title: Apathy is associated with white matter abnormalities in anterior, medial brain regions in persons with HIV infection.
abstract: Apathy is a relatively common psychiatric syndrome in HIV infection, but little is known about its neural correlates. In the present study, we examined the associations between apathy and diffusion tensor imaging (DTI) indices in key frontal white matter regions in the thalamocorticostriatal circuit, which has been implicated in the expression of apathy. Nineteen participants with HIV infection and 19 demographically comparable seronegative comparison subjects completed the Apathy subscale of the Frontal Systems Behavioral Scale as a part of a comprehensive neuropsychiatric research evaluation. When compared to the seronegative participants, the HIV+ group had significantly more frontal white matter abnormalities. Within HIV+ persons, and as predicted, higher ratings of apathy were associated with greater white matter alterations in the anterior corona radiata, genu, and orbital medial prefrontal cortex. The associations between white matter alterations and apathy were independent of depression and were stronger among participants with lower current cluster of differentiation 4 (CD4) counts. All told, these findings indicate that apathy is independently associated with white matter abnormalities in anterior, medial brain regions in persons infected with HIV, particularly in the setting of lower current immune functioning, which may have implications for antiretroviral therapy.
authors.affiliation: a San Diego University/University of California, San Diego Joint Doctoral Program in Clinical Psychology , San Diego , CA , USA.
authors.forename: Rujvi
authors.initials: R
authors.lastname: Kamat
authors.forename: Gregory G
authors.initials: GG
authors.lastname: Brown
authors.forename: Khalima
authors.initials: K
authors.lastname: Bolden
authors.forename: Christine
authors.initials: C
authors.lastname: Fennema-Notestein
authors.forename: Sarah
authors.initials: S
authors.lastname: Archibald
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Marcotte
authors.forename: Scott L
authors.initials: SL
authors.lastname: Letendre
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Ellis
authors.forename: Steven Paul
authors.initials: SP
authors.lastname: Woods
authors.forename: Igor
authors.initials: I
authors.lastname: Grant
authors.forename: Robert K
authors.initials: RK
authors.lastname: Heaton
mesh_terms: D000328:Adult; D057565:Apathy; D015331:Cohort Studies; D056324:Diffusion Tensor Imaging; D005260:Female; D005625:Frontal Lobe / Q000473:pathology* / Q000821:virology; D015658:HIV Infections / Q000150:complications* / Q000523:psychology*; D006801:Humans; D056784:Leukoencephalopathies / Q000175:diagnosis / Q000209:etiology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D018709:Statistics, Nonparametric
keywords: Apathy; Depression; Diffusion tensor imaging; HIV/AIDS; Prefrontal cortex