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Yadav SK, Gupta RK, Garg RK, Venkatesh V, Gupta PK, Singh AK, Hashem S, Al-Sulaiti A, Kaura D, Wang E, Marincola FM, Haris M. Altered structural brain changes and neurocognitive performance in pediatric HIV. Neuroimage Clin 2017; 14:316-322. [PMID: 28224079 PMCID: PMC5304232 DOI: 10.1016/j.nicl.2017.01.032] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Revised: 01/11/2017] [Accepted: 01/29/2017] [Indexed: 11/23/2022]
Abstract
Pediatric HIV patients often suffer with neurodevelopmental delay and subsequently cognitive impairment. While tissue injury in cortical and subcortical regions in the brain of adult HIV patients has been well reported there is sparse knowledge about these changes in perinatally HIV infected pediatric patients. We analyzed cortical thickness, subcortical volume, structural connectivity, and neurocognitive functions in pediatric HIV patients and compared with those of pediatric healthy controls. With informed consent, 34 perinatally infected pediatric HIV patients and 32 age and gender matched pediatric healthy controls underwent neurocognitive assessment and brain magnetic resonance imaging (MRI) on a 3 T clinical scanner. Altered cortical thickness, subcortical volumes, and abnormal neuropsychological test scores were observed in pediatric HIV patients. The structural network connectivity analysis depicted lower connection strengths, lower clustering coefficients, and higher path length in pediatric HIV patients than healthy controls. The network betweenness and network hubs in cortico-limbic regions were distorted in pediatric HIV patients. The findings suggest that altered cortical and subcortical structures and regional brain connectivity in pediatric HIV patients may contribute to deficits in their neurocognitive functions. Further, longitudinal studies are required for better understanding of the effect of HIV pathogenesis on brain structural changes throughout the brain development process under standard ART treatment. Structural brain MRI and cognitive assessments were performed in pediatric HIV. Pediatric HIV showed altered cortical thickness and subcortical volumes. Disrupted structural connectivity was observed in pediatric HIV. Altered brain structures and connectivity contribute to deficits in neurocognition.
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Key Words
- AIDS, acquired immunodeficiency syndrome
- C, clustering coefficient
- Cortical thickness
- ELISA, enzyme-linked immunosorbent assay
- FA, flip angel
- FLAIR, fluid attenuation inversion recovery
- FOV, field of view
- FSPGR, fast spoiled gradient echo
- GAT, graph-theoretical analysis toolbox
- HIV, human immunodeficiency virus
- Human immunodeficiency virus
- L, characteristic path length
- MRI, magnetic resonance imaging
- Magnetic resonance imaging
- Neurocognitive functions
- RAKIT, revised Amsterdamse kinder intelligence
- ROIs, regions of interest
- SW, small-world index
- Structural connectivity
- Subcortical volume
- TBM, tensor based morphometry
- TE, echo time
- TR, repetition time
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Affiliation(s)
- Santosh K Yadav
- Division of Translational Medicine, Research Branch, Sidra Medical and Research Center, Doha, Qatar
| | - Rakesh K Gupta
- Department of Radiology and Imaging, Fortis Memorial Research Institute, Gurgaon, Delhi, India
| | - 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, Delhi, India
| | - Alok K Singh
- Department of Neurology, King George Medical University, Lucknow, India
| | - Sheema Hashem
- Division of Translational Medicine, Research Branch, Sidra Medical and Research Center, Doha, Qatar
| | - Asma Al-Sulaiti
- Division of Translational Medicine, Research Branch, Sidra Medical and Research Center, Doha, Qatar
| | - Deepak Kaura
- Department of Radiology, Sidra Medical and Research Center, Doha, Qatar
| | - Ena Wang
- Division of Translational Medicine, Research Branch, Sidra Medical and Research Center, Doha, Qatar
| | - Francesco M Marincola
- Division of Translational Medicine, Research Branch, Sidra Medical and Research Center, Doha, Qatar
| | - Mohammad Haris
- Division of Translational Medicine, Research Branch, Sidra Medical and Research Center, Doha, Qatar
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