Journal of NeuroVirology

, Volume 20, Issue 3, pp 209–218

HIV-associated distal neuropathic pain is associated with smaller total cerebral cortical gray matter

  • John R. Keltner
  • Christine Fennema-Notestine
  • Florin Vaida
  • Dongzhe Wang
  • Donald R. Franklin
  • Robert H. Dworkin
  • Chelsea Sanders
  • J. Allen McCutchan
  • Sarah L. Archibald
  • David J. Miller
  • George Kesidis
  • Clint Cushman
  • Sung Min Kim
  • Ian Abramson
  • Michael J. Taylor
  • Rebecca J. Theilmann
  • Michelle D. Julaton
  • Randy J. Notestine
  • Stephanie Corkran
  • Mariana Cherner
  • Nichole A. Duarte
  • Terry Alexander
  • Jessica Robinson-Papp
  • Benjamin B. Gelman
  • David M. Simpson
  • Ann C. Collier
  • Christina M. Marra
  • Susan Morgello
  • Greg Brown
  • Igor Grant
  • J. Hampton Atkinson
  • Terry L. Jernigan
  • Ronald J. Ellis
  • for the CHARTER Group
Article

Abstract

Despite modern antiretroviral therapy, HIV-associated sensory neuropathy affects over 50 % of HIV patients. The clinical expression of HIV neuropathy is highly variable: many individuals report few symptoms, but about half report distal neuropathic pain (DNP), making it one of the most prevalent, disabling, and treatment-resistant complications of HIV disease. The presence and intensity of pain is not fully explained by the degree of peripheral nerve damage, making it unclear why some patients do, and others do not, report pain. To better understand central nervous system contributions to HIV DNP, we performed a cross-sectional analysis of structural magnetic resonance imaging volumes in 241 HIV-infected participants from an observational multi-site cohort study at five US sites (CNS HIV Anti-Retroviral Treatment Effects Research Study, CHARTER). The association between DNP and the structural imaging outcomes was investigated using both linear and nonlinear (Gaussian Kernel support vector) multivariable regression, controlling for key demographic and clinical variables. Severity of DNP symptoms was correlated with smaller total cerebral cortical gray matter volume (r = −0.24; p = 0.004). Understanding the mechanisms for this association between smaller total cortical volumes and DNP may provide insight into HIV DNP chronicity and treatment-resistance.

Keywords

HIV distal neuropathic pain Structural MRI Cortical volume 

Supplementary material

13365_2014_236_MOESM1_ESM.pdf (369 kb)
ESM 1(PDF 368 kb)

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Copyright information

© Journal of NeuroVirology, Inc. 2014

Authors and Affiliations

  • John R. Keltner
    • 1
    • 12
  • Christine Fennema-Notestine
    • 1
  • Florin Vaida
    • 2
  • Dongzhe Wang
    • 3
  • Donald R. Franklin
    • 1
  • Robert H. Dworkin
    • 4
  • Chelsea Sanders
    • 1
  • J. Allen McCutchan
    • 5
  • Sarah L. Archibald
    • 1
  • David J. Miller
    • 3
  • George Kesidis
    • 3
  • Clint Cushman
    • 1
  • Sung Min Kim
    • 6
  • Ian Abramson
    • 1
  • Michael J. Taylor
    • 1
  • Rebecca J. Theilmann
    • 7
  • Michelle D. Julaton
    • 1
  • Randy J. Notestine
    • 1
  • Stephanie Corkran
    • 1
  • Mariana Cherner
    • 1
  • Nichole A. Duarte
    • 1
  • Terry Alexander
    • 8
  • Jessica Robinson-Papp
    • 9
  • Benjamin B. Gelman
    • 10
  • David M. Simpson
    • 9
  • Ann C. Collier
    • 11
  • Christina M. Marra
    • 11
  • Susan Morgello
    • 9
  • Greg Brown
    • 12
    • 1
  • Igor Grant
    • 1
  • J. Hampton Atkinson
    • 1
    • 12
  • Terry L. Jernigan
    • 1
  • Ronald J. Ellis
    • 8
  • for the CHARTER Group
  1. 1.Department of PsychiatryUniversity of California San DiegoSan DiegoUSA
  2. 2.Department of Family and Preventative MedicineUniversity of California San DiegoSan DiegoUSA
  3. 3.Department of Electrical EngineeringPennsylvania State UniversityState CollegeUSA
  4. 4.Department of AnesthesiologyUniversity of Rochester Medical CenterRochesterUSA
  5. 5.Department of MedicineUniversity of California San DiegoSan DiegoUSA
  6. 6.Department of BioengineeringUniversity of CaliforniaSan DiegoUSA
  7. 7.Department of RadiologyUniversity of California San DiegoSan DiegoUSA
  8. 8.Department of NeurosciencesUniversity of California San DiegoSan DiegoUSA
  9. 9.Department of NeurologyThe Mount Sinai School of MedicineNew YorkUSA
  10. 10.Department of PathologyUniversity of Texas Medical BranchGalvestonUSA
  11. 11.Department of MedicineUniversity of WashingtonSeattleUSA
  12. 12.VA San Diego Healthcare SystemSan DiegoUSA

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