Journal of Neural Transmission

, Volume 123, Issue 6, pp 643–651 | Cite as

Prefrontal cortical thinning in HIV infection is associated with impaired striatal functioning

  • Stéfan du Plessis
  • Matthijs Vink
  • John A. Joska
  • Eleni Koutsilieri
  • Asif Bagadia
  • Dan J. Stein
  • Robin Emsley
Psychiatry and Preclinical Psychiatric Studies - Original Article


While cortical thinning has been associated with HIV infection, it is unclear whether this reflects a direct effect of the virus, whether it is related to disruption of subcortical function or whether it is better explained by epiphenomena, such as drug abuse or comorbid medical conditions. The present study investigated the relationship between cortical thickness and subcortical function in HIV+ patients. Specifically, we examined the relationship between prefrontal cortical thickness and striatal function. Twenty-three largely treatment naïve, non-substance abusing HIV+ participants and 19 healthy controls matched for age, gender, and educational status were included. Cortical morphometry was performed using FreeSurfer software analysis. Striatal function was measured during an fMRI stop-signal anticipation task known to engage the striatum. Any cortical regions showing significant thinning were entered as dependent variables into a single linear regression model which included subcortical function, age, CD4 count, and a measure of global cognitive performance as independent predictors. The only cortical region that was significantly reduced after correction for multiple comparisons was the right superior frontal gyrus. Striatal activity was found to independently predict superior frontal gyral cortical thickness. While cortical thinning in HIV infection is likely multifactorial, viral induced subcortical dysfunction appears to play a role.


fMRI Cortex Atrophy HIV Inhibition Striatum 



The authors would like to thank Dr Hetta Gouse from the University of Cape Town, as well as Prof Rob Paul from the University of Missouri-St. Louis, for their assistance in determining the neuropsychological assessment battery as well as giving input into the neuropsychological assessments. The authors would also like to thank Mr Teboho Linda from the University of Cape Town for assisting in the recruiting of participants. S.D.P has received support from a National Research Fund International Research Training Grant (IRTG 1522), as well as support from the Medical Research Council of South Africa, Biological Psychiatry Special Interest Group of the South African Society of Psychiatrists as well as the HIV research Trust (HIVRT14-049). M.V and A.B. have reported no biomedical financial interests or potential conflicts of interest. J.J has received support from the Medical Research Council of South Africa. E.K. is supported by an EDCTP Strategic Primary Grant (SP. 2011.41304.065.) as well as a “Verein für Parkinson-Forschung” grant. D.S. has received research grants and/or consultancy honoraria from Abbott, Astrazeneca, Biocodex, Eli-Lilly, GlaxoSmithKline, Jazz Pharmaceuticals, Johnson & Johnson, Lundbeck, Novartis, Orion, Pfizer, Pharmacia, Roche, Servier, Solvay, Sumitomo, Sun, Takeda, Tikvah, and Wyeth. He is supported by the MRC of South Africa. R.E. has participated in speakers/advisory boards and received honoraria from AstraZeneca, Bristol-Myers Squibb, Janssen, Lilly, Lundbeck, Servier and Otsuka. He has also received research funding from Janssen, Lundbeck, and AstraZeneca.

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest to declare.


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Copyright information

© Springer-Verlag Wien 2016

Authors and Affiliations

  • Stéfan du Plessis
    • 1
  • Matthijs Vink
    • 2
  • John A. Joska
    • 5
  • Eleni Koutsilieri
    • 3
  • Asif Bagadia
    • 6
  • Dan J. Stein
    • 4
    • 5
  • Robin Emsley
    • 1
  1. 1.Department of Psychiatry, 2nd Floor Clinical Building, Faculty of Heath SciencesUniversity of StellenboschCape TownSouth Africa
  2. 2.Departments of Experimental and Developmental Psychology, Faculty of Social SciencesUtrecht UniversityUtrechtThe Netherlands
  3. 3.Institute for Virology and ImmunobiologyUniversity of WürzburgWürzburgGermany
  4. 4.Medical Research Council (Unit on Anxiety and Stress Disorders), 2nd Floor Clinical Building, Faculty of Heath SciencesUniversity of StellenboschCape TownSouth Africa
  5. 5.Department of PsychiatryUniversity of Cape Town, J-Block, Groote Schuur HospitalCape TownSouth Africa
  6. 6.Department of Radiology, 5th Floor Clinical Building, Faculty of Heath SciencesUniversity of StellenboschCape TownSouth Africa

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