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Madzime J, Jankiewicz M, Meintjes EM, Torre P, Laughton B, van der Kouwe AJW, Holmes M. Reduced white matter maturation in the central auditory system of children living with HIV. FRONTIERS IN NEUROIMAGING 2024; 3:1341607. [PMID: 38510428 PMCID: PMC10951401 DOI: 10.3389/fnimg.2024.1341607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/15/2024] [Indexed: 03/22/2024]
Abstract
Introduction School-aged children experience crucial developmental changes in white matter (WM) in adolescence. The human immunodeficiency virus (HIV) affects neurodevelopment. Children living with perinatally acquired HIV (CPHIVs) demonstrate hearing and neurocognitive impairments when compared to their uninfected peers (CHUUs), but investigations into the central auditory system (CAS) WM integrity are lacking. The integration of the CAS and other brain areas is facilitated by WM fibers whose integrity may be affected in the presence of HIV, contributing to neurocognitive impairments. Methods We used diffusion tensor imaging (DTI) tractography to map the microstructural integrity of WM between CAS regions, including the lateral lemniscus and acoustic radiation, as well as between CAS regions and non-auditory regions of 11-year-old CPHIVs. We further employed a DTI-based graph theoretical framework to investigate the nodal strength and efficiency of the CAS and other brain regions in the structural brain network of the same population. Finally, we investigated associations between WM microstructural integrity outcomes and neurocognitive outcomes related to auditory and language processing. We hypothesized that compared to the CHUU group, the CPHIV group would have lower microstructural in the CAS and related regions. Results Our analyses showed higher mean diffusivity (MD), a marker of axonal maturation, in the lateral lemniscus and acoustic radiations, as well as WM between the CAS and non-auditory regions predominantly in frontotemporal areas. Most affected WM connections also showed higher axial and radial diffusivity (AD and RD, respectively). There were no differences in the nodal properties of the CAS regions between groups. The MD of frontotemporal and subcortical WM-connected CAS regions, including the inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, and internal capsule showed negative associations with sequential processing in the CPHIV group but not in the CHUU group. Discussion The current results point to reduced axonal maturation in WM, marked by higher MD, AD, and RD, within and from the CAS. Furthermore, alterations in WM integrity were associated with sequential processing, a neurocognitive marker of auditory working memory. Our results provide insights into the microstructural integrity of the CAS and related WM in the presence of HIV and link these alterations to auditory working memory.
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Affiliation(s)
- Joanah Madzime
- Biomedical Engineering Research Centre, Division of Biomedical Engineering, Department of Human Biology, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Marcin Jankiewicz
- Biomedical Engineering Research Centre, Division of Biomedical Engineering, Department of Human Biology, University of Cape Town, Cape Town, South Africa
- Cape Universities Body Imaging Centre, University of Cape Town, Cape Town, South Africa
| | - Ernesta M. Meintjes
- Biomedical Engineering Research Centre, Division of Biomedical Engineering, Department of Human Biology, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Cape Universities Body Imaging Centre, University of Cape Town, Cape Town, South Africa
| | - Peter Torre
- School of Speech, Language, and Hearing Sciences, College of Health and Human Services, San Diego, CA, United States
| | - Barbara Laughton
- Family Centre for Research with Ubuntu, Department of Paediatrics and Child Health, Stellenbosch University, Stellenbosch, South Africa
| | - Andre J. W. van der Kouwe
- A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States
| | - Martha Holmes
- Biomedical Engineering Research Centre, Division of Biomedical Engineering, Department of Human Biology, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
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Minosse S, Picchi E, Conti A, di Giuliano F, di Ciò F, Sarmati L, Teti E, de Santis S, Andreoni M, Floris R, Guerrisi M, Garaci F, Toschi N. Multishell diffusion MRI reveals whole-brain white matter changes in HIV. Hum Brain Mapp 2023; 44:5113-5124. [PMID: 37647214 PMCID: PMC10502617 DOI: 10.1002/hbm.26448] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 07/15/2023] [Accepted: 07/26/2023] [Indexed: 09/01/2023] Open
Abstract
Diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI) have been previously used to explore white matter related to human immunodeficiency virus (HIV) infection. While DTI and DKI suffer from low specificity, the Combined Hindered and Restricted Model of Diffusion (CHARMED) provides additional microstructural specificity. We used these three models to evaluate microstructural differences between 35 HIV-positive patients without neurological impairment and 20 healthy controls who underwent diffusion-weighted imaging using three b-values. While significant group effects were found in all diffusion metrics, CHARMED and DKI analyses uncovered wider involvement (80% vs. 20%) of all white matter tracts in HIV infection compared with DTI. In restricted fraction (FR) analysis, we found significant differences in the left corticospinal tract, middle cerebellar peduncle, right inferior cerebellar peduncle, right corticospinal tract, splenium of the corpus callosum, left superior cerebellar peduncle, left superior cerebellar peduncle, pontine crossing tract, left posterior limb of the internal capsule, and left/right medial lemniscus. These are involved in language, motor, equilibrium, behavior, and proprioception, supporting the functional integration that is frequently impaired in HIV-positivity. Additionally, we employed a machine learning algorithm (XGBoost) to discriminate HIV-positive patients from healthy controls using DTI and CHARMED metrics on an ROIwise basis, and unique contributions to this discrimination were examined using Shapley Explanation values. The CHARMED and DKI estimates produced the best performance. Our results suggest that biophysical multishell imaging, combining additional sensitivity and built-in specificity, provides further information about the brain microstructural changes in multimodal areas involved in attentive, emotional and memory networks often impaired in HIV patients.
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Affiliation(s)
- Silvia Minosse
- Diagnostic Imaging UnitUniversity Hospital Rome Tor VergataRomeItaly
| | - Eliseo Picchi
- Diagnostic Imaging UnitUniversity Hospital Rome Tor VergataRomeItaly
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
| | - Allegra Conti
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
| | - Francesca di Giuliano
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
- Neuroradiology UnitUniversity Hospital of Rome Tor VergataRomeItaly
| | - Francesco di Ciò
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
| | - Loredana Sarmati
- Clinical Infectious Diseases UnitUniversity Hospital of Rome Tor VergataRomeItaly
- Department of Systems MedicineUniversity of Rome Tor VergataRomeItaly
| | - Elisabetta Teti
- Clinical Infectious Diseases UnitUniversity Hospital of Rome Tor VergataRomeItaly
| | - Silvia de Santis
- Instituto de NeurocienciasConsejo Superior de Investigaciones Científicas and Universidad Miguel HernándezSant Joan d'AlacantSpain
| | - Massimo Andreoni
- Clinical Infectious Diseases UnitUniversity Hospital of Rome Tor VergataRomeItaly
- Department of Systems MedicineUniversity of Rome Tor VergataRomeItaly
| | - Roberto Floris
- Diagnostic Imaging UnitUniversity Hospital Rome Tor VergataRomeItaly
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
| | - Maria Guerrisi
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
| | - Francesco Garaci
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
- Neuroradiology UnitUniversity Hospital of Rome Tor VergataRomeItaly
- IRCSS San Raffaele CassinoFrosinoneItaly
| | - Nicola Toschi
- Neuroradiology UnitUniversity Hospital of Rome Tor VergataRomeItaly
- Athinoula A. Martinos Center for Biomedical ImagingHarvard Medical SchoolBostonMassachusettsUSA
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Li R, Gao Y, Wang W, Jiao Z, Rao B, Liu G, Li H. Altered gray matter structural covariance networks in drug-naïve and treated early HIV-infected individuals. Front Neurol 2022; 13:869871. [PMID: 36203980 PMCID: PMC9530039 DOI: 10.3389/fneur.2022.869871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 08/19/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundWhile regional brain structure and function alterations in HIV-infected individuals have been reported, knowledge about the topological organization in gray matter networks is limited. This research aims to investigate the effects of early HIV infection and combination antiretroviral therapy (cART) on gray matter structural covariance networks (SCNs) by employing graph theoretical analysis.MethodsSixty-five adult HIV+ individuals (25–50 years old), including 34 with cART (HIV+/cART+) and 31 medication-naïve (HIV+/cART–), and 35 demographically matched healthy controls (HCs) underwent high-resolution T1-weighted images. A sliding-window method was employed to create “age bins,” and SCNs (based on cortical thickness) were constructed for each bin by calculating Pearson's correlation coefficients. The group differences of network indices, including the mean nodal path length (Nlp), betweenness centrality (Bc), number of modules, modularity, global efficiency, local efficiency, and small-worldness, were evaluated by ANOVA and post-hoc tests employing the network-based statistics method.ResultsRelative to HCs, less efficiency in terms of information transfer in the parietal and occipital lobe (decreased Bc) and a compensated increase in the frontal lobe (decreased Nlp) were exhibited in both HIV+/cART+ and HIV+/cART– individuals (P < 0.05, FDR-corrected). Compared with HIV+/cART– and HCs, less specialized function segregation (decreased modularity and small-worldness property) and stronger integration in the network (increased Eglob and little changed path length) were found in HIV+/cART+ group (P < 0.05, FDR-corrected).ConclusionEarly HIV+ individuals exhibited a decrease in the efficiency of information transmission in sensory regions and a compensatory increase in the frontal lobe. HIV+/cART+ showed a less specialized regional segregation function, but a stronger global integration function in the network.
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Affiliation(s)
- Ruili Li
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
- Department of Radiology, Beijing Youan Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Yuxun Gao
- Department of Radiology, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Wei Wang
- Department of Radiology, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Zengxin Jiao
- Department of Radiology, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Bo Rao
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
- *Correspondence: Bo Rao
| | - Guangxue Liu
- Department of Natural Medicines, School of Pharmaceutical Sciences, Peking University Health Science Center, Beijing, China
- Guangxue Liu
| | - Hongjun Li
- Department of Radiology, Beijing Youan Hospital, Capital Medical University, Beijing, China
- Hongjun Li
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Aili X, Wang W, Zhang A, Jiao Z, Li X, Rao B, Li R, Li H. Rich-Club Analysis of Structural Brain Network Alterations in HIV Positive Patients With Fully Suppressed Plasma Viral Loads. Front Neurol 2022; 13:825177. [PMID: 35812120 PMCID: PMC9263507 DOI: 10.3389/fneur.2022.825177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveEven with successful combination antiretroviral therapy (cART), patients with human immunodeficiency virus positive (HIV+) continue to present structural alterations and neuropsychological impairments. The purpose of this study is to investigate structural brain connectivity alterations and identify the hub regions in HIV+ patients with fully suppressed plasma viral loads.MethodsIn this study, we compared the brain structural connectivity in 48 patients with HIV+ treated with a combination of antiretroviral therapy and 48 healthy controls, using diffusion tensor imaging. Further comparisons were made in 24 patients with asymptomatic neurocognitive impairment (ANI) and 24 individuals with non-HIV-associated neurocognitive disorders forming a subset of HIV+ patients. The graph theory model was used to establish the topological metrics. Rich-club analysis was used to identify hub nodes across groups and abnormal rich-club connections. Correlations of connectivity metrics with cognitive performance and clinical variables were investigated as well.ResultsAt the regional level, HIV+ patients demonstrated lower degree centrality (DC), betweenness centrality (BC), and nodal efficiency (NE) at the occipital lobe and the limbic cortex; and increased BC and nodal cluster coefficient (NCC) in the occipital lobe, the frontal lobe, the insula, and the thalamus. The ANI group demonstrated a significant reduction in the DC, NCC, and NE in widespread brain regions encompassing the occipital lobe, the frontal lobe, the temporal pole, and the limbic system. These results did not survive the Bonferroni correction. HIV+ patients and the ANI group had similar hub nodes that were mainly located in the occipital lobe and subcortical regions. The abnormal connections were mainly located in the occipital lobe in the HIV+ group and in the parietal lobe in the ANI group. The BC in the calcarine fissure was positively correlated with complex motor skills. The disease course was negatively correlated with NE in the middle occipital gyrus.ConclusionThe results suggest that the occipital lobe and the subcortical regions may be important in structural connectivity alterations and cognitive impairment. Rich-club analysis may contribute to our understanding of the neuropathology of HIV-associated neurocognitive disorders.
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Affiliation(s)
- Xire Aili
- Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing, China
- Department of Radiology, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Wei Wang
- Department of Radiology, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Aidong Zhang
- Department of Radiology, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Zengxin Jiao
- Department of Radiology, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Xing Li
- Department of Radiology, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Bo Rao
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
- Bo Rao
| | - Ruili Li
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
- Ruili Li
| | - Hongjun Li
- Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing, China
- Department of Radiology, Beijing Youan Hospital, Capital Medical University, Beijing, China
- *Correspondence: Hongjun Li
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Cong S, Yao X, Xie L, Yan J, Shen L. Genetic Influence Underlying Brain Connectivity Phenotype: A Study on Two Age-Specific Cohorts. Front Genet 2022; 12:782953. [PMID: 35237294 PMCID: PMC8884108 DOI: 10.3389/fgene.2021.782953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 11/16/2021] [Indexed: 11/29/2022] Open
Abstract
Background: Human brain structural connectivity is an important imaging quantitative trait for brain development and aging. Mapping the network connectivity to the phenotypic variation provides fundamental insights in understanding the relationship between detailed brain topological architecture, function, and dysfunction. However, the underlying neurobiological mechanism from gene to brain connectome, and to phenotypic outcomes, and whether this mechanism changes over time, remain unclear. Methods: This study analyzes diffusion-weighted imaging data from two age-specific neuroimaging cohorts, extracts structural connectome topological network measures, performs genome-wide association studies of the measures, and examines the causality of genetic influences on phenotypic outcomes mediated via connectivity measures. Results: Our empirical study has yielded several significant findings: 1) It identified genetic makeup underlying structural connectivity changes in the human brain connectome for both age groups. Specifically, it revealed a novel association between the minor allele (G) of rs7937515 and the decreased network segregation measures of the left middle temporal gyrus across young and elderly adults, indicating a consistent genetic effect on brain connectivity across the lifespan. 2) It revealed rs7937515 as a genetic marker for body mass index in young adults but not in elderly adults. 3) It discovered brain network segregation alterations as a potential neuroimaging biomarker for obesity. 4) It demonstrated the hemispheric asymmetry of structural network organization in genetic association analyses and outcome-relevant studies. Discussion: These imaging genetic findings underlying brain connectome warrant further investigation for exploring their potential influences on brain-related complex diseases, given the significant involvement of altered connectivity in neurological, psychiatric and physical disorders.
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Affiliation(s)
- Shan Cong
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Xiaohui Yao
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Linhui Xie
- Department of Electrical and Computer Engineering, School of Engineering, Indiana University Purdue University Indianapolis, Indianapolis, IN, United States
| | - Jingwen Yan
- Department of BioHealth Informatics, School of Informatics and Computing, Indiana University Purdue University Indianapolis, Indianapolis, IN, United States
| | - Li Shen
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
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Minosse S, Picchi E, Giuliano FD, di Cio F, Pistolese CA, Sarmati L, Teti E, Andreoni M, Floris R, Guerrisi M, Garaci F, Toschi N. Compartmental models for diffusion weighted MRI reveal widespread brain changes in HIV-infected patients. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:3834-3837. [PMID: 34892070 DOI: 10.1109/embc46164.2021.9629510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Diffusion tensor imaging (DTI) has been used to explore changes in the brain of subjects with human immunodeficiency virus (HIV) infection. However, DTI notoriously suffers from low specificity. Neurite orientation dispersion and density imaging (NODDI) is a compartmental model able to provide specific microstructural information with additional sensitivity/specificity. In this study we use both the NODDI and the DTI models to evaluate microstructural differences between 35 HIV-positive patients and 20 healthy controls. Diffusion-weighted imaging was acquired using three b-values (0, 1000 and 2500 s/mm2). Both DTI and NODDI models were fitted to the data, obtaining estimates for fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), axial diffusivity (AD), neurite density index (NDI) and orientation dispersion index (ODI), after which we performed group comparisons using Tract-based spatial statistics (TBSS). While significant group effects were found in in FA, MD, RD, AD and NDI, NDI analysis uncovered a much wider involvement of brain tissue in HIV infection as compared to DTI. In region-of interest (ROI)-based analysis, NDI estimates from the right corticospinal tract produced excellent performance in discriminating the two groups (AUC = 0.974, sensitivity = 90%; specificity =97%).
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Di Cio F, Minosse S, Picchi E, Di Giuliano F, Sarmati L, Teti E, Andreoni M, Floris R, Guerrisi M, Garaci F, Toschi N. Whole-brain white matter network reorganization in HIV. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:3830-3833. [PMID: 34892069 DOI: 10.1109/embc46164.2021.9629503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The human immunodeficiency virus (HIV) causes an infectious disease with a high viral tropism toward CD4 T-lymphocytes and macrophage. Since the advent of combined antiretroviral therapy (CART), the number of opportunistic infectious disease has diminished, turning HIV into a chronic condition. Nevertheless, HIV-infected patients suffer from several life-long symptoms, including the HIV-associated neurocognitive disorder (HAND), whose biological substrates remain unclear. HAND includes a range of cognitive impairments which have a huge impact on daily patient life. The aim of this study was to examine putative structural brain network changes in HIV-infected patient to test whether diffusion-imaging-related biomarkers could be used to discover and characterize subtle neurological alterations in HIV infection. To this end, we employed multi-shell, multi-tissue constrained spherical deconvolution in conjunction with probabilistic tractography and graph-theoretical analyses. We found several statistically significant effects in both local (right postcentral gyrus, right precuneus, right inferior parietal lobule, right transverse temporal gyrus, right inferior temporal gyrus, right putamen and right pallidum) and global graph-theoretical measures (global clustering coefficient, global efficiency and transitivity). Our study highlights a global and local reorganization of the structural connectome which support the possible application of graph theory to detect subtle alteration of brain regions in HIV patients.Clinical Relevance-Brain measures able to detect subtle alteration in HIV patients could also be used in e.g. evaluating therapeutic responses, hence empowering clinical trials.
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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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Zhao T, Chen J, Fang H, Fu D, Su D, Zhang W. Diffusion tensor magnetic resonance imaging of white matter integrity in patients with HIV-associated neurocognitive disorders. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1314. [PMID: 33209894 PMCID: PMC7661883 DOI: 10.21037/atm-20-6342] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Background This study investigated the efficacy and neurotoxicity of highly active antiretroviral therapy (HAART) by evaluating white matter (WM) injury using diffusion tensor magnetic resonance imaging (DTI) in patients with human immunodeficiency virus (HIV)-associated neurocognitive disorders (HAND). Methods Forty-six patients with HAND underwent DTI before and every six months during HAART treatment. DTI data, including fractional anisotropy (FA) and mean diffusivity (MD) values of structural WM before and after HAART, were compared. The relationship between DTI values and plasma viral loads was tested. MD was more sensitive than FA for evaluating WM injury in HAND-positive patients. Results Following 12 months of HAART, increased MD values (compared to 6 months of HAART) were observed in the right temporal lobe, right parietal lobe, right occipital lobe, right anterior limb of the internal capsule, right lenticular nucleus, the right cerebral peduncle, left caudate nucleus, left dorsal thalamus, and left posterior limb of the internal capsule. MD values in the left genu of the internal capsule (r=0.350, P=0.017) and left corona radiata (r=0.338, P=0.021) were positively correlated with plasma viral loads. Conclusions DTI may be useful for assessing the efficacy and neurotoxicity of HAART in HAND-positive patients. Starting HAART may halt WM injury; however, prolonged HAART could worsen WM injury, highlighting the importance of optimal HAART duration.
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Affiliation(s)
| | | | - Hang Fang
- Department of Radiology, Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Danhui Fu
- Guangxi Medical University, Nanning, China
| | - Danke Su
- Guangxi Medical University, Nanning, China
| | - Wei Zhang
- Department of Radiology, Affiliated Hospital of Guilin Medical University, Guilin, China
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Zhuang Y, Zhang Z, Tivarus M, Qiu X, Zhong J, Schifitto G. Whole-brain computational modeling reveals disruption of microscale brain dynamics in HIV infected individuals. Hum Brain Mapp 2020; 42:95-109. [PMID: 32941693 PMCID: PMC7721235 DOI: 10.1002/hbm.25207] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 08/13/2020] [Accepted: 08/30/2020] [Indexed: 01/07/2023] Open
Abstract
MRI‐based neuroimaging techniques have been used to investigate brain injury associated with HIV‐infection. Whole‐brain cortical mean‐field dynamic modeling provides a way to integrate structural and functional imaging outcomes, allowing investigation of microscale brain dynamics. In this study, we adopted the relaxed mean‐field dynamic modeling to investigate structural and functional connectivity in 42 HIV‐infected subjects before and after 12‐week of combination antiretroviral therapy (cART) and compared them with 46 age‐matched healthy subjects. Microscale brain dynamics were modeled by a set of parameters including two region‐specific microscale brain properties, recurrent connection strengths, and subcortical inputs. We also analyzed the relationship between the model parameters (i.e., the recurrent connection and subcortical inputs) and functional network topological characterizations, including smallworldness, clustering coefficient, and network efficiency. The results show that untreated HIV‐infected individuals have disrupted local brain dynamics that in part correlate with network topological measurements. Notably, after 12 weeks of cART, both the microscale brain dynamics and the network topological measurements improved and were closer to those in the healthy brain. This was also associated with improved cognitive performance, suggesting that improvement in local brain dynamics translates into clinical improvement.
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Affiliation(s)
- Yuchuan Zhuang
- Department of Electrical and Computer Engineering, University of Rochester, Rochester, New York, USA
| | - Zhengwu Zhang
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, New York, USA.,Department of Neuroscience, University of Rochester Medical Center, Rochester, New York, USA
| | - Madalina Tivarus
- Department of Neuroscience, University of Rochester Medical Center, Rochester, New York, USA.,Department of Imaging Sciences, University of Rochester Medical Center, Rochester, New York, USA
| | - Xing Qiu
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, New York, USA
| | - Jianhui Zhong
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, New York, USA.,Department of Biomedical Engineering, University of Rochester, Rochester, New York, USA
| | - Giovanni Schifitto
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, New York, USA.,Department of Neurology, University of Rochester Medical Center, Rochester, New York, USA
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Hassanzadeh-Behbahani S, Shattuck KF, Bronshteyn M, Dawson M, Diaz M, Kumar P, Moore DJ, Ellis RJ, Jiang X. Low CD4 nadir linked to widespread cortical thinning in adults living with HIV. NEUROIMAGE-CLINICAL 2019; 25:102155. [PMID: 31901790 PMCID: PMC6948363 DOI: 10.1016/j.nicl.2019.102155] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 12/11/2019] [Accepted: 12/26/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND The history of immune suppression, especially CD4 nadir, has been shown to be a strong predictor of HIV-associated neurocognitive disorders (HAND). However, the potential mechanism of this association is not well understood. METHODS High resolution structural MRI images and neuropsychological data were obtained from fifty-nine HIV+ adults (mean age, 56.5 ± 5.8) to investigate the correlation between CD4 nadir and cortical thickness. RESULTS Low CD4 nadir was associated with widespread cortical thinning, especially in the frontal and temporal regions, and global mean cortical thickness correlated with CD4 nadir. In addition, worse global neurocognitive function was associated with bilateral frontal cortical thinning, and the association largely persisted (especially in the left frontal cortex) in the subset of participants who did not meet HAND criteria. CONCLUSIONS These results suggest that low CD4 nadir may be associated with widespread neural injury in the brain, especially in the frontal and temporal regions. The diffuse neural injury might contribute to the prevalence and the phenotypes of HAND, as well as the difficulty treating HAND due to a broad network of brain regions affected. Low CD4 nadir related neural injury to the frontal cortex might contribute to subtle neurocognitive impairment/decline, even in the absence of HAND diagnosis.
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Affiliation(s)
| | - Kyle F Shattuck
- Departments of Neuroscience, Georgetown University Medical Center, Washington, DC 20057, United States
| | - Margarita Bronshteyn
- Departments of Neuroscience, Georgetown University Medical Center, Washington, DC 20057, United States
| | - Matthew Dawson
- Department of Psychiatry, University of California, La Jolla, San Diego, CA 92093, United States
| | - Monica Diaz
- Department of Neurosciences, University of California, La Jolla, San Diego, CA 92093, United States
| | - Princy Kumar
- Department of Medicine, Georgetown University Medical Center, Washington, DC 20057, United States
| | - David J Moore
- Department of Psychiatry, University of California, La Jolla, San Diego, CA 92093, United States
| | - Ronald J Ellis
- Department of Psychiatry, University of California, La Jolla, San Diego, CA 92093, United States; Department of Neurosciences, University of California, La Jolla, San Diego, CA 92093, United States
| | - Xiong Jiang
- Departments of Neuroscience, Georgetown University Medical Center, Washington, DC 20057, United States.
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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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