Altered structural brain changes and neurocognitive performance in pediatric HIV

• Published in: NeuroImage clinical Vol. 14; no. C; pp. 316 - 322
• Main Authors: Yadav, Santosh K, Gupta, Rakesh K, Garg, Ravindra K, Venkatesh, Vimala, Gupta, Pradeep K, Singh, Alok K, Hashem, Sheema, Al-Sulaiti, Asma, Kaura, Deepak, Wang, Ena, Marincola, Francesco M, Haris, Mohammad
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier 01.01.2017
• Subjects: Adolescent; Brain - diagnostic imaging; Brain Mapping; CD4 Antigens - metabolism; Child; Cognition Disorders - diagnostic imaging; Cognition Disorders - etiology; Cortical thickness; Female; HIV Infections - complications; HIV Infections - metabolism; Human immunodeficiency virus; Humans; Imaging, Three-Dimensional; Magnetic Resonance Imaging; Male; Nerve Net - diagnostic imaging; Neural Pathways - diagnostic imaging; Neurocognitive functions; Neuropsychological Tests; Regular; Structural connectivity; Subcortical volume; C, clustering coefficient; Cortical thickness; FOV, field of view; HIV, human immunodeficiency virus; TR, repetition time; SW, small-world index; TBM, tensor based morphometry; AIDS, acquired immunodeficiency syndrome; ELISA, enzyme-linked immunosorbent assay; FSPGR, fast spoiled gradient echo; MRI, magnetic resonance imaging; Subcortical volume; ROIs, regions of interest; Magnetic resonance imaging; Structural connectivity; FLAIR, fluid attenuation inversion recovery; FA, flip angel; Neurocognitive functions; TE, echo time; Human immunodeficiency virus; GAT, graph-theoretical analysis toolbox; L, characteristic path length; RAKIT, revised Amsterdamse kinder intelligence
• ISSN: 2213-1582; 2213-1582
• DOI: 10.1016/j.nicl.2017.01.032

Pediatric HIV patients often suffer with neurodevelopmental delay and subsequently cognitive impairment. While tissue injury in cortical and subcortical regions in the brain of adult HIV patients has been well reported there is sparse knowledge about these changes in perinatally HIV infected pediatric patients. We analyzed cortical thickness, subcortical volume, structural connectivity, and neurocognitive functions in pediatric HIV patients and compared with those of pediatric healthy controls. With informed consent, 34 perinatally infected pediatric HIV patients and 32 age and gender matched pediatric healthy controls underwent neurocognitive assessment and brain magnetic resonance imaging (MRI) on a 3 T clinical scanner. Altered cortical thickness, subcortical volumes, and abnormal neuropsychological test scores were observed in pediatric HIV patients. The structural network connectivity analysis depicted lower connection strengths, lower clustering coefficients, and higher path length in pediatric HIV patients than healthy controls. The network betweenness and network hubs in cortico-limbic regions were distorted in pediatric HIV patients. The findings suggest that altered cortical and subcortical structures and regional brain connectivity in pediatric HIV patients may contribute to deficits in their neurocognitive functions. Further, longitudinal studies are required for better understanding of the effect of HIV pathogenesis on brain structural changes throughout the brain development process under standard ART treatment.