Antiretroviral treatment is associated with increased attentional load-dependent brain activation in HIV patients
Antiretroviral treatment is associated with increased attentional load-dependent brain activation in HIV patients
复制标题
DOI：
10.1007/s11481-007-9092-0
复制
发表时间：
2008-06-01
影响因子：
6.2
通讯作者：
Ernst, T.
中科院分区：
文献类型：
--
作者：
Chang, L.;Yakupov, R.;Ernst, T.
本文的目的是确定抗逆转录病毒药物，尤其是核苷类似物逆转录酶抑制剂，由于其对人类免疫缺陷病毒 (HIV) 感染患者的潜在神经毒性作用，是否会导致大脑激活改变。 42 名右手男性被分为三组：血清阴性对照组（SN，n = 18）、接受抗逆转录病毒药物治疗的 HIV 受试者 （HIV+ARV，n = 12），或未接受抗逆转录病毒药物治疗（HIV+NARV，n = 12）。每个受试者在功能性磁共振成像期间执行一组难度或负荷不断增加的视觉注意力任务（跟踪两个、三个或四个球）。与 SN 相比，两组 HIV 受试者的右额叶区域大脑激活显示出更大的负荷依赖性增加（p 校正 = 0.006）。与 SN 相比，HIV+ARV 在双侧上额叶区域还表现出更大的负载依赖性激活增加（p 校正 = 0.032），并且在执行最困难的任务（跟踪四个球）时准确率较低。感兴趣区域分析进一步表明，SN 表现出负荷依赖性降低（尽管难度增加，但仍进行重复试验），而 HIV 受试者在处理更困难的任务时表现出负荷依赖性激活增加，尤其是那些使用 ARV 的任务。这些发现表明，长期 ARV 治疗可能会导致对注意力网络储备的更大要求，从而降低这些 HIV 患者的注意力网络使用效率和练习效果。由于大脑的储备能力有限，耗尽 HIV+ARV 的储备能力将导致在处理更困难、需要更多注意力的任务时表现下降。
The purpose of this paper was to determine whether antiretroviral medications, especially the nucleoside analogue reverse transcriptase inhibitors, lead to altered brain activation due to their potential neurotoxic effects in patients with human immunodeficiency virus (HIV) infection.Forty-two right-handed men were enrolled in three groups: seronegative controls (SN, n = 18), HIV subjects treated with antiretroviral medications (HIV+ARV, n = 12), or not treated with antiretroviral medications (HIV+NARV, n = 12). Each subject performed a set of visual attention tasks with increasing difficulty or load (tracking two, three or four balls) during functional magnetic resonance imaging.HIV subjects, both groups combined, showed greater load-dependent increases in brain activation in the right frontal regions compared to SN (p-corrected = 0.006). HIV+ARV additionally showed greater load-dependent increases in activation compared to SN in bilateral superior frontal regions (p-corrected = 0.032) and a lower percent accuracy on the performance of the most difficult task (tracking four balls). Region of interest analyses further demonstrated that SN showed load-dependent decreases (with repeated trials despite increasing difficulty), while HIV subjects showed load-dependent increases in activation with the more difficult tasks, especially those on ARVs.These findings suggest that chronic ARV treatments may lead to greater requirement of the attentional network reserve and hence less efficient usage of the network and less practice effects in these HIV patients. As the brain has a limited reserve capacity, exhausting the reserve capacity in HIV+ARV would lead to declined performance with more difficult tasks that require more attention.