Abstract
Objectives
To identify brain cortical regions relevant to HIV-associated neurocognitive disorder (HAND) in HIV patients.
Methods
HIV patients with HAND (n = 10), those with intact cognition (HIV-IC; n = 12), and age-matched, seronegative controls (n = 11) were recruited. All participants were male and underwent 3-dimensional T1-weighted imaging. Both vertex-wise and region of interest (ROI) analyses were performed to analyse cortical thickness.
Results
Compared to controls, both HIV-IC and HAND showed decreased cortical thickness mainly in the bilateral primary sensorimotor areas, extending to the prefrontal and parietal cortices. When directly comparing HIV-IC and HAND, HAND showed cortical thinning in the left retrosplenial cortex, left dorsolateral prefrontal cortex, left inferior parietal lobule, bilateral superior medial prefrontal cortices, right temporoparietal junction and left hippocampus, and cortical thickening in the left middle occipital cortex. Left retrosplenial cortical thinning showed significant correlation with slower information processing, declined verbal memory and executive function, and impaired fine motor skills.
Conclusions
This study supports previous research suggesting the selective vulnerability of the primary sensorimotor cortices and associations between cortical thinning in the prefrontal and parietal cortices and cognitive impairment in HIV-infected patients. Furthermore, for the first time, we propose retrosplenial cortical thinning as a possible major contributor to HIV-associated cognitive impairment.
Key points
• Primary sensorimotor and supplementary motor cortices were selectively vulnerable to HIV infection
• Prefrontal and parietal cortical thinning was associated with HIV-associated cognitive impairment
• Retrosplenial cortical thinning might be a major contributor to HIV-associated cognitive impairment
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Abbreviations
- DLPFC:
-
dorsolateral prefrontal cortex
- K-AVLT:
-
Korean version of auditory verbal learning test
- KCFT:
-
Korean version of complex figure test
- K-WAIS:
-
Korean version of Wechsler Adult Intelligence Scale
- HAART:
-
highly active antiretroviral therapy
- HAND:
-
HIV-associated neurocognitive disorder
- HIV-IC:
-
HIV patients with intact cognition
- IPL:
-
inferior parietal lobule
- MPFC:
-
medial prefrontal cortex
- RNA:
-
ribonucleic acid
- ROI:
-
region-of-interest
- TMT A:
-
trail making test part A
- TMT B:
-
trail making test part B
- TPJ:
-
temporoparietal junction
- WCST:
-
Wisconsin card sorting test
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The scientific guarantor of this publication is Soo Mee Lim.
Conflict of interest
The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.
Funding
This study has received funding by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (NRF-2013R1A1A2005412), a Chronic Infectious Disease Cohort grant (4800-4859-304-260) from the Korea Centers for Disease Control and Prevention, and BioNano Health-Guard Research Center funded by the Ministry of Science, ICT, and Future Planning of Korea as a Global Frontier Project (Grant H-GUARD_2013M3A6B2078953).
Statistics and biometry
No complex statistical methods were necessary for this paper.
Informed consent
Written informed consent was obtained from all subjects (patients) in this study.
Ethical approval
Institutional review board approval was obtained.
Study subjects or cohorts overlap
Some study subjects or cohorts have been previously reported in Ann HW, Jun S, Shin NY et al (2016) Characteristics of resting-state functional connectivity in HIV-associated neurocognitive disorder. PLoS One, 11(4), e0153493.
Methodology
• Prospective
• Case-control study
• Performed at one institution
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Shin, NY., Hong, J., Choi, J.Y. et al. Retrosplenial cortical thinning as a possible major contributor for cognitive impairment in HIV patients. Eur Radiol 27, 4721–4729 (2017). https://doi.org/10.1007/s00330-017-4836-6
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DOI: https://doi.org/10.1007/s00330-017-4836-6