The Use of Visual Rating Scales to Quantify Brain MRI Lesions in Patients with HIV Infection

Robinson‐Papp, Jessica; Navis, Allison; Dhamoon, Mandip S.; Clark, Uraina S.; Gutierrez-Contreras, Jose; Morgello, Susan

doi:10.1111/jon.12466

Cited by 13 publications

(9 citation statements)

References 54 publications

(97 reference statements)

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“…Hence, our findings provide foundational evidence for future investigations that seek to examine specific ELS-related and HIV-related neural mechanisms underlying RT-IIV elevations in HIV+ High-ELS adults. With prior reports of ELS-related abnormalities in default mode network suppression ( Philip et al, 2013 ), and HIV-related frontostriatal ( Melrose et al, 2008 ; Ipser et al, 2015 ), dopaminergic ( Berger et al, 1994 ; Kumar et al, 2009 ), and white matter abnormalities ( Pomara et al, 2001 ; Tate et al, 2011 ; Robinson-Papp et al, 2017 ), several neural mechanisms could be implicated.…”

Section: Discussionmentioning

confidence: 96%

Early Life Stress-Related Elevations in Reaction Time Variability Are Associated with Brain Volume Reductions in HIV+ Adults

Clark

Rentería

Hegde

et al. 2018

Front. Behav. Neurosci.

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There is burgeoning evidence that, among HIV+ adults, exposure to high levels of early life stress (ELS) is associated with increased cognitive impairment as well as brain volume abnormalities and elevated neuropsychiatric symptoms. Currently, we have a limited understanding of the degree to which cognitive difficulties observed in HIV+ High-ELS samples reflect underlying neural abnormalities rather than increases in neuropsychiatric symptoms. Here, we utilized a behavioral marker of cognitive function, reaction time intra-individual variability (RT-IIV), which is sensitive to both brain volume reductions and neuropsychiatric symptoms, to elucidate the unique contributions of brain volume abnormalities and neuropsychiatric symptoms to cognitive difficulties in HIV+ High-ELS adults. We assessed the relation of RT-IIV to neuropsychiatric symptom levels and total gray and white matter volumes in 44 HIV+ adults (26 with high ELS). RT-IIV was examined during a working memory task. Self-report measures assessed current neuropsychiatric symptoms (depression, stress, post-traumatic stress disorder). Magnetic resonance imaging was used to quantify total gray and white matter volumes. Compared to Low-ELS participants, High-ELS participants exhibited elevated RT-IIV, elevated neuropsychiatric symptoms, and reduced gray and white matter volumes. Across the entire sample, RT-IIV was significantly associated with gray and white matter volumes, whereas significant associations with neuropsychiatric symptoms were not observed. In the High-ELS group, despite the presence of elevated neuropsychiatric symptom levels, brain volume reductions explained more than 13% of the variance in RT-IIV, whereas neuropsychiatric symptoms explained less than 1%. Collectively, these data provide evidence that, in HIV+ High-ELS adults, ELS-related cognitive difficulties (as indexed by RT-IIV) exhibit strong associations with global brain volumes, whereas ELS-related elevations in neuropsychiatric symptoms appear to contribute minimally to these cognitive difficulties. Such findings support a growing body of evidence indicating that high ELS exposure is a significant risk factor for neurocognitive dysfunction in HIV+ adults. Further, these data highlight the need to better understand how ELS-related pathophysiological mechanisms contribute to volumetric and other neural abnormalities in HIV+ individuals.

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Section: Discussionmentioning

confidence: 96%

Early Life Stress-Related Elevations in Reaction Time Variability Are Associated with Brain Volume Reductions in HIV+ Adults

Clark

Rentería

Hegde

et al. 2018

Front. Behav. Neurosci.

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“…The prevalence of WMH was high in our sample, with a main effect of age and no significant impact of HIV status. The association between age and WMH has been described in the general population ( Ovbiagele and Saver, 2006 ) and in PLHIV ( McMurtray et al, 2008 ; Robinson-Papp et al, 2018 ; Seider et al, 2016 ). Concerning the impact of HIV status on WHM burden, no consensus could be reached from published data, mainly due to samples’ characteristics.…”

Section: Discussionmentioning

confidence: 99%

Cerebral alterations in West African HIV and non-HIV adults aged ≥50: An MRI study

Bernard

Dilharreguy

Font

et al. 2021

International Journal of Infectious Diseases

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To cross-sectionally describe brain alterations in PLHIV aged above 50 years old, receiving antiretroviral treatment (ART) and living in Senegal compared to HIV-negative subjects. Methods: Twenty PLHIV and 26 HIV-negative subjects with comparable socio-demographic and clinical characteristics underwent an MRI exam (3D-T1 and FLAIR sequences). Global atrophy and White Matter Hyperintensities (WMH) were evaluated. After assessing the feasibility and acceptability of MRI scans in this population, we described atrophy and WHM prevalence and associated factors using logistic regressions. Results: Overall, 43.5% of the study sample were aged !60 years, 58.7% were women, and 28.3% had hypertension. The overall prevalence of atrophy and WMH was 19.6% [95% CI: 8.1-31.1] and 30.4% [95% CI: 17.1-43.7]. HIV status had no significant effect on atrophy or WMH. Unemployment and hypertension were significantly associated with atrophy, whereas women were less likely to present atrophy. Aged !60 years was the only factor associated with WMH. Conclusions: A high prevalence of atrophy and WMH was observed in West African adults aged over 50 years without a clear HIV impact. As brain MRI studies are critical to better understand cognitive and emotional outcomes, we encourage those studies in older PLHIV in West Africa.

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“…In non-cirrhotic HCV patients relative to controls, imaging provides evidence for an increased incidence of WMH representing cerebral vasculitis (Heckmann et al, 1999 ; Casato et al, 2005 ; Bezerra et al, 2011 ). Indeed, in HIV, the presence of HCV was the strongest predictor of WMH (Robinson-Papp et al, 2017 ).…”

Section: In Vivo Neuroimaging Of Hiv and Comorbiditiesmentioning

confidence: 99%

The Aging Brain With HIV Infection: Effects of Alcoholism or Hepatitis C Comorbidity

Zahr

2018

Front. Aging Neurosci.

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As successfully treated individuals with Human Immunodeficiency Virus (HIV)-infected age, cognitive and health challenges of normal aging ensue, burdened by HIV, treatment side effects, and high prevalence comorbidities, notably, Alcohol Use Disorders (AUD) and Hepatitis C virus (HCV) infection. In 2013, people over 55 years old accounted for 26% of the estimated number of people living with HIV (~1.2 million). The aging brain is increasingly vulnerable to endogenous and exogenous insult which, coupled with HIV infection and comorbid risk factors, can lead to additive or synergistic effects on cognitive and motor function. This paper reviews the literature on neuropsychological and in vivo Magnetic Resonance Imaging (MRI) evaluation of the aging HIV brain, while also considering the effects of comorbidity for AUD and HCV.

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The Use of Visual Rating Scales to Quantify Brain MRI Lesions in Patients with HIV Infection

Abstract: VRSs reliably quantify WMH in HIV-infected individuals and correlate with cognitive impairment. Future studies may find routinely acquired brain MRI quantified by VRS to be an accessible and meaningful neurologic outcome measure in HIV.

Cited by 13 publications

References 54 publications

Early Life Stress-Related Elevations in Reaction Time Variability Are Associated with Brain Volume Reductions in HIV+ Adults

Early Life Stress-Related Elevations in Reaction Time Variability Are Associated with Brain Volume Reductions in HIV+ Adults

Cerebral alterations in West African HIV and non-HIV adults aged ≥50: An MRI study

The Aging Brain With HIV Infection: Effects of Alcoholism or Hepatitis C Comorbidity

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