Diagnostic Neuroradiology

Neuroradiology

, Volume 54, Issue 2, pp 113-121

First online:

Factors affecting brain structure in men with HIV disease in the post-HAART era

  • James T. BeckerAffiliated withDepartment of Psychiatry, University of Pittsburgh School of MedicineDepartment of Neurology, University of Pittsburgh School of MedicineDepartment of Psychology, University of Pittsburgh School of MedicineNeuropsychology Research Program Email author 
  • , Victoria MarucaAffiliated withSpalding University
  • , Lawrence A. KingsleyAffiliated withDepartment of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh
  • , Joanne M. SandersAffiliated withDepartment of Epidemiology, Bloomberg School of Public Health, The Johns Hopkins University
  • , Jeffery R. AlgerAffiliated withDepartment of Neurology, University of California Los Angeles
  • , Peter B. BarkerAffiliated withDepartment of Radiology, The Johns Hopkins University School of Medicine
  • , Karl GoodkinAffiliated withNeuropsychiatric Institute, University of California Los Angeles
  • , Eileen MartinAffiliated withDepartment of Psychiatry, University of Illinois at Chicago
  • , Eric N. MillerAffiliated withNeuropsychiatric Institute, University of California Los Angeles
    • , Ann RaginAffiliated withDepartment of Neurology, Feinberg School of Medicine, Northwestern University
    • , Ned SacktorAffiliated withDepartment of Neurology, The Johns Hopkins University School of Medicine
    • , Ola SelnesAffiliated withDepartment of Neurology, The Johns Hopkins University School of Medicine
    • , for the Multicenter AIDS Cohort Study

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Abstract

Introduction

The purpose of this study was to characterize brain volumetric differences in HIV seropositive and seronegative men and to determine effects of age, cardiovascular risk, and HIV infection on structural integrity.

Methods

Magnetic resonance imaging was used to acquire high-resolution neuroanatomic data in 160 men aged 50 years and over, including 84 HIV seropositive and 76 seronegative controls. Voxel-based morphometry was used to derive volumetric measurements at the level of the individual voxel. Data from a detailed neuropsychological test battery were recombined into four summary scores representing psychomotor speed, visual memory, verbal memory, and verbal fluency.

Results

Both age and HIV status had a significant effect on both gray matter (GM) and white matter (WM) volume. The age-related GM atrophy was primarily in the superior temporal and inferior frontal regions; the HIV-related GM loss included the posterior and inferior temporal lobes, the parietal lobes, and the cerebellum. Among all subjects, the performance on neuropsychological tests, as indexed by a summary variable, was related to the volume of both the GM and WM. Contrary to our predictions, the CVD variables were not linked to brain volume in statistically adjusted models.

Conclusion

In the post-HAART era, having HIV infection is still linked to atrophy in both GM and WM. Secondly, advancing age, even in this relatively young cohort, is also linked to changes in GM and WM volume. Thirdly, CNS structural integrity is associated with overall cognitive functions, regardless of the HIV infection status of the study volunteers.

Keywords

MRI Cognition HIV Age Voxel-based morphometry