Altered Brain Function in Young HIV Patients with Syphilis Infection: A Voxel-Wise Degree Centrality Analysis

Xiao-Dong Zhang,1,2 Guang-Xue Liu,3 Xiao-Yue Wang,2 Xiao-Jie Huang,4 Jing-Li Li,1 Rui-Li Li,2 Hong-Jun Li2 1Department of Radiology, Tianjin First Central Hospital, Tianjin 300192, People’s Republic of China; 2Department of Radiology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, People’s Republic of China; 3Department of Natural Medicines, School of Pharmaceutical Sciences, Peking University Health Science Center, Beijing 100191, People’s Republic of China; 4Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing 100069, People’s Republic of ChinaCorrespondence: Rui-Li Li; Hong-Jun LiDepartment of Radiology, Beijing Youan Hospital, Capital Medical University, No. 8, Xi Tou Tiao, Youanmen Wai, Fengtai District, Beijing 100069, People’s Republic of ChinaTel +86 010 83997337Fax +86 010 63051182Email 1985lrli@sina.com; lihongjun00113@sina.comObjective: This study assessed the possible effect of syphilis co-infection in the brain function in young HIV patients by using voxel-wise degree centrality (DC) analysis.Methods: Forty-four syphilis-co-infected HIV patients (HIV+/syphilis+), 45 HIV patients without syphilis history (HIV+/syphilis-) and 43 matched healthy controls (HC) underwent resting-state fMRI examinations. Laboratory tests and a battery of neuropsychological tests were performed before each MRI examination. One-way ANOVA was used to compare the differences of DC among the three groups. The correlations between MRI metrics and laboratory/neuropsychological tests in each patient’s group were performed by Pearson correlation analysis.Results: Compared with HIV+/syphilis-, worse performance in complex motor skills was found in HIV+/syphilis+. Compared with HC, HIV+/syphilis+ and HIV+/syphilis- groups showed attenuated DC in the right orbital frontal cortex and increased DC in the left parietal/temporal cortex. Besides, we also found increased DC in the left inferior frontal cortex and bilateral posterior cingulated cortex/precuneus in HIV+/syphilis+ compared with HC. Moreover, compared with HIV+/syphilis-, HIV+/syphilis+ displayed decreased DC in the left middle occipital cortex. Additionally, in HIV+/syphilis+ group, the mean z value of DC was correlated to the CD4+ cell counts and the learning and delayed recall score.Conclusion: Syphilis co-infection might be related to more brain functional reorganization in young HIV patients which could be reflected by DC value.Keywords: syphilis, HIV, functional connectivity, fMRI, brain