title: HIV-associated distal neuropathic pain is associated with smaller total cerebral cortical gray matter.
abstract: Despite modern antiretroviral therapy, HIV-associated sensory neuropathy affects over 50 % of HIV patients. The clinical expression of HIV neuropathy is highly variable: many individuals report few symptoms, but about half report distal neuropathic pain (DNP), making it one of the most prevalent, disabling, and treatment-resistant complications of HIV disease. The presence and intensity of pain is not fully explained by the degree of peripheral nerve damage, making it unclear why some patients do, and others do not, report pain. To better understand central nervous system contributions to HIV DNP, we performed a cross-sectional analysis of structural magnetic resonance imaging volumes in 241 HIV-infected participants from an observational multi-site cohort study at five US sites (CNS HIV Anti-Retroviral Treatment Effects Research Study, CHARTER). The association between DNP and the structural imaging outcomes was investigated using both linear and nonlinear (Gaussian Kernel support vector) multivariable regression, controlling for key demographic and clinical variables. Severity of DNP symptoms was correlated with smaller total cerebral cortical gray matter volume (r = -0.24; p = 0.004). Understanding the mechanisms for this association between smaller total cortical volumes and DNP may provide insight into HIV DNP chronicity and treatment-resistance.
authors.affiliation: Department of Psychiatry, University of California San Diego, 220 Dickinson St., San Diego, CA, 92103, USA, jkeltner@ucsd.edu.
authors.forename: John R
authors.initials: JR
authors.lastname: Keltner
authors.forename: Christine
authors.initials: C
authors.lastname: Fennema-Notestine
authors.forename: Florin
authors.initials: F
authors.lastname: Vaida
authors.forename: Dongzhe
authors.initials: D
authors.lastname: Wang
authors.forename: Donald R
authors.initials: DR
authors.lastname: Franklin
authors.forename: Robert H
authors.initials: RH
authors.lastname: Dworkin
authors.forename: Chelsea
authors.initials: C
authors.lastname: Sanders
authors.forename: J Allen
authors.initials: JA
authors.lastname: McCutchan
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Archibald
authors.forename: David J
authors.initials: DJ
authors.lastname: Miller
authors.forename: George
authors.initials: G
authors.lastname: Kesidis
authors.forename: Clint
authors.initials: C
authors.lastname: Cushman
authors.forename: Sung Min
authors.initials: SM
authors.lastname: Kim
authors.forename: Ian
authors.initials: I
authors.lastname: Abramson
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Taylor
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Theilmann
authors.forename: Michelle D
authors.initials: MD
authors.lastname: Julaton
authors.forename: Randy J
authors.initials: RJ
authors.lastname: Notestine
authors.forename: Stephanie
authors.initials: S
authors.lastname: Corkran
authors.forename: Mariana
authors.initials: M
authors.lastname: Cherner
authors.forename: Nichole A
authors.initials: NA
authors.lastname: Duarte
authors.forename: Terry
authors.initials: T
authors.lastname: Alexander
authors.forename: Jessica
authors.initials: J
authors.lastname: Robinson-Papp
authors.forename: Benjamin B
authors.initials: BB
authors.lastname: Gelman
authors.forename: David M
authors.initials: DM
authors.lastname: Simpson
authors.forename: Ann C
authors.initials: AC
authors.lastname: Collier
authors.forename: Christina M
authors.initials: CM
authors.lastname: Marra
authors.forename: Susan
authors.initials: S
authors.lastname: Morgello
authors.forename: Greg
authors.initials: G
authors.lastname: Brown
authors.forename: Igor
authors.initials: I
authors.lastname: Grant
authors.forename: J Hampton
authors.initials: JH
authors.lastname: Atkinson
authors.forename: Terry L
authors.initials: TL
authors.lastname: Jernigan
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Ellis
mesh_terms: D015526:AIDS Dementia Complex / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology*; D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D001930:Brain Injuries / Q000453:epidemiology / Q000473:pathology / Q000821:virology; D002540:Cerebral Cortex / Q000473:pathology / Q000821:virology; D003072:Cognition Disorders / Q000453:epidemiology / Q000473:pathology / Q000821:virology; D015986:Confounding Factors, Epidemiologic; D003430:Cross-Sectional Studies; D005260:Female; D066128:Gray Matter / Q000473:pathology / Q000821:virology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000473:pathology / Q000821:virology; D008875:Middle Aged; D009437:Neuralgia / Q000453:epidemiology / Q000473:pathology / Q000821:virology; D015995:Prevalence; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000473:pathology / Q000821:virology
chemical_list: D044966:Anti-Retroviral Agents