title: Factors affecting brain structure in men with HIV disease in the post-HAART era.
abstract: BACKGROUND
  The purpose of this study was to characterize brain volumetric differences in HIV seropositive and seronegative men and to determine effects of age, cardiovascular risk, and HIV infection on structural integrity.
  
  
  METHODS
  Magnetic resonance imaging was used to acquire high-resolution neuroanatomic data in 160 men aged 50 years and over, including 84 HIV seropositive and 76 seronegative controls. Voxel-based morphometry was used to derive volumetric measurements at the level of the individual voxel. Data from a detailed neuropsychological test battery were recombined into four summary scores representing psychomotor speed, visual memory, verbal memory, and verbal fluency.
  
  
  RESULTS
  Both age and HIV status had a significant effect on both gray matter (GM) and white matter (WM) volume. The age-related GM atrophy was primarily in the superior temporal and inferior frontal regions; the HIV-related GM loss included the posterior and inferior temporal lobes, the parietal lobes, and the cerebellum. Among all subjects, the performance on neuropsychological tests, as indexed by a summary variable, was related to the volume of both the GM and WM. Contrary to our predictions, the CVD variables were not linked to brain volume in statistically adjusted models.
  
  
  CONCLUSIONS
  In the post-HAART era, having HIV infection is still linked to atrophy in both GM and WM. Secondly, advancing age, even in this relatively young cohort, is also linked to changes in GM and WM volume. Thirdly, CNS structural integrity is associated with overall cognitive functions, regardless of the HIV infection status of the study volunteers.
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. beckerjt@upmc.edu
authors.forename: James T
authors.initials: JT
authors.lastname: Becker
authors.forename: Victoria
authors.initials: V
authors.lastname: Maruca
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Kingsley
authors.forename: Joanne M
authors.initials: JM
authors.lastname: Sanders
authors.forename: Jeffery R
authors.initials: JR
authors.lastname: Alger
authors.forename: Peter B
authors.initials: PB
authors.lastname: Barker
authors.forename: Karl
authors.initials: K
authors.lastname: Goodkin
authors.forename: Eileen
authors.initials: E
authors.lastname: Martin
authors.forename: Eric N
authors.initials: EN
authors.lastname: Miller
authors.forename: Ann
authors.initials: A
authors.lastname: Ragin
authors.forename: Ned
authors.initials: N
authors.lastname: Sacktor
authors.forename: Ola
authors.initials: O
authors.lastname: Selnes
mesh_terms: D023241:Antiretroviral Therapy, Highly Active; D001284:Atrophy; D001921:Brain / Q000473:pathology*; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D015658:HIV Infections / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009929:Organ Size; D011859:Radiography; D014463:Ultrasonography