Cocaine use is associated with cerebral white matter hyperintensities in HIV disease.
Cocaine use is associated with cerebral white matter hyperintensities in HIV disease.
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DOI：
10.1002/acn3.51854
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发表时间：
2023-09
影响因子：
5.3
通讯作者：
Gibson, Matthew J.
中科院分区：
文献类型：
--
作者：
Meade, Christina S.;Bell, Ryan P.;Towe, Sheri L.;Lascola, Christopher D.;Al-Khalil, Kareem;Gibson, Matthew J.
白质高强度（WMH）是脑血管疾病的标志和认知能力下降的预测因子，在艾滋病毒感染者（PWH）中观察到更高的发生率。使用可卡因，一种有效的中枢神经系统兴奋剂，在PWH中尤为常见，并可能导致WMH。样本包括110名接受抗逆转录病毒治疗的PWH。收集了液体衰减反转恢复（FLAIR）和T1加权解剖MRI扫描，并进行了神经心理测试。使用病灶分割工具箱对FLAIR图像进行处理。采用层次回归模型研究WMH负担的预测因素[第1部分：人口统计学；block 2：脑血管疾病（CVD）风险；第3块：病变负担]。样本中20%为女性，79%为非洲裔美国人，平均年龄为45.37岁。所有参与者都有持续的HIV病毒抑制，CD4+ T细胞计数中位数为750。近三分之一（29%）的人目前经常使用可卡因，在过去90年中平均为23.75天（SD = 20.95）。在分层线性回归模型中，可卡因使用是WMH负担的显著预测因子（β = .28）。WMH负担与较差的认知功能显著相关（r = - 0.27）。最后，较高的WMH负担与血清干扰素γ诱导蛋白10 （IP - 10）浓度升高和髓过氧化物酶（MPO）浓度降低显著相关；然而，这些标记并不因COC状态而异。WMH负担与PWH患者较差的认知表现有关。可卡因使用和心血管疾病风险都是造成WMH的独立因素，将这些情况作为艾滋病毒护理的一部分加以解决可能会减轻潜在的神经认知障碍的脑损伤。
White matter hyperintensities (WMH), a marker of cerebral small vessel disease and predictor of cognitive decline, are observed at higher rates in persons with HIV (PWH). The use of cocaine, a potent central nervous system stimulant, is disproportionately common in PWH and may contribute to WMH. The sample included of 110 PWH on antiretroviral therapy. Fluid‐attenuated inversion recovery (FLAIR) and T1‐weighted anatomical MRI scans were collected, along with neuropsychological testing. FLAIR images were processed using the Lesion Segmentation Toolbox. A hierarchical regression model was run to investigate predictors of WMH burden [block 1: demographics; block 2: cerebrovascular disease (CVD) risk; block 3: lesion burden]. The sample was 20% female and 79% African American with a mean age of 45.37. All participants had persistent HIV viral suppression, and the median CD4+ T‐cell count was 750. Nearly a third (29%) currently used cocaine regularly, with an average of 23.75 (SD = 20.95) days in the past 90. In the hierarchical linear regression model, cocaine use was a significant predictor of WMH burden (β = .28). WMH burden was significantly correlated with poorer cognitive function (r = −0.27). Finally, higher WMH burden was significantly associated with increased serum concentrations of interferon‐γ‐inducible protein 10 (IP‐10) but lower concentrations of myeloperoxidase (MPO); however, these markers did not differ by COC status. WMH burden is associated with poorer cognitive performance in PWH. Cocaine use and CVD risk independently contribute to WMH, and addressing these conditions as part of HIV care may mitigate brain injury underlying neurocognitive impairment.
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DOI：
10.1136/bmj.c3666
发表时间：
2010-07-26
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Debette S;Markus HS
通讯作者：
Markus HS
DOI：
10.1076/jcen.25.4.571.13876
发表时间：
2003-06-01
影响因子：
2.2
作者：
Diehr, MC;Cherner, M;Heaton, RK
通讯作者：
Heaton, RK
DOI：
10.1073/pnas.0803945105
发表时间：
2008-11-25
影响因子：
11.1
作者：
Breckwoldt, Michael O.;Chen, John W.;Weissleder, Ralph
通讯作者：
Weissleder, Ralph
影响因子：
8.3
作者：
Cheng YC;Ryan KA;Qadwai SA;Shah J;Sparks MJ;Wozniak MA;Stern BJ;Phipps MS;Cronin CA;Magder LS;Cole JW;Kittner SJ
通讯作者：
Kittner SJ
影响因子：
3.7
作者：
Alford K;Daley S;Banerjee S;Vera JH
通讯作者：
Vera JH