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Neuropsychological Function and Cerebral Metabolites in HIV-infected Youth

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Abstract

The effects of HIV on brain metabolites and cognitive function are not well understood. Sixteen HIV+youths (15 vertical, 1 transfusion transmissions) receiving combination antiretroviral therapy and 14 age-matched HIV- youths (13–25 years of age) were evaluated with brain two-dimensional (2D) magnetic resonance spectroscopy (MRS) at 3 Tesla (T) and a neuropsychological battery that assessed three cognitive domains (attention/processing speed, psychomotor ability, and executive function). The relationship between brain metabolite ratios and cognitive performance was explored. Compared to HIV- controls, HIV+ subjects had higher sycllo-inositol (Scy)/total creatine (tCr) (+32%, p = 0.016) and higher Scy/total choline (tCho) (+31%, p = 0.018) on 2D-MRS in the right frontal lobe. HIV+ subjects also had higher glutamate (Glu)/tCr (+13%, p = 0.022) and higher Glu/tCho (+15%, p = 0.048) than controls. HIV+ subjects demonstrated poorer attention/processing speed (p = 0.011, d = 1.03) but similar psychomotor and executive function compared to HIV- controls. The attention/processing score also correlated negatively with the ratio of N-acetylaspartate (NAA) to tCr on 2D-MRS (r = −0.75, p = 0.0019) in the HIV- controls, but not in the HIV+ subjects (Fisher’s r-z transformation, p < 0.05). Our results suggest that attention/processing speed is impacted by early HIV infection and is associated with right hemisphere NAA/tCr. Scy and Glu ratios are also potential markers of brain health in chronic, lifelong HIV infection in perinatally infected youths receiving antiretroviral therapy.

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Acknowledgments

The authors wish to thank Patricia Taylor for library assistance; Drs. ChrisAnna Mink and Monica Sifuentes for recruitment of control pediatric subjects at Harbor-UCLA Medical Center; Seema Kanwal, M.D., Yolanda Gonzalez, R.N., and Alma Ramirez for assistance in subject recruitment and support. Drs. Keller and Thomas acknowledge grant support from NIH NINDS (1R21NS060620-01A1).

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, CA, USA

    R. Nagarajan, M. K. Sarma, M. A. Thomas, K. Nielsen-Saines & J. Deville

  2. University of Hawaii, Honolulu, HI, USA

    L. Chang

  3. Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA

    U. Natha, M. Wright, J. Hayes, K. Mason, T. Critton-Mastandrea, S. Nazarian, J. Jing & M. A. Keller

  4. Miller’s Children’s Hospital of Long Beach, Long Beach, CA, USA

    D. E. Michalik

  5. Children’s Hospital Los Angeles, Los Angeles, CA, USA

    J. A. Church

  6. Department of Pediatrics, Harbor-UCLA Medical Center, 1000 West Carson Street, Liu Building, RB3, Box 467, Torrance, CA, 90509, USA

    M. A. Keller

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  1. R. Nagarajan
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Nagarajan, R., Sarma, M.K., Thomas, M.A. et al. Neuropsychological Function and Cerebral Metabolites in HIV-infected Youth. J Neuroimmune Pharmacol 7, 981–990 (2012). https://doi.org/10.1007/s11481-012-9407-7

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