Neuroimaging the Neuropathogenesis of HIV

Boerwinkle, Anna H.; Meeker, Karin L.; Luckett, Patrick; Ances, Beau M.

doi:10.1007/s11904-021-00548-z

Cited by 14 publications

(12 citation statements)

References 91 publications

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“…Even with the success of combination antiretroviral therapy (cART), various neurological complications caused by the infiltration of the human immunodeficiency virus (HIV) in the central nervous system (CNS) (1), especially HIV-associated neurocognitive disorder (2), remain a heavy disease burden. Neuroimaging is a vital tool to provide insight into structural, functional, and molecular changes occurring in the brain and has the potential to comprehensively elucidate the pathogenesis of HIV-associated neurocognitive disorder (3,4). Structural magnetic resonance imaging (sMRI) studies of HIV-infected (HIV+) individuals have found widespread brain atrophy and volume reduction in the subcortical structures including caudate nucleus, putamen, amygdala, thalamus, hippocampus, and parahippocampus (5)(6)(7)(8), and cerebellar (9,10).…”

Section: Introductionmentioning

confidence: 99%

HIV-Associated Structural and Functional Brain Alterations in Homosexual Males

Shi²,

Chen³

et al. 2022

Front. Neurol.

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Purpose:Neuroimaging elucidations have shown structural and functional brain alterations in HIV-infected (HIV+) individuals when compared to HIV-negative (HIV–) controls. However, HIV− groups used in previous studies were not specifically considered for sexual orientation, which also affects the brain structures and functions. The current study aimed to characterize the brain alterations associated with HIV infection while controlling for sexual orientation.Methods:Forty-three HIV+ and 40 HIV– homosexual men (HoM) were recruited and underwent resting-state MRI scanning. Group differences in gray matter volume (GMV) were assessed using a voxel-based morphometry analysis. Brain regions with the altered GMV in the HIV+ HoM group were then taken as regions of interest in a seed-based analysis to identify altered functional connectivity. Furthermore, the amplitude of low-frequency fluctuation (ALFF) and regional homogeneity values were compared between the two groups to evaluate the HIV-associated functional abnormalities in local brain regions.Results:HIV+ HoM showed significantly increased GMV in the bilateral parahippocampal gyrus and amygdala, and decreased GMV in the right inferior cerebellum, compared with the HIV– HoM. The brain regions with increased GMV were hyper-connected with the left superior cerebellum, right lingual gyrus, and left precuneus in the HIV+ HoM. Moreover, the ALFF values of the right fusiform gyrus, and left parahippocampal gyrus were increased in the HIV+ HoM. The regional homogeneity values of the right anterior cingulate and paracingulate gyri, and left superior cerebellum were decreased in the HIV+ HoM.Conclusion:When the study population was restricted to HoM, HIV+ individuals exhibited structural alterations in the limbic system and cerebellum, and functional abnormalities in the limbic, cerebellum, and visual network. These findings complement the existing knowledge on the HIV-associated neurocognitive impairment from the previous neuroimaging studies by controlling for the potential confounding factor, sexual orientation. Future studies on brain alternations with the exclusion of related factors like sexual orientation are needed to understand the impact of HIV infection on neurocognitive function more accurately.

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Section: Introductionmentioning

confidence: 99%

HIV-Associated Structural and Functional Brain Alterations in Homosexual Males

Shi²,

Chen³

et al. 2022

Front. Neurol.

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“…Although effects of opioids on the BG have not been reported previously, past research suggests an antagonistic effect between volume decreases and increases related to other substance use in the setting of HIV infection 22 , 50 . One explanation for this volumetric increase is neuroinflammation 28 , which can be beneficial (e.g., tissue regeneration, protection against infection) or detrimental (e.g., cell death, chronic neurodegeneration). Sil et al .…”

Section: Discussionmentioning

confidence: 99%

“…Effects from combined methamphetamine use and seropositivity were not observed, suggesting that opposing effects masked GM changes in the BG. Alterations to the BG among PLWH who use opioids, in contrast, have not been examined 28 . It thus remains unclear whether the BG is differentially affected by stimulants and/or opioids within the context of HIV infection.…”

Section: Introductionmentioning

confidence: 99%

Characterization of basal ganglia volume changes in the context of HIV and polysubstance use

Monick

Joyce

Chugh

et al. 2022

Sci Rep

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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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“…Methods that have been developed or tested in the low- to middle-income contexts where pediatric HIV infection is concentrated are particularly critical. At the same time, promising advances in neuroimaging of HIV offer additional tools for research with this population [ 90 ].…”

Section: Conclusion and Current Directionsmentioning

confidence: 99%

“…In addition, youth with PHIV have high rates of mental health problems and substance use disorders [34,[85][86][87] which often emerge during adolescence and may impact cognition directly [88] or indirectly through medication adherence [89]. Substance use is a high priority area of research due to its interactions with HIV in affecting CNS functioning and neuropathogenesis through dopamine systems and inflammation, as well as discussion of therapeutic versus harmful effects of cannabis [90][91][92][93][94][95][96][97][98][99][100]. Studies specifically focused on youth are needed due to their different profile of substance use and the potential for greater impact due to exposure during brain development, which continues into young adulthood.…”

Section: Conclusion and Current Directionsmentioning

confidence: 99%

Central Nervous System Impact of Perinatally Acquired HIV in Adolescents and Adults: an Update

Nichols

2022

Curr HIV/AIDS Rep

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Purpose of Review Perinatally acquired HIV infection (PHIV) can confer neurodevelopmental risk. As children with PHIV increasingly survive through adolescence and into adulthood, understanding its long-term central nervous system (CNS) impacts is critical for maximizing adult outcomes and quality of life. Recent Findings Recently published neurocognitive and neuroimaging findings show impacts on the CNS associated with early HIV disease progression that endure into adolescence and young adulthood. Although developmental trajectories in adolescence largely appear stable, further research on maturational processes is indicated. Summary Although early antiretroviral therapy in infancy appears to be protective, it is not universally available and current youth largely developed without its benefit. The neurocognitive effects of HIV and the multiple other risks to neurodevelopment experienced by youth with PHIV call for further longitudinal research and a multifaceted approach to prevention and intervention.

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Neuroimaging the Neuropathogenesis of HIV

Cited by 14 publications

References 91 publications

HIV-Associated Structural and Functional Brain Alterations in Homosexual Males

HIV-Associated Structural and Functional Brain Alterations in Homosexual Males

Characterization of basal ganglia volume changes in the context of HIV and polysubstance use

Central Nervous System Impact of Perinatally Acquired HIV in Adolescents and Adults: an Update

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