April D Thames1, Philip Sayegh2, Kevin Terashima2, Jessica M Foley3, Andrew Cho2, Alyssa Arentoft4, Charles H Hinkin5, Susan Y Bookheimer2. 1. Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, 740 Westwood Plaza C8-746, Los Angeles, CA 90095, USA. Electronic address: athames@mednet.ucla.edu. 2. Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, 740 Westwood Plaza C8-746, Los Angeles, CA 90095, USA. 3. University of California San Francisco Medical Center, 505 Parnassus Ave, San Francisco, CA 94143, USA. 4. Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, 740 Westwood Plaza C8-746, Los Angeles, CA 90095, USA; Department of Psychology, California State University Northridge, 18111 Nordhoff St, Northridge, CA 91330, USA. 5. Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, 740 Westwood Plaza C8-746, Los Angeles, CA 90095, USA; VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd, Los Angeles, CA 90073, USA.
Abstract
BACKGROUND: Deficits in lexical retrieval, present in approximately 40% of HIV+ patients, are thought to reflect disruptions to frontal-striatal functions and may worsen with immunosuppression. Coupling frontal-striatal tasks such as lexical retrieval with functional neuroimaging may help delineate the pathophysiologic mechanisms underlying HIV-associated neurological dysfunction. OBJECTIVE: We examined whether HIV infection confers brain functional changes during lexical access and retrieval. It was expected that HIV+ individuals would demonstrate greater brain activity in frontal-subcortical regions despite minimal differences between groups on neuropsychological testing. Within the HIV+ sample, we examined associations between indices of immunosuppression (recent and nadir CD4+ count) and task-related signal change in frontostriatal structures. Method16 HIV+ participants and 12 HIV- controls underwent fMRI while engaged in phonemic/letter and semantic fluency tasks. Participants also completed standardized measures of verbal fluency RESULTS: HIV status groups performed similarly on phonemic and semantic fluency tasks prior to being scanned. fMRI results demonstrated activation differences during the phonemic fluency task as a function of HIV status, with HIV+ individuals demonstrating significantly greater activation in BG structures than HIV- individuals. There were no significant differences in frontal brain activation between HIV status groups during the phonemic fluency task, nor were there significant brain activation differences during the semantic fluency task. Within the HIV+ group, current CD4+ count, though not nadir, was positively correlated with increased activity in the inferior frontal gyrus and basal ganglia. CONCLUSION: During phonemic fluency performance, HIV+ patients recruit subcortical structures to a greater degree than HIV- controls despite similar task performances suggesting that fMRI may be sensitive to neurocompromise before overt cognitive declines can be detected. Among HIV+ individuals, reduced activity in the frontal-subcortical structures was associated with lower CD4+ count.
BACKGROUND: Deficits in lexical retrieval, present in approximately 40% of HIV+ patients, are thought to reflect disruptions to frontal-striatal functions and may worsen with immunosuppression. Coupling frontal-striatal tasks such as lexical retrieval with functional neuroimaging may help delineate the pathophysiologic mechanisms underlying HIV-associated neurological dysfunction. OBJECTIVE: We examined whether HIV infection confers brain functional changes during lexical access and retrieval. It was expected that HIV+ individuals would demonstrate greater brain activity in frontal-subcortical regions despite minimal differences between groups on neuropsychological testing. Within the HIV+ sample, we examined associations between indices of immunosuppression (recent and nadirCD4+ count) and task-related signal change in frontostriatal structures. Method16 HIV+ participants and 12 HIV- controls underwent fMRI while engaged in phonemic/letter and semantic fluency tasks. Participants also completed standardized measures of verbal fluency RESULTS:HIV status groups performed similarly on phonemic and semantic fluency tasks prior to being scanned. fMRI results demonstrated activation differences during the phonemic fluency task as a function of HIV status, with HIV+ individuals demonstrating significantly greater activation in BG structures than HIV- individuals. There were no significant differences in frontal brain activation between HIV status groups during the phonemic fluency task, nor were there significant brain activation differences during the semantic fluency task. Within the HIV+ group, current CD4+ count, though not nadir, was positively correlated with increased activity in the inferior frontal gyrus and basal ganglia. CONCLUSION: During phonemic fluency performance, HIV+ patients recruit subcortical structures to a greater degree than HIV- controls despite similar task performances suggesting that fMRI may be sensitive to neurocompromise before overt cognitive declines can be detected. Among HIV+ individuals, reduced activity in the frontal-subcortical structures was associated with lower CD4+ count.
Authors: C H Hinkin; W G van Gorp; M A Mandelkern; M Gee; P Satz; S Holston; T D Marcotte; G Evans; D H Paz; J R Ropchan Journal: J Neuropsychiatry Clin Neurosci Date: 1995 Impact factor: 2.198
Authors: E A Childs; R H Lyles; O A Selnes; B Chen; E N Miller; B A Cohen; J T Becker; J Mellors; J C McArthur Journal: Neurology Date: 1999-02 Impact factor: 9.910
Authors: Nina Ventura; Linda Douw; Diogo G Correa; Tania M Netto; Rafael F Cabral; Fernanda Cristina Rueda Lopes; Emerson L Gasparetto Journal: Neuroradiol J Date: 2018-06-13
Authors: Raha M Dastgheyb; Ned Sacktor; Donald Franklin; Scott Letendre; Thomas Marcotte; Robert Heaton; Igor Grant; Justin C McArthur; Leah H Rubin; Norman J Haughey Journal: J Acquir Immune Defic Syndr Date: 2019-09-01 Impact factor: 3.771
Authors: Marloes A M Janssen; Max Hinne; Ronald J Janssen; Marcel A van Gerven; Stefan C Steens; Bozena Góraj; Peter P Koopmans; Roy P C Kessels Journal: Brain Imaging Behav Date: 2017-10 Impact factor: 3.978