Declined neural efficiency in cognitively stable human immunodeficiency virus patients.
Declined neural efficiency in cognitively stable human immunodeficiency virus patients.
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DOI：
10.1002/ana.21594
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发表时间：
2009-03
影响因子：
11.2
通讯作者：
Chang, Linda
中科院分区：
文献类型：
--
作者：
Ernst, Thomas;Yakupov, Renat;Nakama, Helenna;Crocket, Grace;Cole, Michael;Watters, Michael;Ricardo-Dukelow, Mary Lynn;Chang, Linda
确定临床和神经认知正常的人类免疫缺陷病毒（HIV）感染者和HIV血清阴性对照（SN）受试者在1年内的脑激活是否发生变化。在基线和1年后对32名SN和31名HIV患者（均接受稳定的抗逆转录病毒联合治疗）进行功能性磁共振成像（fMRI）。每个参与者执行一组视觉注意力任务，注意力负荷不断增加（从跟踪两个，三个或四个球）。所有HIV和SN参与者在两次检查中神经心理功能均正常。超过1年，HIV患者在功能磁共振成像中的神经认知状态或任务表现没有变化。然而，HIV患者在前额叶和后顶叶皮质的fMRI信号中表现出显着的1年增加，而SN对照参与者在这些区域的大脑激活仅显示出减少。这导致了艾滋病病毒状态和左颞叶，左顶叶，左颞叶和几个额叶区域（左，右额中回，前扣带回）的研究时间之间的显着相互作用。由于两组的fMRI任务表现保持不变，HIV患者似乎通过增加注意力网络的使用来保持表现，而对照组参与者在1年后减少了注意力网络的使用。这些发现表明SN参与者的效率提高或实践效果，但HIV患者的神经基质效率下降，可能是因为与HIV感染相关的持续脑损伤，尽管他们的临床病程明显稳定。
To determine whether brain activation changes in clinically and neurocognitively normal human immunodeficiency virus (HIV)–infected and in HIV-seronegative control (SN) participants over a 1-year period. Functional magnetic resonance imaging (fMRI) was performed in 32 SN and 31 HIV patients (all with stable combination antiretroviral treatment) at baseline and after 1 year. Each participant performed a set of visual attention tasks with increasing attentional load (from tracking two, three, or four balls). All HIV and SN participants had normal neuropsychological function at both examinations. Over 1 year, HIV patients showed no change in their neurocognitive status or in task performance during fMRI. However, HIV patients showed significant 1-year increases in fMRI signals in the prefrontal and posterior parietal cortices for the more difficult tasks, whereas SN control participants showed only decreases in brain activation in these regions. This resulted in significant interactions between HIV status and time of study in left insula, left parietal, left temporal, and several frontal regions (left and right middle frontal gyrus, and anterior cingulate). Because fMRI task performance remained unchanged in both groups, the HIV patients appeared to maintain performance by increasing usage of the attention network, whereas the control participants reduced usage of the attention network after 1 year. These findings suggest improved efficiency or a practice effect in the SN participants but declined efficiency of the neural substrate in HIV patients, possibly because of ongoing brain injury associated with the HIV infection, despite their apparent stable clinical course.
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