Axonal chronic injury in treatment-naïve HIV+ adults with asymptomatic neurocognitive impairment and its relationship with clinical variables and cognitive status

Li, Ruili; Sun, Jun; Tang, Zhenchao; Jing-ji, Zhang; Li, Hong-jun

doi:10.1186/s12883-018-1069-5

Cited by 25 publications

(39 citation statements)

References 46 publications

(72 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The findings from our current study are consistent with numerous studies that documented elevated diffusivity in widespread white matter regions (Chang et al 2008; Gongvatana et al 2009; Pfefferbaum et al 2009;Masters and Ances 2014; Nir et al 2014; O’Connor et al 2017), and most frequently in the corpus callosum, of HIV+ patients (Masters and Ances 2014; O’Connor et al 2017). Our findings of elevated mean diffusivity, primarily due to elevated AD, with normal FA, in our HIV+ participants are consistent with prior reports (Pfefferbaum et al 2009; Li et al 2018). However, lower FA and higher RD in HIV+ compared to SN participants were also reported by others (Leite et al 2013; Underwood et al 2017).…”

Section: Discussionsupporting

confidence: 93%

Independent and Combined Effects of Chronic HIV-Infection and Tobacco Smoking on Brain Microstructure

Liang

Chang

Chen

et al. 2018

J Neuroimmune Pharmacol

View full text Add to dashboard Cite

HIV-infected individuals (HIV+) have 2-3 times higher prevalence of tobacco smoking than the general U.S. population. This study aims to evaluate the independent and combined effects of tobacco-smoking and HIV-infection on brain microstructure and cognition using a 2 × 2 design. 21 HIV + Smokers, 25 HIV + Nonsmokers, 25 Seronegative (SN)-Smokers and 23 SN-Nonsmokers were evaluated using diffusion tensor imaging. Fractional anisotropy (FA), mean (MD), radial (RD) and axial (AD) diffusivity were assessed in 8 major cerebral fiber tracts and 5 subcortical regions. Cognitive performance in 7 neurocognitive domains was also assessed. Compared to SN, HIV+ had higher AD in genu of corpus callosum (GCC, p = 0.002). Smokers also had higher diffusivities in GCC, splenium of corpus callosum (SCC), anterior corona radiata (ACR), sagittal stratum (SS) and superior fronto-occipital fasciculus (SFO), than Nonsmokers (p-values<0.001-0.003). Tobacco-Smoking and HIV-infection showed synergistic effects on AD_SS (p = 0.002) and RD_SFO (p = 0.02), but opposite effects in FA_putamen (p = 0.024). Additive effects from HIV+ and Tobacco-Smoking were observed in 9 other white matter tracts, with highest diffusivities and lowest FA in HIV + Smokers. Higher diffusivities in the GCC, SCC, ACR and SS predicted poorer cognitive performance across all participants (p ≤ 0.001). Higher AD_GCC also predicted slower Speed of information processing and poorer Fluency and Attention only in HIV + Smokers (p = 0.001-0.003). Chronic tobacco smoking and HIV-infection appear to have additive and synergistic adverse effects on brain diffusivities, suggesting greater neuroinflammation, which may contribute to poorer cognition. Therefore, chronic tobacco-smoking may be a risk factor for HIV-associated neurocognitive disorders. Graphical Abstract ᅟ.

show abstract

Section: Discussionsupporting

confidence: 93%

Independent and Combined Effects of Chronic HIV-Infection and Tobacco Smoking on Brain Microstructure

Liang

Chang

Chen

et al. 2018

J Neuroimmune Pharmacol

View full text Add to dashboard Cite

show abstract

“…Myelin damage has been found in central white matter in the pre-antiretroviral therapy era (Gray et al 1992). Like Li et al (2018), we found that the HIV group had increased MD in the corpus callosum and corona radiata among other regions. It has been suggested that these regions, being periventricular, are more vulnerable to viral invasion and neuro-inflammation in early infection when HIV infiltrates the CSF and by extension the white matter tracts (Li et al 2018; Ragin et al 2015).…”

Section: Discussionsupporting

confidence: 83%

“…Like Li et al (2018), we found that the HIV group had increased MD in the corpus callosum and corona radiata among other regions. It has been suggested that these regions, being periventricular, are more vulnerable to viral invasion and neuro-inflammation in early infection when HIV infiltrates the CSF and by extension the white matter tracts (Li et al 2018; Ragin et al 2015). A meta-analysis by O’Connor et al (2017), while only revealing a small reduction in FA in HIV, with high study heterogeneity, revealed a significant increase in MD in HIV.…”

Section: Discussionsupporting

confidence: 83%

See 1 more Smart Citation

Clinical and neuroimaging correlates of cognition in HIV

et al. 2019

View full text Add to dashboard Cite

This study investigated whether HIV-positive participants, stable on combined antiretroviral therapy (cART), showed cognitive impairments relative to HIV-negative controls; and whether clinical and neuroimaging factors correlated with cognitive function in the HIV-positive participants. One hundred and twenty-six white men who have sex with men, of whom 78 were HIV-positive and stable on cART and 48 were HIV negative, were recruited to this cross-sectional study. The median age of HIV-positive participants in this study was 47. They underwent clinical and neuropsychological evaluation and magnetic resonance imaging of the brain, including diffusion tensor imaging (DTI). Cognitive scores for both groups were compared, and regression models were run to explore the influence of clinical, psychiatric, lifestyle, and neuroimaging variables on cognition. The prevalence of neurocognitive impairment, using the multivariate normative comparison criteria, was 28% in HIV-positive participants and 5% in HIV-negative participants. After covarying for age, years of education, and non-English speaking background, there were significant differences between the HIV group and the controls across four cognitive domains. The HIV group showed significantly higher mean diffusivity (MD) and lower fractional anisotropy (FA) than the control group on DTI. Although anxiety levels were clinically low, anxiety and DTI measures were the only variables to show significant correlations with cognitive function. In the HIV group, poorer cognitive performance was associated with higher MD and lower FA on DTI and higher (albeit clinically mild) levels of anxiety. Our findings suggest that white matter changes and subtle anxiety levels contribute independently to cognitive impairment in HIV.

show abstract

“…Following initial infection, HIV crosses the blood-brain-barrier and can produce diffuse neuropathology, affecting both cortical and subcortical grey matter as well as white matter tracts linking different brain regions (Janssen et al 2015;van Zoest et al 2017;O'Connor et al 2018;Li et al 2018;Oh et al 2018). This non-localised pattern of infection may explain why HAND is characterised by a broad range of possible impairments (Woods et al 2009).…”

Section: Discussionmentioning

confidence: 99%

Childhood trauma interacts with ApoE to influence neurocognitive function in women living with HIV

et al. 2018

View full text Add to dashboard Cite

HIV-associated neurocognitive disorder (HAND) describes a spectrum of behavioural, motor and cognitive disturbances that can occur secondary to HIV infection. Less severe forms of the disorder persist despite advances in antiretroviral medication efficacy and availability. Childhood trauma (CT) may predispose individuals to developing HAND. As genetic variation in human apolipoprotein E (ApoE) has been implicated in cognitive decline and may mediate the development of long-term health outcomes following CT, we investigated the influence of ApoE and CT on cognitive function in the context of HIV. One hundred twenty-eight HIV-positive Xhosa women completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF) as well as the HIV Neurobehavioral Research Center neurocognitive test battery. rs7412 and rs429358 were genotyped using KASP assays, and this data was used to determine the ApoE isoform. Baseline differences in demographic and clinical variables according to CT exposure were calculated. Analysis of covariance was used to assess the contributions of CT and ApoE variants, as well as their interaction, to cognitive function. Eighty-eight participants reported experiencing CT. The rs7412 C allele protected against the harmful effect of CT on motor scores using an additive model. The interaction of ApoE ε4 and CT was associated with worse attention/working memory scores. ApoE ε4, alone and in combination with CT, is associated with poorer cognitive function. Further research into this gene-environment interaction may assist in identifying at-risk individuals for targeted interventions.

show abstract

Axonal chronic injury in treatment-naïve HIV+ adults with asymptomatic neurocognitive impairment and its relationship with clinical variables and cognitive status

Cited by 25 publications

References 46 publications

Independent and Combined Effects of Chronic HIV-Infection and Tobacco Smoking on Brain Microstructure

Independent and Combined Effects of Chronic HIV-Infection and Tobacco Smoking on Brain Microstructure

Clinical and neuroimaging correlates of cognition in HIV

Childhood trauma interacts with ApoE to influence neurocognitive function in women living with HIV

Contact Info

Product

Resources

About