title: A diffusion tensor imaging and neurocognitive study of HIV-positive children who are HAART-naïve "slow progressors".
abstract: There are few neuropsychological or neuroimaging studies of HIV-positive children with "slow progression". "Slow progressors" are typically defined as children or adolescents who were vertically infected with HIV, but who received no or minimal antiretroviral therapy. We compared 12 asymptomatic HIV-positive children (8 to 12 years) with matched controls on a neuropsychological battery as well as diffusion tensor imaging in a masked region of interest analysis focusing on the corpus callosum, internal capsule and superior longitudinal fasciculus. The "slow progressor" group performed significantly worse than controls on the Wechsler Abbreviated Scale of Intelligence Verbal and Performance IQ scales, and on standardised tests of visuospatial processing, visual memory and executive functioning. "Slow progressors" had lower fractional anisotropy (FA), higher mean diffusivity (MD) and radial diffusivity (RD) in the corpus callosum (p= <0.05), and increased MD in the superior longitudinal fasciculus, compared to controls. A correlation was found between poor performance on a test of executive function and a test of attention with corpus callosum FA, and a test of executive function with lowered FA in the superior longitudinal fasiculus. These data suggest that demyelination as reflected by the increase in RD may be a prominent disease process in paediatric HIV infection.
authors.affiliation: Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa. hoare.jax@googlemail.com
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Hoare
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Fouche
authors.forename: Bruce
authors.initials: B
authors.lastname: Spottiswoode
authors.forename: Kirsty
authors.initials: K
authors.lastname: Donald
authors.forename: Nicole
authors.initials: N
authors.lastname: Philipps
authors.forename: Heidre
authors.initials: H
authors.lastname: Bezuidenhout
authors.forename: Christine
authors.initials: C
authors.lastname: Mulligan
authors.forename: Victoria
authors.initials: V
authors.lastname: Webster
authors.forename: Charity
authors.initials: C
authors.lastname: Oduro
authors.forename: Leigh
authors.initials: L
authors.lastname: Schrieff
authors.forename: Robert
authors.initials: R
authors.lastname: Paul
authors.forename: Heather
authors.initials: H
authors.lastname: Zar
authors.forename: Kevin
authors.initials: K
authors.lastname: Thomas
authors.forename: Dan
authors.initials: D
authors.lastname: Stein
mesh_terms: D023241:Antiretroviral Therapy, Highly Active; D016022:Case-Control Studies; D002648:Child; D003071:Cognition; D003337:Corpus Callosum / Q000473:pathology / Q000503:physiopathology*; D056324:Diffusion Tensor Imaging; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology / Q000821:virology; D006801:Humans; D020772:Internal Capsule / Q000473:pathology / Q000503:physiopathology*; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D019580:Perforant Pathway / Q000473:pathology / Q000503:physiopathology*; D013019:South Africa; D013647:Task Performance and Analysis; D014888:Wechsler Scales