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Retrosplenial cortical thinning as a possible major contributor for cognitive impairment in HIV patients

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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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Author information

Authors and Affiliations

  1. Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea

    Na-Young Shin

  2. Department of Biomedical Engineering, College of Health and Medical Science, Catholic University of Daegu, Hayang-Ro 13-13, Hayang-Eup, Gyeongsan-si, Gyeongbuk, Republic of Korea, 38430

    Jinwoo Hong & Uicheul Yoon

  3. Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea

    Jun Yong Choi

  4. Department of Radiology, Yonsei University College of Medicine, Seoul, Korea

    Seung-Koo Lee

  5. Department of Radiology, Ewha Womans University, School of Medicine, Seoul, Korea

    Soo Mee Lim

Authors
  1. Na-Young Shin
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Corresponding author

Correspondence to Uicheul Yoon.

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Guarantor

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

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