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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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