title: Micro-structural brain alterations in aviremic HIV+ patients with minor neurocognitive disorders: a multi-contrast study at high field.
abstract: OBJECTIVE
  Mild neurocognitive disorders (MND) affect a subset of HIV+ patients under effective combination antiretroviral therapy (cART). In this study, we used an innovative multi-contrast magnetic resonance imaging (MRI) approach at high-field to assess the presence of micro-structural brain alterations in MND+ patients.
  
  
  METHODS
  We enrolled 17 MND+ and 19 MND- patients with undetectable HIV-1 RNA and 19 healthy controls (HC). MRI acquisitions at 3T included: MP2RAGE for T1 relaxation times, Magnetization Transfer (MT), T2* and Susceptibility Weighted Imaging (SWI) to probe micro-structural integrity and iron deposition in the brain. Statistical analysis used permutation-based tests and correction for family-wise error rate. Multiple regression analysis was performed between MRI data and (i) neuropsychological results (ii) HIV infection characteristics. A linear discriminant analysis (LDA) based on MRI data was performed between MND+ and MND- patients and cross-validated with a leave-one-out test.
  
  
  RESULTS
  Our data revealed loss of structural integrity and micro-oedema in MND+ compared to HC in the global white and cortical gray matter, as well as in the thalamus and basal ganglia. Multiple regression analysis showed a significant influence of sub-cortical nuclei alterations on the executive index of MND+ patients (p = 0.04 he and R² = 95.2). The LDA distinguished MND+ and MND- patients with a classification quality of 73% after cross-validation.
  
  
  CONCLUSIONS
  Our study shows micro-structural brain tissue alterations in MND+ patients under effective therapy and suggests that multi-contrast MRI at high field is a powerful approach to discriminate between HIV+ patients on cART with and without mild neurocognitive deficits.
authors.affiliation: Department of Clinical Neurosciences, Neuroimmunology Unit, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Vaud, Switzerland ; Department of Clinical Neurosciences, Laboratoire de Recherche En Neuroimagerie (LREN), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Vaud, Switzerland ; Advanced Clinical Imaging Technology, Centre d'imagerie biomédical, École Polytechnique Fédérale de Lausanne, Lausanne, Vaud, Switzerland.
authors.forename: Cristina
authors.initials: C
authors.lastname: Granziera
authors.forename: Alessandro
authors.initials: A
authors.lastname: Daducci
authors.forename: Samanta
authors.initials: S
authors.lastname: Simioni
authors.forename: Matthias
authors.initials: M
authors.lastname: Cavassini
authors.forename: Alexis
authors.initials: A
authors.lastname: Roche
authors.forename: Djalel
authors.initials: D
authors.lastname: Meskaldji
authors.forename: Tobias
authors.initials: T
authors.lastname: Kober
authors.forename: Melanie
authors.initials: M
authors.lastname: Metral
authors.forename: Alexandra
authors.initials: A
authors.lastname: Calmy
authors.forename: Gunther
authors.initials: G
authors.lastname: Helms
authors.forename: Bernard
authors.initials: B
authors.lastname: Hirschel
authors.forename: François
authors.initials: F
authors.lastname: Lazeyras
authors.forename: Reto
authors.initials: R
authors.lastname: Meuli
authors.forename: Gunnar
authors.initials: G
authors.lastname: Krueger
authors.forename: Renaud A
authors.initials: RA
authors.lastname: Du Pasquier
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use; D001479:Basal Ganglia / Q000473:pathology; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000473:pathology*; D060825:Cognitive Dysfunction / Q000139:chemically induced / Q000175:diagnosis* / Q000821:virology; D016002:Discriminant Analysis; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy / Q000473:pathology*; D015497:HIV-1 / Q000235:genetics*; D006801:Humans; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D013788:Thalamus / Q000473:pathology
chemical_list: D019380:Anti-HIV Agents; D012367:RNA, Viral
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