Effects of social adversity and HIV on subcortical shape and neurocognitive function
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The purpose of the current study was to examine the independent and interactive effects of social adversity (SA) and HIV infection on subcortical shape alterations and cognitive functions. Participants included HIV+ (n = 70) and HIV- (n = 23) individuals who underwent MRI, neurocognitive and clinical assessment, in addition to completing questionnaires from which responses were used to create an SA score. Bilateral amygdalae and hippocampi were extracted from T1-weighted images. Parametric statistical analyses were used to compare the radial distance of the structure surface to a median curve to determine the presence of localized shape differences as a function of HIV, SA and their interaction. Next, multiple regression was used to examine the interactive association between HIV and SA with cognitive performance data. An HIV*SA interactive effect was found on the shape of the right amygdala and left hippocampus. Specifically, HIV-infected participants (but not HIV-uninfected controls) who evidenced higher levels of SA displayed an inward deformation of the surface consistent with reduced volume of these structures. We found interactive effects of HIV and SA on learning/memory performance. These results suggest that HIV+ individuals may be more vulnerable to neurological and cognitive changes in the hippocampus and amygdala as a function of SA than HIV- individuals, and that SA indicators of childhood SES and perceived racial discrimination are important components of adversity that are associated with cognitive performance.
KeywordsHuman immunodeficiency virus Hippocampus Amygdala Adversity Structural neuroimaging Cognition
We would like to thank William Cunningham, M.D., M.P.H. and Ronald Hays, Ph.D. for their helpful comments and suggestions on the manuscript.
We would like to acknowledge the following funding sources:
National Institute of Mental Health (NIMH) K23 MH095661 (PI: A. Thames)
Dr. Kuhn is supported through a National Institute of Mental Health T32 Postdoctoral Fellowship (Kuhn, MH 19535).
Mr. Williamson is supported through a National Institute of Mental Health Predoctoral Fellowship (Williamson, MH 15750)
Compliance with ethical standards
This study was funded by National Institute of Mental Health (NIMH) K23 MH095661 (PI: A. Thames)
Conflict of interest
Dr. April Thames declares that she has no conflict of interest.
Dr. Taylor Kuhn declares that he has no conflict of interest.
Ms. Zanjbeel Mahmood declares that she has no conflict of interest.
Dr. Robert Bilder declares that he has no conflict of interest.
Mr. Timothy Williamson declares that he has no conflict of interest.
Dr. Elyse Singer declares that she has no conflict of interest.
Dr. Alyssa Arentoft declares no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study. All procedures were approved by UCLA Institutional Review Board.
- Allison, P. (2012). When can you safely ignore multicollinearity? Statistical Horizons. Last modified September 10, 2012.Google Scholar
- Alvarez-Uria, G., Naik, P. K., Pakam, R., & Midde, M. (2012). Early HIV viral load determination after initiating first-line antiretroviral therapy for indentifying patients with high risk of developing virological failure: data from a cohort study in a resource-limited setting. Tropical Medicine & International Health, 17, 1152–1155. doi: 10.1111/j.1365-3156.2012.02982.x.CrossRefGoogle Scholar
- Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the beck depression inventory-II. San Antonio: Psychological Corporation, 1, 82.Google Scholar
- Bosch, N. M., Riese, H., Reijneveld, S. A., Bakker, M. P., Verhulst, F. C., Ormel, J., & Oldehinkel, A. J. (2012). Timing matters: long term effects of adversities from prenatal period up to adolescence on adolescents’ cortisol stress response. The TRAILS study. Psychoneuroendocrinology, 37(9), 1439–1447.CrossRefPubMedGoogle Scholar
- Centers for Disease Control (2015). HIV in African Americans. Fast Facts. Retrived online from: www.cdc.gov/hif/pdf/HIV-AA-english-508.pdf.
- Clark, U. S., Cohen, R. A., Sweet, L. H., Gongvatana, A., Devlin, K. N., Hana, G. N., et al. (2012). Effects of HIV and early life stress on amygdala morphometry and neurocognitive function. Journal of the International Neuropsychological Society, 18(04), 657–668.CrossRefPubMedPubMedCentralGoogle Scholar
- Costafreda, S. G., Dinov, I. D., Zhuowen, T., Shi, Y., Liu, C.-Y., Kloszewska, I., Mecocci, P., Soininen, H., Tsolaki, M., Vellas, B., Wahlund, L.-O., Spenger, C., Toga, A. W., Lovestone, S., & Simmons, A. (2011). Automated hippocampal shape analysis predicts the onset of dementia in mild cognitive impairment. NeuroImage, 56(1), 212–219.CrossRefPubMedPubMedCentralGoogle Scholar
- Cunningham, W. E., Hays, R. D., Duan, N., Andersen, R., Nakazono, T. T., Bozzette, S. A., & Shapiro, M. F. (2005). The effect of socioeconomic status on the survival of people receiving care for HIV infection in the United States. Journal of Health Care for the Poor and Underserved, 16(4), 655–676.CrossRefPubMedGoogle Scholar
- Heaton, R. K., Franklin, D. R., Ellis, R. J., McCutchan, J. A., Letendre, S. L., LeBlanc, S., et al. (2011). HIV-associated neurocognitive disorders before and during the era of combination antiretroviral therapy: differences in rates, nature, and predictors. Journal of Neurovirology, 17(1), 3–16.CrossRefPubMedGoogle Scholar
- Hollingshead, A. B. & Redlich, F. C. (2007). Social class and mental illness: a community study. 1958. American Journal of Public Health, 97(10), 1756–1757.Google Scholar
- Jednoróg, K., Altarelli, I., Monzalvo, K., Fluss, J., Dubois, J., et al. (2012). Correction: the influence of socioeconomic status on children’s brain structure. PloS One, 7(10). doi: 10.1371/annotation/47661de2-2c53-4396-9f88-06b5ad233566.
- Kumar, M., Kumar, A. M., Morgan, R., Szapocznik, J., & Eisdorfer, C. (1993). Abnormal pituitary-adrenocortical response in early HIV-1 infection. Journal of Aquired Immune Deficiency Syndrome, 6, 61–65.Google Scholar
- Montez, J. K., Bromberger, J. T., Harlow, S. D., Kravitz, H. M., & Matthews, K. A. (2016). Life-course socioeconomic status and metabolic syndrome among midlife women. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences. doi: 10.1093/geronb/gbw014.
- Patterson, S., Moran, P., Epel, E., Sinclair, E., Kemeny, M., Deeks, S.G., Bacchetti, P., Acree, M., Epling, L., Kirschbaum, C., Hecht, F.M. (2013). Cortisol patterns are associated with T cell activation in HIV. PLOS One: Retrieved online from http://www.plosone.org.
- Rubin, L. H., Cook, J. A., Weber, K. M., Cohen, M. H., Martin, E., Valcour, V., Milam, J., Anastos, K., Young, M. A., Alden, C., Gustafson, D. R., & Maki, P. M. (2015). The association of perceived stress and verbal memory is greater in HIV-infected versus HIV-uninfected women. Journal of Neurovirology, 21(4), 422–432 PMID: 25791344.CrossRefPubMedPubMedCentralGoogle Scholar
- Schuster, M. A., Collins, R., Cunningham, W. E., Morton, S. C., Zierler, S., Wong, M., & Kanouse, D. E. (2005). Perceived discrimination in clinical care in a nationally representative sample of HIV-infected adults receiving health care. Journal of General Internal Medicine, 20(9), 807–813.CrossRefPubMedPubMedCentralGoogle Scholar
- Spies, G. & Seedat, S. (2014). Depression and resilience in women with HIV and early life stress: does trauma play a mediating role? A cross-sectional study 4(2).Google Scholar
- Spitzer, R. L., Williams, J. B., Gibbon, M., & First, M. B. (1995). Structured clinical interview for DSM-IV (SCID). New York: Biometrics Research.Google Scholar
- Tang, X., Holland, D., Dale, A. M., Younes, L., & Miller, M. I. (2014). Shape abnormalities of subcortical and ventricular structures in mild cognitive impairment and Alzheimer's disease: detecting, quantifying, and predicting. Human Brain Mapping, 35(8), 3701–3725.CrossRefPubMedPubMedCentralGoogle Scholar
- Thames, A. D., Hinkin, C. H., Byrd, D. A., Bilder, R. M., Duff, K. J., Mindt, M. R., et al. (2013). Effects of stereotype threat, perceived discrimination, and examiner race on neuropsychological performance: simple as black and white? Journal of the International Neuropsychological Society, 19(05), 583–593.CrossRefPubMedPubMedCentralGoogle Scholar
- Tozzi, V., Balestra, P., Bellagamba, R., Corpolongo, A., Salvatori, M. F., Visco-Comandini, U., et al. (2007). Persistence of neuropsychologic deficits despite long-term highly active antiretroviral therapy in patients with HIV-related neurocognitive impairment: prevalence and risk factors. Journal of Acquired Immune Deficiency Syndromes, 45(2), 174–182.CrossRefPubMedGoogle Scholar
- Van den Bogaard, S. J., Dumas, E. M., Ferrarini, L., Milles, J., van Buchem, M. A., van der Grond, J., & Roos, R. A. (2011). Shape analysis of subcortical nuclei in Huntington's disease, global versus local atrophy–A results from the TRACK-HD study. Journal of Neurological Sciences, 307(1-2), 60–68.CrossRefGoogle Scholar
- WHO (2010). Antiretroviral therapy for HIV infection in adults and adolescents 2010. http://www.who.int/hiv/pub/arv/ adult2010/en/index.html. Accessed 29 Sept 2016.