Axonal chronic injury in treatment-naïve HIV+ adults with asymptomatic neurocognitive impairment and its relationship with clinical variables and cognitive status.
Axonal chronic injury in treatment-naïve HIV+ adults with asymptomatic neurocognitive impairment and its relationship with clinical variables and cognitive status.
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未接受治疗的 HIV 加上无症状神经认知障碍成人的轴突慢性损伤及其与临床变量和认知状态的关系
DOI：
10.1186/s12883-018-1069-5
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发表时间：
2018-05-10
期刊：
影响因子：
2.6
通讯作者：
Li HJ
中科院分区：
文献类型：
--
作者：
Li RL;Sun J;Tang ZC;Zhang JJ;Li HJ
艾滋病毒是一种嗜神经病毒，它可以导致神经变性，甚至可能导致认知障碍。HIV相关的白色物质（WM）损伤的确切机制尚不清楚。多个临床因素对WM损伤的影响以及WM改变与认知表现之间的关系值得进一步研究。对20例抗逆转录病毒初治HIV阳性的无症状神经认知障碍（ANI）成人和20例健康志愿者进行了扩散张量成像（DTI）。采用基于束的空间统计（TBSS）进行组间DTI指标的全脑分析，包括各向异性分数（FA）、平均扩散率（MD）、轴向扩散率（AD）和径向扩散率（RD）。多元线性回归分析显示DTI参数与临床变量（年龄、CD 4+细胞计数、CD 4 +/CD 8+比值、血浆病毒载量和HIV感染持续时间）和多项认知测试相关。DTI定量显示胼胝体和放射冠的弥散改变（MD显著增加，P < 0.05），胼胝体、放射冠、内囊、外囊、丘脑后放射、矢状层和上级纵束的慢性轴索损伤（AD显著增加，P < 0.05）。辐射冠的损害与当前的CD 4 +/CD 8+比值有显着相关性。在多个白色物质结构中MD或AD值的增加与许多认知领域测试显示出显着关联。WM损伤存在于神经学上无症状的HIV+成人中，脑室周围WM（胼胝体和放射冠）是优先的隐匿性损伤，其与轴突慢性损伤而不是脱髓鞘相关。轴突病可能存在于髓鞘损伤之前。DTI-TBSS有助于揭示WM的微结构异常，为研究HIV相关WM损伤的病理机制提供了新的视角。
HIV is a neurotropic virus, and it can bring about neurodegeneration and may even result in cognitive impairments. The precise mechanism of HIV-associated white matter (WM) injury is unknown. The effects of multiple clinical contributors on WM impairments and the relationship between the WM alterations and cognitive performance merit further investigation. Diffusion tensor imaging (DTI) was performed in 20 antiretroviral-naïve HIV-positive asymptomatic neurocognitive impairment (ANI) adults and 20 healthy volunteers. Whole-brain analysis of DTI metrics between groups was conducted by employing tract-based spatial statistics (TBSS), including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD). DTI parameters were correlated with clinical variables (age, CD4+ cell count, CD4+/CD8+ ratio, plasma viral load and duration of HIV infection) and multiple cognitive tests by using multilinear regression analyses. DTI quantified diffusion alterations in the corpus callosum and corona radiata (MD increased significantly, P < 0.05) and chronic axonal injury in the corpus callosum, corona radiata, internal capsule, external capsule, posterior thalamic radiation, sagittal stratum, and superior longitudinal fasciculus (AD increased significantly, P < 0.05). The impairments in the corona radiata had significant correlations with the current CD4+/CD8+ ratios. Increased MD or AD values in multiple white matter structures showed significant associations with many cognitive domain tests. WM impairments are present in neurologically asymptomatic HIV+ adults, periventricular WM (corpus callosum and corona radiata) are preferential occult injuries, which is associated with axonal chronic damage rather than demyelination. Axonopathy may exist before myelin injury. DTI-TBSS is helpful to explore the WM microstructure abnormalities and provide a new perspective for the investigation of the pathomechanism of HIV-associated WM injury.
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影响因子：
3.2
作者：
Nakamoto, Beau K.;Jahanshad, Neda;McMurtray, Aaron;Kallianpur, Kalpana J.;Chow, Dominic C.;Valcour, Victor G.;Paul, Robert H.;Marotz, Liron;Thompson, Paul M.;Shikuma, Cecilia M.
通讯作者：
Shikuma, Cecilia M.
HIV 相关神经认知障碍中基于表现的功能测量的比较。
影响因子：
3.2
作者：
Gandhi, Nishiena S.;Skolasky, Richard L.;Peters, Katherine B.;Moxley, Richard T.;Creighton, Jason;Roosa, Heidi Vornbrock;Selnes, Ola A.;McArthur, Justin;Sacktor, Ned
通讯作者：
Sacktor, Ned
影响因子：
3.2
作者：
Seider TR;Gongvatana A;Woods AJ;Chen H;Porges EC;Cummings T;Correia S;Tashima K;Cohen RA
通讯作者：
Cohen RA
影响因子：
6.4
作者：
Peluso, Michael J.;Meyerhoff, Dieter J.;Spudich, Serena
通讯作者：
Spudich, Serena
DOI：
10.3174/ajnr.a5229
发表时间：
2017-08
期刊：
AJNR. American journal of neuroradiology
影响因子：
--
作者：
O'Connor EE;Jaillard A;Renard F;Zeffiro TA
通讯作者：
Zeffiro TA