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Wang Y, Wu G, Wen Z, Lei H, Lin F. Highly active antiretroviral therapy-related effects on morphological connectivity in HIV. AIDS 2024; 38:207-215. [PMID: 37861678 DOI: 10.1097/qad.0000000000003759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
OBJECTIVE Suboptimal concentration of the antiretroviral drug is insufficient to inhibit HIV destruction on brain structure and function due to the resistance of blood brain barrier. We aimed to investigate highly active antiretroviral therapy (HAART)-related effects on the morphological connectivity in people with HIV (PWH). DESIGN Case-control study. METHODS Fifty-five HAART-treated for more than 3 months and 54 untreated PWH, as well as 66 demographically matched healthy controls underwent a high-resolution 3D T1-weighted MRI. Individual-level morphological brain network based on gray matter volume of 90 brain regions was constructed and network topological properties were analyzed. Network-based statistics (NBS) was performed to identify sub-networks showing significant differences in morphological connectivity. Correlation and mediation analyses were employed to evaluate associations between the morphological properties and clinical variables of PWH. RESULTS Although PWH exhibited small-world architecture in their morphological brain networks, untreated PWH demonstrated altered network properties while HAART-treated PWH showed relatively similar network properties compared to healthy controls. Furthermore, HAART-related effects were mainly involved the bilateral putamen and left thalamus. The findings of NBS further indicated the cortico-striatum-thalamic-cortical loop was involved in the therapeutic-associated morphological network. The positive correlations between the HAART treatment and nodal degree and efficiency of the putamen were mediated by the number of CD4 + T lymphocytes. CONCLUSIONS The topological properties are recovered to normal in PWH after HAART and the effects induced by HAART are mostly within the cortical-subcortical circuit.
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Affiliation(s)
- Yiwen Wang
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences
- University of Chinese Academy of Sciences, Beijing, China
| | - Guangyao Wu
- Department of Radiology, Zhongnan Hospital, Wuhan University, Wuhan
- Department of Medical Imaging, Shenzhen University General Hospital, Medical College of Shenzhen University, Shenzhen
| | - Zhi Wen
- Department of Radiology, Zhongnan Hospital, Wuhan University, Wuhan
- Department of Radiology, Renmin Hospital, Wuhan University, Wuhan
| | - Hao Lei
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences
- University of Chinese Academy of Sciences, Beijing, China
| | - Fuchun Lin
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences
- University of Chinese Academy of Sciences, Beijing, China
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Schantell M, Taylor BK, Spooner RK, May PE, O’Neill J, Morsey BM, Wang T, Ideker T, Bares SH, Fox HS, Wilson TW. Epigenetic aging is associated with aberrant neural oscillatory dynamics serving visuospatial processing in people with HIV. Aging (Albany NY) 2022; 14:9818-9831. [PMID: 36534452 PMCID: PMC9831734 DOI: 10.18632/aging.204437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Despite effective antiretroviral therapy, cognitive impairment and other aging-related comorbidities are more prevalent in people with HIV (PWH) than in the general population. Previous research examining DNA methylation has shown PWH exhibit accelerated biological aging. However, it is unclear how accelerated biological aging may affect neural oscillatory activity in virally suppressed PWH, and more broadly how such aberrant neural activity may impact neuropsychological performance. METHODS In the present study, participants (n = 134) between the ages of 23 - 72 years underwent a neuropsychological assessment, a blood draw to determine biological age via DNA methylation, and a visuospatial processing task during magnetoencephalography (MEG). Our analyses focused on the relationship between biological age and oscillatory theta (4-8 Hz) and alpha (10 - 16 Hz) activity among PWH (n=65) and seronegative controls (n = 69). RESULTS PWH had significantly elevated biological age when controlling for chronological age relative to controls. Biological age was differentially associated with theta oscillations in the left posterior cingulate cortex (PCC) and with alpha oscillations in the right medial prefrontal cortex (mPFC) among PWH and seronegative controls. Stronger alpha oscillations in the mPFC were associated with lower CD4 nadir and lower current CD4 counts, suggesting such responses were compensatory. Participants who were on combination antiretroviral therapy for longer had weaker theta oscillations in the PCC. CONCLUSIONS These findings support the concept of interactions between biological aging and HIV status on the neural oscillatory dynamics serving visuospatial processing. Future work should elucidate the long-term trajectory and impact of accelerated aging on neural oscillatory dynamics in PWH.
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Affiliation(s)
- Mikki Schantell
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE 68010, USA
- College of Medicine, University of Nebraska Medical Center (UNMC), Omaha, NE 68198, USA
| | - Brittany K. Taylor
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE 68010, USA
- Department of Pharmacology and Neuroscience, Creighton University, Omaha, NE 68178, USA
| | - Rachel K. Spooner
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE 68010, USA
- Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine University, Düsseldorf, Germany
| | - Pamela E. May
- Department of Neurological Sciences, UNMC, Omaha, NE 68198, USA
| | - Jennifer O’Neill
- Department of Internal Medicine, Division of Infectious Diseases, UNMC, Omaha, NE 68198, USA
| | | | - Tina Wang
- Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA
| | - Trey Ideker
- Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA
| | - Sara H. Bares
- Department of Internal Medicine, Division of Infectious Diseases, UNMC, Omaha, NE 68198, USA
| | - Howard S. Fox
- Department of Neurological Sciences, UNMC, Omaha, NE 68198, USA
| | - Tony W. Wilson
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE 68010, USA
- College of Medicine, University of Nebraska Medical Center (UNMC), Omaha, NE 68198, USA
- Department of Pharmacology and Neuroscience, Creighton University, Omaha, NE 68178, USA
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Rizzi L, Aventurato ÍK, Balthazar MLF. Neuroimaging Research on Dementia in Brazil in the Last Decade: Scientometric Analysis, Challenges, and Peculiarities. Front Neurol 2021; 12:640525. [PMID: 33790850 PMCID: PMC8005640 DOI: 10.3389/fneur.2021.640525] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 02/18/2021] [Indexed: 12/12/2022] Open
Abstract
The last years have evinced a remarkable growth in neuroimaging studies around the world. All these studies have contributed to a better understanding of the cerebral outcomes of dementia, even in the earliest phases. In low- and middle-income countries, studies involving structural and functional neuroimaging are challenging due to low investments and heterogeneous populations. Outstanding the importance of diagnosing mild cognitive impairment and dementia, the purpose of this paper is to offer an overview of neuroimaging dementia research in Brazil. The review includes a brief scientometric analysis of quantitative information about the development of this field over the past 10 years. Besides, discusses some peculiarities and challenges that have limited neuroimaging dementia research in this big and heterogeneous country of Latin America. We systematically reviewed existing neuroimaging literature with Brazilian authors that presented outcomes related to a dementia syndrome, published from 2010 to 2020. Briefly, the main neuroimaging methods used were morphometrics, followed by fMRI, and DTI. The major diseases analyzed were Alzheimer's disease, mild cognitive impairment, and vascular dementia, respectively. Moreover, research activity in Brazil has been restricted almost entirely to a few centers in the Southeast region, and funding could be the main driver for publications. There was relative stability concerning the number of publications per year, the citation impact has historically been below the world average, and the author's gender inequalities are not relevant in this specific field. Neuroimaging research in Brazil is far from being developed and widespread across the country. Fortunately, increasingly collaborations with foreign partnerships contribute to the impact of Brazil's domestic research. Although the challenges, neuroimaging researches performed in the native population regarding regional peculiarities and adversities are of pivotal importance.
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Affiliation(s)
- Liara Rizzi
- Department of Neurology, University of Campinas (UNICAMP), Campinas, Brazil
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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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Bell RP, Towe SL, Lalee Z, Huettel SA, Meade CS. Neural sensitivity to risk in adults with co-occurring HIV infection and cocaine use disorder. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2020; 20:859-872. [PMID: 32648056 PMCID: PMC7773226 DOI: 10.3758/s13415-020-00806-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Persons with co-occurring HIV infection and cocaine use disorder tend to engage in riskier decision-making. However, the neural correlates of sensitivity to risk are not well-characterized in this population. The purpose of this study was to examine the neural interaction effects of HIV infection and cocaine use disorder to sensitivity to risk. The sample included 79 adults who differed on HIV status and cocaine use disorder. During functional magnetic resonance imaging (fMRI), participants completed a Wheel of Fortune (WoF) task that assessed neural activation in response to variations of monetary risk (i.e., lower probability of winning a larger reward). Across groups, neural activation to increasing risk was in cortical and subcortical regions similar to previous investigations using the WoF in nondrug-using populations. Our analyses showed that there was a synergistic effect between HIV infection and cocaine use in the left precuneus/posterior cingulate cortex and hippocampus, and right postcentral gyrus, lateral occipital cortex, cerebellum, and posterior parietal cortex. HIV+ individuals with cocaine use disorder displayed neural hyperactivation to increasing risk that was not observed in the other groups. These results support a synergistic effect of co-occurring HIV infection and cocaine dependence in neural processing of risk probability that may reflect compensation. Future studies can further investigate and validate how neural activation to increasing risk is associated with risk-taking behavior.
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Affiliation(s)
- Ryan P Bell
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27708, USA
| | - Sheri L Towe
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27708, USA
| | - Zahra Lalee
- Duke University Department of Psychology and Neuroscience, Durham, NC, 27708, USA
| | - Scott A Huettel
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27708, USA
- Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC, 27708, USA
- Duke University Department of Psychology and Neuroscience, Durham, NC, 27708, USA
| | - Christina S Meade
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27708, USA.
- Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC, 27708, USA.
- Duke University Department of Psychology and Neuroscience, Durham, NC, 27708, USA.
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Detecting cognitive impairment in HIV-infected individuals using mutual connectivity analysis of resting state functional MRI. J Neurovirol 2020; 26:188-200. [PMID: 31912459 DOI: 10.1007/s13365-019-00823-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 10/29/2019] [Accepted: 12/03/2019] [Indexed: 01/03/2023]
Abstract
It is estimated that more than 50% of the individuals affected with Human Immunodeficiency Virus (HIV) present deficits in multiple cognitive domains, collectively known as HIV-associated neurocognitive disorder (HAND). Early stages of brain injury may be clinically silent but potentially measurable via neuroimaging. A total of 40 subjects (20 HIV positive and 20 age-matched controls) volunteered for the study. All subjects underwent a standard battery of neuropsychological tests used for the clinical diagnosis of HAND. Fourteen HIV+ and five healthy subjects showed signs of neurological impairment. Connectivity was computed using mutual connectivity analysis (MCA) with generalized radial basis function neural network, a framework for quantifying non-linear connectivity as well as conventional correlation from 160 regional time-series that were extracted based on the Dosenbach (DOS) atlas. We subsequently applied graph theoretic as well as network analysis approaches for characterizing the connectivity matrices obtained and localizing between-group differences. We focused on trying to detect cognitive impairment using the subset of 29 (14 subjects with HAND and 15 cognitively normal controls) subjects. For the global analysis, significant differences (p < 0.05) were seen in the variance in degree, modularity and Smallworldness. Regional analysis revealed changes occurring mainly in portions of the lateral occipital cortex and the cingulate cortex. Furthermore, using Network Based Statistics (NBS), we uncovered an affected sub-network of 19 nodes comprising predominantly of regions of the default mode network. Similar analysis using the conventional correlation method revealed no significant results at a global scale, while regional analysis shows some differences spread across resting state networks. These results suggest that there is a subtle reorganization occurring in the topology of brain networks in HAND, which can be captured using improved connectivity analysis.
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Aging, comorbidities, and the importance of finding biomarkers for HIV-associated neurocognitive disorders. J Neurovirol 2019; 25:673-685. [PMID: 30868422 DOI: 10.1007/s13365-019-00735-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 02/01/2019] [Accepted: 02/14/2019] [Indexed: 01/08/2023]
Abstract
HIV-associated neurocognitive disorders (HAND) continue to affect a large proportion of persons living with HIV despite effective viral suppression with combined antiretroviral therapy (cART). Importantly, milder versions of HAND have become more prevalent. The pathogenesis of HAND in the era of cART appears to be multifactorial with contributions from central nervous system (CNS) damage that occur prior to starting cART, chronic immune activation, cART neurotoxicity, and various age-related comorbidities (i.e., cardiovascular and cerebrovascular disease, diabetes, hyperlipidemia). Individuals with HIV may experience premature aging, which could also contribute to cognitive impairment. Likewise, degenerative disorders aside from HAND increase with age and there is evidence of shared pathology between HAND and other neurodegenerative diseases, such as Alzheimer's disease, which can occur with or without co-existing HAND. Given the aforementioned complex interactions associated with HIV, cognitive impairment, and aging, it is important to consider an age-appropriate differential diagnosis for HAND as the HIV-positive population continues to grow older. These factors make the accuracy and reliability of the diagnosis of mild forms of HAND in an aging population of HIV-infected individuals challenging. The complexity of current diagnosis of mild HAND also highlights the need to develop reliable biomarkers. Ultimately, the identification of a set of specific biomarkers will be required to achieve early and accurate diagnosis, which will be necessary assuming specific treatments for HAND are developed.
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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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