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Cerebrovascular risk factors and brain microstructural abnormalities on diffusion tensor images in HIV-infected individuals

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Abstract

HIV-associated neurocognitive disorder remains prevalent in HIV-infected individuals despite effective antiretroviral therapy. As these individuals age, comorbid cerebrovascular disease will likely impact cognitive function. Effective tools to study this impact are needed. This study used diffusion tensor imaging (DTI) to characterize brain microstructural changes in HIV-infected individuals with and without cerebrovascular risk factors. Diffusion-weighted MRIs were obtained in 22 HIV-infected subjects aged 50 years or older (mean age = 58 years, standard deviation = 6 years; 19 males, three females). Tensors were calculated to obtain fractional anisotropy (FA) and mean diffusivity (MD) maps. Statistical comparisons accounting for multiple comparisons were made between groups with and without cerebrovascular risk factors. Abnormal glucose metabolism (i.e., impaired fasting glucose, impaired glucose tolerance, or diabetes mellitus) was associated with significantly higher MD (false discovery rate (FDR) critical p value = 0.008) and lower FA (FDR critical p value = 0.002) in the caudate and lower FA in the hippocampus (FDR critical p value = 0.004). Pearson correlations were performed between DTI measures in the caudate and hippocampus and age- and education-adjusted composite scores of global cognitive function, memory, and psychomotor speed. There were no detectable correlations between the neuroimaging measures and measures of cognition. In summary, we demonstrate that brain microstructural abnormalities are associated with abnormal glucose metabolism in the caudate and hippocampus of HIV-infected individuals. Deep gray matter structures and the hippocampus may be vulnerable in subjects with comorbid abnormal glucose metabolism, but our results should be confirmed in further studies.

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Abbreviations

Aβ:

Amyloid-beta

APOE ε4:

Apolipoprotein epsilon 4

ATP-III:

Adult Treatment Panel III

BDI-II:

Beck Depression Inventory II

cART:

Combination antiretroviral therapy

DBP:

Diastolic blood pressure

DTI:

Diffusion tensor imaging

FA:

Fractional anisotropy

FDR:

False discovery rate

IDE:

Insulin-degrading enzyme

MD:

Mean diffusivity

NPZ-3-mem:

Age- and education-adjusted composite score of memory

NPZ-3-pm:

Age- and education-adjusted composite score of psychomotor speed

NPZ-8:

Age- and education-adjusted composite score of global cognitive function

OGTT:

2-h oral glucose tolerance test

PET:

Positron emission tomography

ROIs:

Regions of interest

SBP:

Systolic blood pressure

SD:

Standard deviation

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Acknowledgments

BKN, KJK, DCC, and CMS are funded in part by research grants P20RR011091, U54NS43049, and U54RR026136. NJ and PT are funded in part by R01 EB008432 and EB 007813, and R01 AG040060 and a UCLA Medical Informatics Fellowship (NJ).

Author information

Authors and Affiliations

  1. University of Hawaii, Honolulu, HI, USA

    Beau K. Nakamoto, Kalpana J. Kallianpur, Dominic C. Chow, Liron Marotz & Cecilia M. Shikuma

  2. Straub Clinics and Hospital, Honolulu, HI, USA

    Beau K. Nakamoto

  3. Laboratory of Neuro Imaging, Departments of Neurology and Psychiatry, UCLA School of Medicine, Los Angeles, CA, USA

    Neda Jahanshad & Paul M. Thompson

  4. Ventura County Medical Center, Ventura, CA, USA

    Aaron McMurtray

  5. University of California at San Francisco, San Francisco, CA, USA

    Victor G. Valcour

  6. University of Missouri, St. Louis, MO, USA

    Robert H. Paul

  7. Hawaii Center for AIDS, John A. Burns School of Medicine, University of Hawaii at Manoa, 3675 Kilauea Ave. Young Bldg 5th Floor, Honolulu, HI, 96816, USA

    Beau K. Nakamoto

Authors
  1. Beau K. Nakamoto
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  2. Neda Jahanshad
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  3. Aaron McMurtray
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  4. Kalpana J. Kallianpur
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  5. Dominic C. Chow
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  6. Victor G. Valcour
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  7. Robert H. Paul
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  8. Liron Marotz
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  9. Paul M. Thompson
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  10. Cecilia M. Shikuma
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Corresponding author

Correspondence to Beau K. Nakamoto.

Additional information

Beau K. Nakamoto and Neda Jahanshad contributed equally to this manuscript.

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Nakamoto, B.K., Jahanshad, N., McMurtray, A. et al. Cerebrovascular risk factors and brain microstructural abnormalities on diffusion tensor images in HIV-infected individuals. J. Neurovirol. 18, 303–312 (2012). https://doi.org/10.1007/s13365-012-0106-1

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  • DOI: https://doi.org/10.1007/s13365-012-0106-1

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