagnoses. Participants who had HIV (HIV +), a history of polysubstance dependence (POLY +), both, or neither completed assessments for cognition, motor function, and risk-taking behaviors (N = 93). All three clinical groups showed a left-lateralized pattern of GM reduction in the BG relative to controls. However, in the HIV + /POLY + group, stimulant use was associated with increased GM volume within the globus pallidus and putamen. This surpassed the effects from opioid use, as indicated by decreased GM volume throughout the BG in the HIV-/POLY + group. Motor learning was impaired in all three clinical groups, and in the HIV + /POLY + group, motor learning was associated with increased caudate and putamen GM volume. We also observed associations between BG GM volume and risk-taking behaviors in the HIV + /POLY- and HIV-/POLY + groups. The effects of substance use on the BG differed as a function of substance type used, HIV seropositivity, and BG subregion. Although BG volume decreased in association with HIV and opioid use, stimulants can, inversely, lead to BG volume increases within the context of HIV.
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Affiliation(s)
- Andrew J Monick
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - Michelle R Joyce
- Department of Neurology, Johns Hopkins University School of Medicine, 1620 McElderry St., Reed Hall W102A, Baltimore, MD, 21205, USA
| | - Natasha Chugh
- Department of Neurology, Johns Hopkins University School of Medicine, 1620 McElderry St., Reed Hall W102A, Baltimore, MD, 21205, USA
| | - Jason A Creighton
- Department of Neurology, Johns Hopkins University School of Medicine, 1620 McElderry St., Reed Hall W102A, Baltimore, MD, 21205, USA
| | - Owen P Morgan
- Department of Neurology, Johns Hopkins University School of Medicine, 1620 McElderry St., Reed Hall W102A, Baltimore, MD, 21205, USA
- Department of Psychology, Cornell University, Ithaca, NY, 14853, USA
| | - Eric C Strain
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Cherie L Marvel
- Department of Neurology, Johns Hopkins University School of Medicine, 1620 McElderry St., Reed Hall W102A, Baltimore, MD, 21205, USA.
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA.
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Hall SA, Towe SL, Nadeem MT, Hobkirk AL, Hartley BW, Li R, Huettel SA, Meade CS. Hypoactivation in the precuneus and posterior cingulate cortex during ambiguous decision making in individuals with HIV. J Neurovirol 2021; 27:463-475. [PMID: 33983505 PMCID: PMC8276275 DOI: 10.1007/s13365-021-00981-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 03/10/2021] [Accepted: 04/14/2021] [Indexed: 11/25/2022]
Abstract
People with human immunodeficiency virus (HIV) often have neurocognitive impairment. People with HIV make riskier decisions when the outcome probabilities are known, and have abnormal neural architecture underlying risky decision making. However, ambiguous decision making, when the outcome probabilities are unknown, is more common in daily life, but the neural architecture underlying ambiguous decision making in people with HIV is unknown. Eighteen people with HIV and 20 controls completed a decision making task while undergoing functional magnetic resonance imaging scanning. Participants chose between a certain reward and uncertain reward with a known (risky) or unknown (ambiguous) probability of winning. There were three levels of risk: high, medium, and low. Ambiguous > risky brain activity was compared between groups. Ambiguous > risky brain activity was correlated with emotional/psychiatric functioning in people with HIV. Both groups were similarly ambiguity-averse. People with HIV were more risk-averse than controls and chose the high-risk uncertain option less often. People with HIV had hypoactivity in the precuneus, posterior cingulate cortex (PCC), and fusiform gyrus during ambiguous > medium risk decision making. Ambiguous > medium risk brain activity was negatively correlated with emotional/psychiatric functioning in individuals with HIV. To make ambiguous decisions, people with HIV underrecruit key regions of the default mode network, which are thought to integrate internally and externally derived information to come to a decision. These regions and related cognitive processes may be candidates for interventions to improve decision-making outcomes in people with HIV.
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Affiliation(s)
- Shana A Hall
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27710, USA.
| | - Sheri L Towe
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27710, USA
| | - M Tauseef Nadeem
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27710, USA
| | - Andrea L Hobkirk
- Department of Psychiatry and Behavioral Sciences, Pennsylvania State University, 500 University Dr. Hershey, PA, 17033, USA
- Department of Public Health Sciences, Pennsylvania State University, 700 HMC Crescent Rd., Hershey, PA, 17033, USA
| | - Bennett W Hartley
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27710, USA
| | - Rosa Li
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, Campus Box #3270 235 E. Cameron Ave., Chapel Hill, NC, 27599-3270, USA
| | - Scott A Huettel
- Department of Psychology and Neuroscience, Duke University, 417 Chapel Dr. Campus Box 90086, Durham, NC, 27708-0086, USA
| | - Christina S Meade
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27710, USA
- Brain Imaging and Analysis Center, Duke University Medical Center, Campus Box 3918, Durham, NC, 27710, USA
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Rowe K, Buivydaite R, Heinsohn T, Rahimzadeh M, Wagner RG, Scerif G, Stein A. Executive function in HIV-affected children and adolescents: a systematic review and meta-analyses. AIDS Care 2021; 33:833-857. [PMID: 33764813 DOI: 10.1080/09540121.2021.1873232] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This review aimed to determine: whether EF is affected in children and adolescents (2-24-years-old) with perinatal HIV infection, perinatal HIV exposure without infection, and behaviourally acquired HIV. A systematic review (PROSPERO number: CRD42017067813) was conducted using 11 electronic databases (01.01.1981-09.07.2019) and 8 conference websites. Primary quantitative studies with EF scores on cognitive tasks and/or behavioural report measures were included. Meta-analyses were performed by EF subtype and subpopulations compared. 1789 records were found. Sixty-one studies were included in the narrative synthesis; 32 (N = 7884 participants) were included in meta-analyses. There was a distinct pattern of reduced EF in those with perinatal HIV infection on antiretroviral therapy compared to controls: pooled effect sizes were largest for verbal and visuospatial working memory, with smaller effects on planning, inhibitory control and set-shifting. Data were limited for other HIV-affected subpopulations. Perinatal HIV infection is associated with reduced EF with varying effect sizes for the different EF subtypes.
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Affiliation(s)
- Kirsten Rowe
- Child and Adolescent Psychiatry, Department of Psychiatry, University of Oxford, Oxford, UK.,MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Ruta Buivydaite
- Child and Adolescent Psychiatry, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Torben Heinsohn
- Medical School, Medical Sciences Division, University of Oxford, Oxford, UK
| | - Mana Rahimzadeh
- Medical School, Medical Sciences Division, University of Oxford, Oxford, UK
| | - Ryan G Wagner
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of Witwatersrand, Johannesburg, South Africa.,Centre for Global Health Research, Umeå University, Umeå, Sweden
| | - Gaia Scerif
- Developmental Cognitive Neuroscience, Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Alan Stein
- Child and Adolescent Psychiatry, Department of Psychiatry, University of Oxford, Oxford, UK.,MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of Witwatersrand, Johannesburg, South Africa
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5
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Torres AG, González-Andrade A, Fernández Muñoz JJ, García MP, Vergara-Moragues E. Objective memory as an indicator of functional impairment in native Spanish-speaking patients with HIV infection. AIDS Care 2019; 31:1540-1547. [PMID: 30957528 DOI: 10.1080/09540121.2019.1601673] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objective memory is one of the most affected cognitive areas in patients with HIV and perhaps one of the best predictors of daily functioning problems. Its relationship with biological markers, mood symptoms, and cognitive complaint is unclear and has received little attention in native Spanish-speakers. The goal of this study is to explore the relationships between the above-mentioned variables and their prediction of objective memory performance in native Spanish-speakers. HIV-related biological markers, mood symptoms, cognitive complaint, and objective memory were assessed in a sample native Spanish-speaking HIV patient with possible cognitive impairment. The results revealed deficit in short- and long-term memory while recognition was retained. Hierarchical regression analysis showed that the combination of independent variables significantly predicted performance in recognition, indicating that the pattern of impairment in short- and long-term memory is related to a difficulty to learn new information discriminately. The non-prediction of short- and long-term memory performance may be related to the inability to estimate the deficit in objective memory. These results show the need to perform specific interventions in mnesic processes, in view of the relation between this cognitive process and patients' daily functioning.
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Affiliation(s)
- Amalia García Torres
- Hogar GERASA, Unidad Gestión Clínica de Enfermedades Infecciosas, Hospital Universitario de Puerto Real , Cádiz , Spain.,Mind, Brain and Behavior Research Center (CIMCYC), University of Granada , Granada , Spain
| | | | - Juan José Fernández Muñoz
- Faculty of Health Sciences, Area of Behavioral Sciences Methodology, Rey Juan Carlos University , Madrid , Spain
| | - Miguel Pérez García
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada , Granada , Spain
| | - Esperanza Vergara-Moragues
- Hogar GERASA, Unidad Gestión Clínica de Enfermedades Infecciosas, Hospital Universitario de Puerto Real , Cádiz , Spain.,Mind, Brain and Behavior Research Center (CIMCYC), University of Granada , Granada , Spain.,Universidad Internacional de la Rioja (UNIR) , Logroño , Spain.,Departamento de Psicobiología y Metodología en Ciencias del Comportamiento, Universidad Complutense de Madrid (UCM) , Madrid , Spain
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Topographies of Cortical and Subcortical Volume Loss in HIV and Aging in the cART Era. J Acquir Immune Defic Syndr 2017; 73:374-383. [PMID: 27454251 DOI: 10.1097/qai.0000000000001111] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Studies of HIV-associated brain atrophy often focus on a priori brain regions of interest, which can introduce bias. A data-driven, minimally biased approach was used to analyze changes in brain volumetrics associated with HIV and their relationship to aging, viral factors, combination antiretroviral therapy (cART), and gender, and smoking. DESIGN A cross-sectional study of 51 HIV-uninfected (HIV-) and 146 HIV-infected (HIV+) participants. METHODS Structural MRI of participants was analyzed using principal component analysis (PCA) to reduce dimensionality and determine topographies of volumetric changes. Neuropsychological (NP) assessment was examined using global and domain-specific scores. The effects of HIV disease factors (eg, viral load, CD4, etc.) on brain volumes and neuropsychological were investigated using penalized regression (LASSO). RESULTS Two components of interest were visualized using principal component analysis. An aging effect predominated for both components. The first component, a cortically weighted topography, accounted for a majority of variance across participants (43.5% of variance) and showed independent effects of HIV and smoking. A secondary, subcortically weighted topography (4.6%) showed HIV-status accentuated age-related volume loss. In HIV+ patients, the cortical topography correlated with global neuropsychological scores and nadir CD4, whereas subcortical volume loss was associated with recent viral load. CONCLUSIONS Cortical regions showed the most prominent volumetric changes because of aging and HIV. Within HIV+ participants, cortical volumes were associated with immune history, whereas subcortical changes correlated with current immune function. Cognitive function was primarily associated with cortical volume changes. Observed volumetric changes in chronic HIV+ patients may reflect both past infection history and current viral status.
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7
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Spitsin S, Meshki J, Winters A, Tuluc F, Benton TD, Douglas SD. Substance P-mediated chemokine production promotes monocyte migration. J Leukoc Biol 2016; 101:967-973. [PMID: 28366881 DOI: 10.1189/jlb.1ab0416-188rr] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 09/29/2016] [Accepted: 10/05/2016] [Indexed: 01/13/2023] Open
Abstract
The neuropeptide SP has physiologic and pathophysiologic roles in CNS and peripheral tissues and is involved in crosstalk between nervous and immune systems in various conditions, including HIV and SIV infection. Increased SP levels were demonstrated in plasma of HIV+ individuals as well as in the CNS of SIV-infected, nonhuman primates. SP increases HIV infection in macrophages through interaction with its receptor, NK1R. The SP effect on immune system is both pro- and anti-inflammatory and includes up-regulation of a number of cytokines and cell receptors. The main goal of this study was to determine whether there is interplay between monocyte exposure to SP and recruitment into sites of inflammation. We now demonstrate that exposure of either human macrophages or PBMCs to SP leads to increased production of chemokines, including MCP-1, for which expression is limited to cells of the myeloid lineage. This effect is inhibited by the NK1R antagonist, aprepitant. Exposure to conditioned medium derived from SP-treated PBMCs resulted in increased monocyte migration through semipermeable membranes and an in vitro human BBB model. Monocyte migration was blocked by anti-MCP-1 antibodies. Our results suggest that increased SP levels associated with HIV and other inflammatory conditions may contribute to increased monocyte migration into the CNS and other tissues through a MCP-1-dependent mechanism.
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Affiliation(s)
- Sergei Spitsin
- Division of Allergy and Immunology, Children's Hospital of Philadelphia Research Institute, Philadelphia, Pennsylvania, USA
| | - John Meshki
- Division of Allergy and Immunology, Children's Hospital of Philadelphia Research Institute, Philadelphia, Pennsylvania, USA
| | - Angela Winters
- Division of Allergy and Immunology, Children's Hospital of Philadelphia Research Institute, Philadelphia, Pennsylvania, USA
| | - Florin Tuluc
- Division of Allergy and Immunology, Children's Hospital of Philadelphia Research Institute, Philadelphia, Pennsylvania, USA
| | - Tami D Benton
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Child and Adolescent Psychiatry and Behavioral Science, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; and
| | - Steven D Douglas
- Division of Allergy and Immunology, Children's Hospital of Philadelphia Research Institute, Philadelphia, Pennsylvania, USA; .,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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8
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Modulatory effects of psychopathy on Wisconsin Card Sorting Test performance in male offenders with Antisocial Personality Disorder. Psychiatry Res 2016; 235:43-8. [PMID: 26708441 DOI: 10.1016/j.psychres.2015.12.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 10/04/2015] [Accepted: 12/04/2015] [Indexed: 01/26/2023]
Abstract
Neuropsychological deficits in executive functions (EF) have been linked to antisocial behavior and considered to be cardinal to the onset and persistence of severe antisocial and aggressive behavior. However, when psychopathy is present, prior evidence suggests that the dorsolateral prefrontal cortex is unaffected leading to intact EF. Ninety-one male offenders with Antisocial Personality Disorder (ASPD) and 24 controls completed the Wisconsin Card Sorting Test (WCST). ASPD individuals were grouped in three categories according to Psychopathy Checklist-Revised (PCL-R) scores (low, medium and high). We hypothesized that ASPD offenders with high PCL-R scores will not differ from healthy controls in EF and will show better EF performance in comparison with subjects with low PCL-R scores. Results showed that ASPD offenders with low PCL-R scores committed more perseverative errors and responses than controls and offenders with high PCL-R scores, which did not differ from healthy controls. Moreover, scores on Factor 1 and the interpersonal facet of the PCL-R were predictors of better WCST performance. Our results suggest a modulatory role of psychopathy in the cognitive performance of ASPD offenders, and provide further evidence supporting that offenders with ASPD and psychopathy are characterized by a cognitive profile different from those with ASPD without psychopathy.
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Abstract
Prior research has suggested benefits of aerobic physical activity (PA) on cognition and brain volumes in HIV uninfected (HIV-) individuals, however, few studies have explored the relationships between PA and brain integrity (cognition and structural brain volumes) in HIV-infected (HIV+) individuals. Seventy HIV+ individuals underwent neuropsychological testing, structural neuroimaging, laboratory tests, and completed a PA questionnaire, recalling participation in walking, running, and jogging activities over the last year. A PA engagement score of weekly metabolic equivalent (MET) hr of activity was calculated using a compendium of PAs. HIV+ individuals were classified as physically active (any energy expended above resting expenditure, n=22) or sedentary (n=48). Comparisons of neuropsychological performance, grouped by executive and motor domains, and brain volumes were completed between groups. Physically active and sedentary HIV+ individuals had similar demographic and laboratory values, but the active group had higher education (14.0 vs. 12.6 years, p=.034). Physically active HIV+ individuals performed better on executive (p=.040, unadjusted; p=.043, adjusted) but not motor function (p=.17). In addition, among the physically active group the amount of physical activity (METs) positively correlated with executive (Pearson's r=0.45, p=0.035) but not motor (r=0.21; p=.35) performance. In adjusted analyses the physically active HIV+ individuals had larger putamen volumes (p=.019). A positive relationship exists between PA and brain integrity in HIV+ individuals. Results from the present study emphasize the importance to conduct longitudinal interventional investigation to determine if PA improves brain integrity in HIV+ individuals.
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Gurney J, Olsen T, Flavin J, Ramaratnam M, Archie K, Ransford J, Herrick R, Wallace L, Cline J, Horton W, Marcus DS. The Washington University Central Neuroimaging Data Archive. Neuroimage 2015; 144:287-293. [PMID: 26439514 DOI: 10.1016/j.neuroimage.2015.09.060] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 09/25/2015] [Accepted: 09/28/2015] [Indexed: 11/30/2022] Open
Abstract
Since the early 2000's, much of the neuroimaging work at Washington University (WU) has been facilitated by the Central Neuroimaging Data Archive (CNDA), an XNAT-based imaging informatics system. The CNDA is uniquely related to XNAT, as it served as the original codebase for the XNAT open source platform. The CNDA hosts data acquired in over 1000 research studies, encompassing 36,000 subjects and more than 60,000 imaging sessions. Most imaging modalities used in modern human research are represented in the CNDA, including magnetic resonance (MR), positron emission tomography (PET), computed tomography (CT), nuclear medicine (NM), computed radiography (CR), digital radiography (DX), and ultrasound (US). However, the majority of the imaging data in the CNDA are MR and PET of the human brain. Currently, about 20% of the total imaging data in the CNDA is available by request to external researchers. CNDA's available data includes large sets of imaging sessions and in some cases clinical, psychometric, tissue, or genetic data acquired in the study of Alzheimer's disease, brain metabolism, cancer, HIV, sickle cell anemia, and Tourette syndrome.
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Affiliation(s)
- Jenny Gurney
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA.
| | | | - John Flavin
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | | | | | - James Ransford
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA
| | - Rick Herrick
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Lauren Wallace
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Jeanette Cline
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Will Horton
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Daniel S Marcus
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
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Behrman-Lay AM, Paul RH, Heaps-Woodruff J, Baker LM, Usher C, Ances BM. Human immunodeficiency virus has similar effects on brain volumetrics and cognition in males and females. J Neurovirol 2015; 22:93-103. [PMID: 26306688 DOI: 10.1007/s13365-015-0373-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Revised: 05/08/2015] [Accepted: 07/29/2015] [Indexed: 01/13/2023]
Abstract
Most studies that have examined neuropsychological impairments associated with human immunodeficiency virus (HIV) have focused on males, yet females represent one of the largest groups of newly infected patients. Further, few studies have examined neuropsychological performance and neuroimaging outcomes among females compared to males in the modern era of highly active anti-retroviral therapy (HAART). The present study investigated neuropsychological performance and brain volumetrics among HIV+ males (n = 93) and females (n = 44) on stable HAART compared to HIV seronegative (HIV-) males (n = 42) and females (n = 49). Results revealed a significant effect of HIV on neuropsychological performance and neuroimaging measures. An effect of gender, independent of HIV status, was also observed for neuroimaging measures but not neuropsychological performance. Additionally, no significant differences in neuropsychological performance or brain volumetrics were seen between HIV+ males and females. No significant interaction was observed between HIV and gender on either neuropsychological or neuroimaging indices. Our results suggest that both HIV+ males and females treated with HAART experience similar outcomes in terms of brain integrity.
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Affiliation(s)
- Ashley M Behrman-Lay
- Department of Psychology, University of Missouri- Saint Louis, St. Louis, MO, 63110, USA
| | - Robert H Paul
- Department of Psychology, University of Missouri- Saint Louis, St. Louis, MO, 63110, USA
- Missouri Institute of Mental Health, St. Louis, MO, 63110, USA
| | - Jodi Heaps-Woodruff
- Department of Psychology, University of Missouri- Saint Louis, St. Louis, MO, 63110, USA
- Missouri Institute of Mental Health, St. Louis, MO, 63110, USA
| | - Laurie M Baker
- Department of Psychology, University of Missouri- Saint Louis, St. Louis, MO, 63110, USA
| | - Christina Usher
- Department of Psychology, University of Missouri- Saint Louis, St. Louis, MO, 63110, USA
| | - Beau M Ances
- Department of Neurology, Washington University in Saint Louis, 660 South Euclid Avenue, Campus Box 8111, St. Louis, MO, 63110, USA.
- Department of Radiology, Washington University in Saint Louis, St. Louis, MO, 63110, USA.
- Department of Biomedical Engineering, Washington University in Saint Louis, St. Louis, MO, 63110, USA.
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