title: Effects of HIV and early life stress on amygdala morphometry and neurocognitive function.
abstract: Both HIV infection and high levels of early life stress (ELS) have been related to abnormalities in frontal-subcortical structures, yet the combined effects of HIV and ELS on brain structure and function have not been previously investigated. In this study we assessed 49 non-demented HIV-seropositive (HIV+) and 47 age-matched HIV-seronegative healthy control (HC) adults. Levels of ELS exposure were quantified and used to define four HIV-ELS groups: HC Low-ELS (N = 20); HC High-ELS (N = 27); HIV+ Low-ELS (N = 24); HIV+ High-ELS (N = 25). An automated segmentation tool measured volumes of brain structures known to show HIV-related or ELS-related effects; a brief neurocognitive battery was administered. A significant HIV-ELS interaction was observed for amygdala volumes, which was driven by enlargements in HIV+ High-ELS participants. The HIV+ High-ELS group also demonstrated significant reductions in psychomotor/processing speed compared with HC Low-ELS. Regression analyses in the HIV+ group revealed that amygdala enlargements were associated with higher ELS, lower nadir CD4 counts, and reduced psychomotor/processing speed. Our results suggest that HIV infection and high ELS interact to increase amygdala volume, which is associated with neurocognitive dysfunction in HIV+ patients. These findings highlight the lasting neuropathological influence of ELS and suggest that high ELS may be a significant risk factor for neurocognitive impairment in HIV-infected individuals.
authors.affiliation: Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, Rhode Island 02912, USA. uraina_clark@brown.edu
authors.forename: Uraina S
authors.initials: US
authors.lastname: Clark
authors.forename: Ronald A
authors.initials: RA
authors.lastname: Cohen
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Sweet
authors.forename: Assawin
authors.initials: A
authors.lastname: Gongvatana
authors.forename: Kathryn N
authors.initials: KN
authors.lastname: Devlin
authors.forename: George N
authors.initials: GN
authors.lastname: Hana
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Westbrook
authors.forename: Richard C
authors.initials: RC
authors.lastname: Mulligan
authors.forename: Beth A
authors.initials: BA
authors.lastname: Jerskey
authors.forename: Tara L
authors.initials: TL
authors.lastname: White
authors.forename: Bradford
authors.initials: B
authors.lastname: Navia
authors.forename: Karen T
authors.initials: KT
authors.lastname: Tashima
mesh_terms: D000328:Adult; D000679:Amygdala / Q000473:pathology*; D001921:Brain / Q000473:pathology; D018791:CD4 Lymphocyte Count; D003071:Cognition / Q000502:physiology*; D005260:Female; D015658:HIV Infections / Q000473:pathology* / Q000523:psychology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011597:Psychomotor Performance / Q000502:physiology; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D014888:Wechsler Scales