Subcortical brain atrophy persists even in HAART-regulated HIV disease

Abstract

The purpose of this study was to determine the pattern and extent of caudate nucleus and putamen atrophy in HIV-infected men with well-controlled immune status and viral replication. 155 men underwent structural brain magnetic resonance imaging; 84 were HIV-infected and 71 were uninfected controls. MRI data were processed using the Fully Deformable Segmentation routine, producing volumes for the right and left caudate nucleus and putamen, and 3-D maps of spatial patterns of thickness. There was significant atrophy in the HIV-infected men in both the caudate and putamen, principally in the anterior regions. The volume of the basal ganglia was inversely associated with the time since first seropositivity, suggesting that either there is a chronic, subclinical process that continues in spite of therapy, or that the extent of the initial insult caused the extent of atrophy.Electronic supplementary materialThe online version of this article (doi:10.1007/s11682-011-9113-8) contains supplementary material, which is available to authorized users.

Regional Cerebral Gray Matter Volume in HIV‐Positive Patients with Executive Function Deficits

“…12 These studies found a correlation between diffuse brain atrophy and motor impairments, 10,14 dementia severity 10 and CDC stages of HIV infection, 11,13 smaller basal ganglia volume and motor dysfunction, 15 caudate and putamen atrophy and longer disease duration. 14 Similarly to these studies, we observed smaller volumes predominantly in the basal ganglia, primarily in the caudate, in HIV-positive patients with cognitive deficits. These results support the hypothesis that quantitative measures of basal ganglia volumes can be a potential biomarker for cognitive impairment assessment in these patients.…”

“…[9][10][11][12][13] Previous studies also found smaller volumes in several specific anatomical structures, such as the basal ganglia, 9 caudate, 11,13,14 putamen, 14 and total cortex volume of HIV-positive patients. 12 These studies found a correlation between diffuse brain atrophy and motor impairments, 10,14 dementia severity 10 and CDC stages of HIV infection, 11,13 smaller basal ganglia volume and motor dysfunction, 15 caudate and putamen atrophy and longer disease duration. 14 Similarly to these studies, we observed smaller volumes predominantly in the basal ganglia, primarily in the caudate, in HIV-positive patients with cognitive deficits.…”

Peripheral blood HIV DNA is associated with atrophy of cerebellar and subcortical gray matter

“…In cART-treated patients, imaging studies associate HIV infection with shrinkage of the basal ganglia, 18 thalamus, 19 hippocampus, 20 cerebellum, 21 cortex, 22 and white matter 19 ; i.e., brain regions in which we have identified volumetric reductions related to HIV DNA. Our findings of smaller brainstem and nucleus accumbens in the pooled HIV1 and D-HIV subjects are novel.…”

Prevalence of HIV-associated neurocognitive disorders in the Multicenter AIDS Cohort Study

“…Indeed, neuroimaging studies within the MACS suggest that gray matter and white matter atrophy, 13 as well as subcortical atrophy in the caudate and putamen, occur in HIV1 individuals with well-controlled immune status and systemic viral replication.…”