White matter measures are near normal in controlled HIV infection except in those with cognitive impairment and longer HIV duration

Abstract

The objective of the current study was to quantify the degree of white matter (WM) abnormalities in chronic and virally suppressed HIV-infected (HIV+) persons while carefully taking into account demographic and disease factors. Diffusion tensor imaging (DTI) was conducted in 40 HIV− and 82 HIV+ men with comparable demographics and life style factors. The HIV+ sample was clinically stable with successful viral control. Diffusion was measured across 32 non-colinear directions with a b-value of 1000 s/mm 2 ; fractional anisotropy (FA) and mean diffusivity (MD) maps were quantified with Itrack IDL. Using the ENIGMA DTI protocol, FA and MD values were extracted for each participant and in 11 skeleton regions of interest (SROI) from standard labels in the JHU ICBM-81 atlas covering major striato-frontal and parietal tracks. We found no major differences in FA and MD values across the 11 SROI between study groups. Within the HIV+ sample, we found that a higher CNS penetrating antiretroviral treatment, higher current CD4+ T cell count, and immune recovery from the nadir CD4+ T cell count were associated with increased FA and decreased MD (p < 0.05-0.006), while HIV duration, symptomatic, and asymptomatic cognitive impairment were associated with decreased FA and increased MD (p < 0.01-0.004). Stability of HIV treatment and antiretroviral CNS penetration efficiency in addition to current and historical immune recovery were related to higher FA and lower MD (p = 0.04-p < 0.01). In conclusion, WM DTI measures are near normal except for patients with neurocognitive impairment and longer HIV disease duration.

Use of Neuroimaging to Inform Optimal Neurocognitive Criteria for Detecting HIV-Associated Brain Abnormalities

“…Lastly, this study analyzed global measures of brain structure acquired on 1.5 Tesla systems. Future studies should utilize scanners with greater field strength (e.g., 3 Tesla) as well as examine specific brain structures and other imaging modalities such as functional MRI and diffusion tensor imaging that have been shown to be sensitive to cognitive functioning in HIV (Ances et al, 2009;Cysique et al, 2017;du Plessis et al, 2017;Masters & Ances, 2014).…”

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

“…Zhuang Y et al investigated WM changes in ANI patients diagnosed according to the Frascati criteria [ 3 ] and found no significant WM microstructural differences between HIV-infected and healthy controls [ 18 ]. Cysique LA et al reported that the location of WM injury in ANI cases was the anterior limb of the internal capsule [ 19 ]. The above findings still exhibit differences.…”

Diffusion tensor imaging indices to predict cognitive changes following adult radiotherapy

“…While our focus in this analysis is radiation‐induced white matter and cognition, the effect of damage and cognition has been shown in non‐radiation related injury. Among persons living with HIV, the white matter measures deviate from normal and are associated with impaired cognition (Cysique et al., 2017). In children with multiple sclerosis where the myelin is progressively attacked by the immune system, the white matter FA and cognitive processing speed are correlated (Bethune et al., 2011).…”