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Correlating brain volume and callosal thickness with clinical and laboratory indicators of disease severity in children with HIV-related brain disease

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Abstract

Background

Objective MRI markers of central nervous system disease severity may precede subjective features of HIV encephalopathy in children. Previous work in HIV-infected adults shows that brain atrophy was associated with low CD4 and with neuropsychological impairment. Significant thinning of the corpus callosum (CC), predominantly anteriorly, was also found in HIV-infected adults and correlated with CD4 levels. These findings have not been tested in children.

Purpose

The aim of this study was to determine if brain volume and midsagittal CC linear measurements (thickness and length) on MRI in children with HIV-related brain disease correlate with clinical and laboratory parameters of disease severity.

Methods

Retrospective MRI analysis in children with HIV-related brain disease used a volumetric analysis software and a semi-automated tool to measure brain volume and callosal thickness/length, respectively. Each measure was correlated with clinical parameters of disease severity including Griffiths Mental Development scores (GMDS), absolute CD4 counts (cells/mm3), nadir CD4 (the lowest CD4 recorded, excluding baseline), duration of HAART, and decreased brain growth.

Results

Thirty-three children with HIV-related brain disease were included. Premotor segment of the CC mean thickness correlated with age (p = 0.394). Motor CC maximum thickness correlated significantly with general developmental quotient (p = 0.0277); CC length correlated with a diagnosis of acquired microcephaly (p = 0.0071) and to CD4 level closest to date of the MRI scan (p = 0.04).

Conclusions

Length of the CC and the “motor CC segment” may represent surrogate clinical biomarkers of central nervous system disease severity and with decreased level of immunity in HIV-infected patients that precede established HIV encephalopathy.

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Abbreviations

CC:

Corpus callosum

TBV:

Total brain volume

GM:

Gray matter

WM:

White matter

GMDS:

Griffiths Mental Development scores

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Authors and Affiliations

  1. Department of Radiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

    Savvas Andronikou

  2. Department of Radiology, Stellenbosch University, Stellenbosch, South Africa

    Christelle Ackermann

  3. Children’s Infectious Diseases Research Unit, Stellenbosch University, Stellenbosch, South Africa

    Barbara Laughton & Mark Cotton

  4. Faculty of Commerce, Department of Management Studies, University of Cape Town, Cape Town, South Africa

    Nicollette Tomazos

  5. MRC/UCT Medical Imaging Research Unit, Department of Human Biology, University of Cape Town, Cape Town, South Africa

    Bruce Spottiswoode

  6. Department of Statistical Sciences, University of Cape Town, Cape Town, South Africa

    Katya Mauff

  7. MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

    John M. Pettifor

  8. Tygerberg Children’s Hospital, Tygerberg, South Africa

    Barbara Laughton & Mark Cotton

  9. 700 Harbouredge, 10 Hospital Str. Greenpoint, Cape Town, 8005, South Africa

    Savvas Andronikou

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  1. Savvas Andronikou
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  2. Christelle Ackermann
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  3. Barbara Laughton
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Correspondence to Savvas Andronikou.

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Andronikou, S., Ackermann, C., Laughton, B. et al. Correlating brain volume and callosal thickness with clinical and laboratory indicators of disease severity in children with HIV-related brain disease. Childs Nerv Syst 30, 1549–1557 (2014). https://doi.org/10.1007/s00381-014-2434-3

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  • DOI: https://doi.org/10.1007/s00381-014-2434-3

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