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March 26, 2013; 80 (13) Article

Pathways to neurodegeneration

Effects of HIV and aging on resting-state functional connectivity

Jewell B. Thomas, Matthew R. Brier, Abraham Z. Snyder, Florin F. Vaida, Beau M. Ances
First published February 27, 2013, DOI: https://doi.org/10.1212/WNL.0b013e318288792b
Jewell B. Thomas
From the Departments of Neurology (J.B.T., M.R.B., A.Z.S., B.M.A.) and Radiology (A.Z.S.), Washington University School of Medicine, St. Louis, MO; and Department of Family and Preventive Medicine (F.F.V.), University of California, San Diego, CA.
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Matthew R. Brier
From the Departments of Neurology (J.B.T., M.R.B., A.Z.S., B.M.A.) and Radiology (A.Z.S.), Washington University School of Medicine, St. Louis, MO; and Department of Family and Preventive Medicine (F.F.V.), University of California, San Diego, CA.
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Abraham Z. Snyder
From the Departments of Neurology (J.B.T., M.R.B., A.Z.S., B.M.A.) and Radiology (A.Z.S.), Washington University School of Medicine, St. Louis, MO; and Department of Family and Preventive Medicine (F.F.V.), University of California, San Diego, CA.
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Florin F. Vaida
From the Departments of Neurology (J.B.T., M.R.B., A.Z.S., B.M.A.) and Radiology (A.Z.S.), Washington University School of Medicine, St. Louis, MO; and Department of Family and Preventive Medicine (F.F.V.), University of California, San Diego, CA.
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Beau M. Ances
From the Departments of Neurology (J.B.T., M.R.B., A.Z.S., B.M.A.) and Radiology (A.Z.S.), Washington University School of Medicine, St. Louis, MO; and Department of Family and Preventive Medicine (F.F.V.), University of California, San Diego, CA.
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Citation
Pathways to neurodegeneration
Effects of HIV and aging on resting-state functional connectivity
Jewell B. Thomas, Matthew R. Brier, Abraham Z. Snyder, Florin F. Vaida, Beau M. Ances
Neurology Mar 2013, 80 (13) 1186-1193; DOI: 10.1212/WNL.0b013e318288792b

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Abstract

Objective: Resting-state functional connectivity MRI (rs-fcMRI) may provide insight into the neurophysiology of HIV and aging.

Methods: In this cross-sectional study, we used rs-fcMRI to investigate intra- and internetwork connectivity among 5 functional brain networks in 58 HIV-infected (HIV+) participants (44% receiving highly active antiretroviral therapy) and 53 HIV-uninfected (HIV−) controls. An analysis of covariance assessed the relationship among age, HIV laboratory markers, or degree of cognitive impairment and brain networks.

Results: Individuals who were HIV+ had decreased rs-fcMRI intranetwork correlations in the default mode (DMN, p = 0.01), control (CON, p = 0.02), and salience (SAL, p = 0.02) networks, but showed no changes in the sensorimotor (SMN) or dorsal attention (DAN) network. Compared with HIV− controls, participants who were HIV+ had a significant loss of internetwork correlations between the DMN-DAN (p = 0.02), trending loss in DMN-SAL (p = 0.1) and CON-SMN (p = 0.1), and trending increase in CON-SAL (p = 0.1). Neither HIV markers (plasma HIV viral load or CD4+ cell count) nor degree of cognitive impairment correlated with rs-fcMRI measures. Aging correlated with a decrease in the magnitude of intranetwork functional connectivity within the DMN (p = 0.04) and SAL (p = 0.006) and with decreased magnitude of internetwork functional connectivity between DMN and SAL (p = 0.009) for both HIV+ and HIV− participants. No interaction was observed between HIV and aging.

Conclusions: HIV and aging may cause independent decreases in rs-fcMRI. HIV may lead to a baseline decrease in brain function similar to deterioration that occurs with aging.

GLOSSARY

ANCOVA=
analysis of covariance;
BOLD=
blood oxygen level dependent;
CON=
control network;
DAN=
dorsal attention network;
DMN=
default mode network;
FSE=
fast spin echo;
HAART=
highly active antiretroviral therapy;
HAND=
HIV-associated neurocognitive disorder;
MPRAGE=
magnetization-prepared rapid gradient echo;
NP=
neuropsychological performance;
NPZ-4=
composite neuropsychological z score;
QA=
quality assurance;
rLP=
right lateral parietal;
ROI=
region of interest;
rs-fcMRI=
resting-state functional connectivity MRI;
SAL=
salience;
SMN=
sensorimotor network;
TE=
echo time;
TR=
repetition time;
VL=
viral load

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Supplemental data at www.neurology.org

  • Editorial, page 1178

  • Received May 5, 2012.
  • Accepted October 23, 2012.
  • © 2013 American Academy of Neurology
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