Structural and functional brain imaging in acute HIV.
Structural and functional brain imaging in acute HIV.
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DOI：
10.1016/j.nicl.2018.07.024
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
RV304 protocol teams
中科院分区：
文献类型：
--
作者：
Samboju V;Philippi CL;Chan P;Cobigo Y;Fletcher JLK;Robb M;Hellmuth J;Benjapornpong K;Dumrongpisutikul N;Pothisri M;Paul R;Ananworanich J;Spudich S;Valcour V;SEARCH 010/RV254;RV304 protocol teams
在估计病毒暴露的8天内，在脑脊液（CSF）中鉴定出HIV RNA。神经系统的结果和受损的神经心理测试性能记录在一个子集的个人与急性艾滋病毒感染（AHI）。本研究的目的是确定是否微观结构的白色物质和静息态功能连接（rsFC）在AHI中断。我们检查了49名AHI（100%男性;平均年龄= 30 ± SD 9.9）和23名HIV未感染的泰国参与者（78%男性;年龄= 30 ± 5.5），采用弥散张量成像（DTI）和在3特斯拉下获得的rsFC，以及四项神经心理学测试（总结为NPZ-4）。在26名参与者中，AHI组在联合抗逆转录病毒治疗（ART）之前进行了MRI检查，23名参与者在ART后平均2天（范围：1-5）进行了MRI检查。定量DTI的各向异性分数（FA）、平均值（MD）、轴向（AD）和径向扩散率（RD）。完成了基于种子的体素rsFC分析的默认模式（DMN），额顶叶，和显着性和6皮层下网络。rsFC和DTI分析校正了家族误差，使用t检验完成了体素比较。组特异性voxelwise回归进行检查之间的关系成像指标，艾滋病毒疾病变量，治疗状态。AHI组的平均（SD）CD 4计数为421（234）个细胞/mm 3，血浆HIV RNA为6.07（1.1）log 10拷贝/mL，估计感染持续时间为20（5.5）天。AHI和CO组之间的差异不符合DTI指标的统计学意义。在AHI组中，体素分析显示短暂暴露于ART与胼胝体、放射冠和上级纵束双侧FA较高、RD和MD较低之间存在相关性（p < 0.05）。扩散指数与临床变量或NPZ-4无关。与CO相比，AHI组在DMN的左侧海马旁皮质（PHC）和左侧额中回之间具有降低的rsFC（p < 0.002）。在AHI中，ART状态与rsFC无关。然而，较高的CD 4细胞计数与DMN中右侧顶叶和PHC种子的rsFC增加相关。注意到NPZ-4与双侧尾状核种子的较高rsFC之间的直接关联（p < 0.002）。研究结果表明，在艾滋病毒的早期阶段，对大脑结构和功能完整性的破坏最小。需要进行纵向研究，以确定在AHI中开始的ART治疗是否足以预防慢性感染个体中确定的脑功能障碍的演变。DTI显示急性HIV和未感染对照之间无显著差异。与未感染对照组相比，rsfMRI反映了急性HIV中rsFC的有限降低。急性HIV与未感染对照组相比，脑完整性相对保留。认知测试和CD 4淋巴细胞计数与急性HIV中的rsFC活性相关。
HIV RNA is identified in cerebrospinal fluid (CSF) within eight days of estimated viral exposure. Neurological findings and impaired neuropsychological testing performance are documented in a subset of individuals with acute HIV infection (AHI). The purpose of this study was to determine whether microstructural white matter and resting-state functional connectivity (rsFC) are disrupted in AHI. We examined 49 AHI (100% male; mean age = 30 ± SD 9.9) and 23 HIV-uninfected Thai participants (78% male; age = 30 ± 5.5) with diffusion tensor imaging (DTI) and rsFC acquired at 3 Tesla, and four neuropsychological tests (summarized as NPZ-4). MRI for the AHI group was performed prior to combination antiretroviral treatment (ART) in 26 participants and on average two days (range:1–5) after ART in 23 participants. Fractional anisotropy (FA), mean (MD), axial (AD), and radial diffusivity (RD) were quantified for DTI. Seed-based voxelwise rsFC analyses were completed for the default mode (DMN), fronto-parietal, and salience and 6 subcortical networks. rsFC and DTI analyses were corrected for family-wise error, with voxelwise comparisons completed using t-tests. Group-specific voxelwise regressions were conducted to examine relationships between imaging indices, HIV disease variables, and treatment status. The AHI group had a mean (SD) CD4 count of 421(234) cells/mm3 plasma HIV RNA of 6.07(1.1) log10 copies/mL and estimated duration of infection of 20(5.5) days. Differences between AHI and CO groups did not meet statistical significance for DTI metrics. Within the AHI group, voxelwise analyses revealed associations between brief exposure to ART and higher FA and lower RD and MD bilaterally in the corpus callosum, corona radiata, and superior longitudinal fasciculus (p < 0.05). Diffusion indices were unrelated to clinical variables or NPZ-4. The AHI group had reduced rsFC between left parahippocampal cortex (PHC) of the DMN and left middle frontal gyrus compared to CO (p < 0.002). Within AHI, ART status was unrelated to rsFC. However, higher CD4 cell count associated with increased rsFC for the right lateral parietal and PHC seeds in the DMN. Direct associations were noted between NPZ-4 correspond to higher rsFC of the bilateral caudate seed (p < 0.002). Study findings reveal minimal disruption to structural and functional brain integrity in the earliest stages of HIV. Longitudinal studies are needed to determine if treatment with ART initiated in AHI is sufficient to prevent the evolution of brain dysfunction identified in chronically infected individuals. DTI indicates no significant differences between acute HIV and uninfected controls. rsfMRI reflects limited reduced rsFC in acute HIV compared to uninfected controls. Relatively preserved brain integrity identified in acute HIV vs uninfected controls. Cognitive testing and CD4 lymphocyte counts associate with rsFC activity in acute HIV.
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影响因子：
11.1
作者：
Ananworanich, Jintanat;Chomont, Nicolas;Eller, Leigh Ann;Kroon, Eugene;Tovanabutra, Sodsai;Bose, Meera;Nau, Martin;Fletcher, James L. K.;Tipsuk, Somporn;Vandergeeten, Claire;O'Connell, Robert J.;Pinyakorn, Suteeraporn;Michael, Nelson;Phanuphak, Nittaya;Robb, Merlin L.
通讯作者：
Robb, Merlin L.
影响因子：
3.5
作者：
Garyfallidis E;Brett M;Amirbekian B;Rokem A;van der Walt S;Descoteaux M;Nimmo-Smith I;Dipy Contributors
通讯作者：
Dipy Contributors
影响因子：
3.2
作者：
Becker KM;Heinrichs-Graham E;Fox HS;Robertson KR;Sandkovsky U;O'Neill J;Swindells S;Wilson TW
通讯作者：
Wilson TW
影响因子：
5.7
作者：
Jenkinson, M;Bannister, P;Smith, S
通讯作者：
Smith, S
DOI：
10.1017/s1355617704102130
发表时间：
2004-05-01
影响因子：
2.6
作者：
Heaton, RK;Marcotte, TD;Grant, I
通讯作者：
Grant, I