title: Regional brain gray and white matter changes in perinatally HIV-infected adolescents.
abstract: Despite the success of antiretroviral therapy (ART), perinatally infected HIV remains a major health problem worldwide. Although advance neuroimaging studies have investigated structural brain changes in HIV-infected adults, regional gray matter (GM) and white matter (WM) volume changes have not been reported in perinatally HIV-infected adolescents and young adults. In this cross-sectional study, we investigated regional GM and WM changes in 16 HIV-infected youths receiving ART (age 17.0 ± 2.9 years) compared with age-matched 14 healthy controls (age 16.3 ± 2.3 years) using magnetic resonance imaging (MRI)-based high-resolution T1-weighted images with voxel based morphometry (VBM) analyses. White matter atrophy appeared in perinatally HIV-infected youths in brain areas including the bilateral posterior corpus callosum (CC), bilateral external capsule, bilateral ventral temporal WM, mid cerebral peduncles, and basal pons over controls. Gray matter volume increase was observed in HIV-infected youths for several regions including the left superior frontal gyrus, inferior occipital gyrus, gyrus rectus, right mid cingulum, parahippocampal gyrus, bilateral inferior temporal gyrus, and middle temporal gyrus compared with controls. Global WM and GM volumes did not differ significantly between groups. These results indicate WM injury in perinatally HIV-infected youths, but the interpretation of the GM results, which appeared as increased regional volumes, is not clear. Further longitudinal studies are needed to clarify if our results represent active ongoing brain infection or toxicity from HIV treatment resulting in neuronal cell swelling and regional increased GM volume. Our findings suggest that assessment of regional GM and WM volume changes, based on VBM procedures, may be an additional measure to assess brain integrity in HIV-infected youths and to evaluate success of current ART therapy for efficacy in the brain.
authors.affiliation: Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA.
authors.forename: Manoj K
authors.initials: MK
authors.lastname: Sarma
authors.affiliation: Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA.
authors.forename: Rajakumar
authors.initials: R
authors.lastname: Nagarajan
authors.affiliation: Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Department of Pediatrics, Torrance, CA 90502, USA.
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Keller
authors.affiliation: Department of Anesthesiology, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Kumar
authors.affiliation: Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, CA 90095, USA.
authors.forename: Karin
authors.initials: K
authors.lastname: Nielsen-Saines
authors.affiliation: Department of Pediatrics, Miller Children's Hospital of Long Beach, Long Beach, CA 90806, USA.
authors.forename: David E
authors.initials: DE
authors.lastname: Michalik
authors.affiliation: Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, CA 90095, USA.
authors.forename: Jaime
authors.initials: J
authors.lastname: Deville
authors.affiliation: Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA 90027, USA.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Church
authors.affiliation: Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA.
authors.forename: M Albert
authors.initials: MA
authors.lastname: Thomas
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D044966:Anti-Retroviral Agents / Q000494:pharmacology / Q000627:therapeutic use; D001921:Brain / Q000187:drug effects / Q000473:pathology* / Q000821:virology; D001931:Brain Mapping; D005260:Female; D066128:Gray Matter / Q000187:drug effects / Q000473:pathology*; D015658:HIV Infections / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D066127:White Matter / Q000187:drug effects / Q000473:pathology*; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents
keywords: ART, antiretroviral therapy; Antiretroviral therapy; CSF, cerebrospinal fluid; GM, gray matter; GMV, gray matter volume; Gray matter; HIV; MRI, magnetic resonance imaging; SPM, statistical parametric mapping; Statistical parametric mapping; VBM, voxel based morphometry; Voxel based morphometry; WM, white matter; WMV, white matter volume; White matter