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2. Putamen volume and its clinical and neurological correlates in primary HIV infection

Author

Wright, Patrick W, Pyakurel, Ashmit, Vaida, Florin F, Price, Richard W, Lee, Evelyn, Peterson, Julia, Fuchs, Dietmar, Zetterberg, Henrik, Robertson, Kevin R, Walter, Rudolph, Meyerhoff, Dieter J, Spudich, Serena S, and Ances, Beau M

Subjects
Medical Microbiology, Biomedical and Clinical Sciences, Immunology, Biomedical Imaging, Neurosciences, Infectious Diseases, Bioengineering, Clinical Research, HIV/AIDS, Sexually Transmitted Infections, Neurological, Infection, Adult, Anthropometry, Cross-Sectional Studies, HIV Infections, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Prospective Studies, Putamen, brain volume loss, neurofilament light chain, primary HIV infection, putamen, structural MRI, Biological Sciences, Medical and Health Sciences, Psychology and Cognitive Sciences, Virology, Biomedical and clinical sciences, Health sciences
Abstract

ObjectiveLittle is known about the extent of cortical and subcortical volumetric alterations that may occur within the first year of HIV infection [primary HIV infection (PHI)].DesignWe used structural MRI in this prospective cross-sectional neuroimaging study to determine the extent of volumetric changes in early HIV infection.MethodsCerebrospinal fluid, blood, neuropsychological testing, and structural T1 MRI scans were acquired from 18 HIV and 47 PHI age-matched antiretroviral-naïve male participants. Using FreeSurfer 5.1, volumetric measurements were obtained from the caudate, amygdala, corpus callosum, ventricles, putamen, thalamus, cortical white matter, and total gray matter. Regional volumes were compared groupwise and related to biomarkers in cerebrospinal fluid (viral load, neopterin, and neurofilament light chain), blood (viral load, CD4, and CD8 T-cell count), and neuropsychometric tests (digit-symbol, grooved pegboard, finger-tapping, and timed gait).ResultsA trend-level moderate reduction of putamen volume (P = 0.076, adjusted Cohen's d = 0.5 after controlling for age) was observed for PHI compared with HIV-uninfected individuals. Within the PHI group, putamen volume associated with CD4 cell count (P = 0.03), CD4/CD8 ratio (P = 0.045), infection duration (P = 0.009), and worsening psychomotor performance on the digit-symbol (P = 0.028), finger-tapping (P = 0.039), and timed gait (P = 0.009) tests.ConclusionOur volumetric results suggest that the putamen is preferentially susceptible to early HIV-associated processes. Examining the natural course of early HIV infection longitudinally will allow for mapping of the trajectory of HIV-associated central nervous system changes, enabling creation of improved interventional strategies to potentially stabilize or reverse these observed structural changes.

Published
2016

3. Cerebral white matter integrity during primary HIV infection

Author

Wright, Patrick W, Vaida, Florin F, Fernández, Ricardo J, Rutlin, Jerrel, Price, Richard W, Lee, Evelyn, Peterson, Julia, Fuchs, Dietmar, Shimony, Joshua S, Robertson, Kevin R, Walter, Rudolph, Meyerhoff, Dieter J, Spudich, Serena, and Ances, Beau M

Subjects
Medical Microbiology, Biomedical and Clinical Sciences, Immunology, Clinical Research, HIV/AIDS, Sexually Transmitted Infections, Neurosciences, Aging, Infectious Diseases, Brain Disorders, 2.1 Biological and endogenous factors, Neurological, Infection, Adult, Anti-HIV Agents, Biomarkers, Blood-Brain Barrier, CD4 Lymphocyte Count, CD4-Positive T-Lymphocytes, Central Nervous System, Corpus Callosum, Cross-Sectional Studies, Diffusion Tensor Imaging, HIV Infections, HIV-1, Humans, Inflammation, Male, Neuropsychological Tests, Prospective Studies, RNA, Viral, Viral Load, White Matter, corpus callosum, cerebrospinal fluid/plasma albumin ratio, diffusion tensor imaging, neopterin, neuropsychometric testing, primary HIV infection, white matter, Biological Sciences, Medical and Health Sciences, Psychology and Cognitive Sciences, Virology, Biomedical and clinical sciences, Health sciences
Abstract

ObjectiveInflammation and infection within the central nervous system is initiated during primary HIV infection (PHI), but the association of these processes with the integrity of brain white matter during PHI is unknown.DesignWe used diffusion tensor imaging (DTI) in this prospective cross-sectional neuroimaging study to determine the extent of white matter involvement in early HIV infection.MethodsAntiretroviral-naive PHI (defined as

Published
2015

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