Early microstructural white matter changes in patients with HIV

TY - JOUR

T1 - Early microstructural white matter changes in patients with HIV

T2 - a diffusion tensor imaging study

AU - Stubbe-Drger, Bianca

AU - Deppe, Michael

AU - Mohammadi, Siawoosh

AU - Keller, Simon S

AU - Kugel, Harald

AU - Gregor, Nora

AU - Evers, Stefan

AU - Young, Peter

AU - Ringelstein, E-Bernd

AU - Arendt, Gabriele

AU - Knecht, Stefan

AU - Husstedt, Ingo W

AU - German Competence Network HIV/AIDS

PY - 2012/1/1

Y1 - 2012/1/1

N2 - BACKGROUND: Previous studies have reported white matter (WM) brain alterations in asymptomatic patients with human immunodeficiency virus (HIV).METHODS: We compared diffusion tensor imaging (DTI) derived WM fractional anisotropy (FA) between HIV-patients with and without mild macroscopic brain lesions determined using standard magnetic resonance imaging (MRI). We furthermore investigated whether WM alterations co-occurred with neurocognitive deficits and depression. We performed structural MRI and DTI for 19 patients and 19 age-matched healthy controls. Regionally-specific WM integrity was investigated using voxel-based statistics of whole-brain FA maps and region-of-interest analysis. Each patient underwent laboratory and neuropsychological tests.RESULTS: Structural MRI revealed no lesions in twelve (HIV-MRN) and unspecific mild macrostructural lesions in seven patients (HIV-MRL). Both analyses revealed widespread FA-alterations in all patients. Patients with HIV-MRL had FA-alterations primarily adjacent to the observed lesions and, whilst reduced in extent, patients with HIV-MRN also exhibited FA-alterations in similar regions. Patients with evidence of depression showed FA-increase in the ventral tegmental area, pallidum and nucleus accumbens in both hemispheres, and patients with evidence of HIV-associated neurocognitive disorder showed widespread FA-reduction.CONCLUSION: These results show that patients with HIV-MRN have evidence of FA-alterations in similar regions that are lesioned in HIV-MRL patients, suggesting common neuropathological processes. Furthermore, they suggest a biological rather than a reactive origin of depression in HIV-patients.

AB - BACKGROUND: Previous studies have reported white matter (WM) brain alterations in asymptomatic patients with human immunodeficiency virus (HIV).METHODS: We compared diffusion tensor imaging (DTI) derived WM fractional anisotropy (FA) between HIV-patients with and without mild macroscopic brain lesions determined using standard magnetic resonance imaging (MRI). We furthermore investigated whether WM alterations co-occurred with neurocognitive deficits and depression. We performed structural MRI and DTI for 19 patients and 19 age-matched healthy controls. Regionally-specific WM integrity was investigated using voxel-based statistics of whole-brain FA maps and region-of-interest analysis. Each patient underwent laboratory and neuropsychological tests.RESULTS: Structural MRI revealed no lesions in twelve (HIV-MRN) and unspecific mild macrostructural lesions in seven patients (HIV-MRL). Both analyses revealed widespread FA-alterations in all patients. Patients with HIV-MRL had FA-alterations primarily adjacent to the observed lesions and, whilst reduced in extent, patients with HIV-MRN also exhibited FA-alterations in similar regions. Patients with evidence of depression showed FA-increase in the ventral tegmental area, pallidum and nucleus accumbens in both hemispheres, and patients with evidence of HIV-associated neurocognitive disorder showed widespread FA-reduction.CONCLUSION: These results show that patients with HIV-MRN have evidence of FA-alterations in similar regions that are lesioned in HIV-MRL patients, suggesting common neuropathological processes. Furthermore, they suggest a biological rather than a reactive origin of depression in HIV-patients.

KW - Adult

KW - Brain

KW - Cognition Disorders

KW - Depression

KW - Diffusion Tensor Imaging

KW - Female

KW - HIV Infections

KW - Humans

KW - Male

KW - Middle Aged

KW - Nerve Fibers, Myelinated

KW - Reproducibility of Results

KW - Sensitivity and Specificity

KW - Young Adult

U2 - 10.1186/1471-2377-12-23

DO - 10.1186/1471-2377-12-23

M3 - SCORING: Journal article

C2 - 22548835

VL - 12

SP - 23

JO - BMC NEUROL

JF - BMC NEUROL

SN - 1471-2377

ER -