title: Effects of HIV and combination antiretroviral therapy on cortico-striatal functional connectivity.
abstract: OBJECTIVE
  Determine whether HIV and combination antiretroviral therapy (cART) affect resting-state functional connectivity (rs-fc) between the striatum and the cortical regions.
  
  
  METHODS
  Forty-nine HIV-uninfected (HIV-) and 132 HIV-infected (HIV+) (65% receiving cART) patients underwent laboratory studies (current and nadir CD4 T-cell counts, and plasma HIV viral load), neuropsychological performance testing, and neuroimaging. Rs-fc, which examines the coordination of neural activity in distant brain regions, was used to investigate the cortico-striatal functional connections. The effect of cART was assessed comparing HIV+ individuals on cART (HIV+/cART+), and HIV+ individuals not currently receiving cART (HIV+/cART-). Relationships between laboratory tests, cognitive performance, and cART on subcortical-cortical rs-fc were assessed by an analysis of variance.
  
  
  RESULTS
  HIV+ individuals had lower cortico-striatal functional connectivity than HIV- controls, specifically between the striatum and the default mode network (P < 0.001) and ventral attention network (P < 0.001). HIV+/cART+ individuals had higher functional connectivity between the striatum, and default mode network (P = 0.02) and ventral attention network (P = 0.01), compared to the HIV+/cART- patients. Laboratory (current and nadir CD4 T-cell counts, plasma viral load) and neuropsychological performance was not correlated with cortico-striatal rs-fc.
  
  
  CONCLUSIONS
  HIV was associated with disrupted cortico-striatal networks, consistent with HIV's known impact on the subcortical areas. Interestingly, within certain networks, HIV+/cART+ individuals had similar rs-fc compared to HIV- controls, suggesting possible improvements in HIV-related neural dysfunction due to medications. Rs-fc may be a sensitive biomarker of neural insult and its recovery following cART. Additional studies may show rs-fc has utility in measuring acute inflammation caused by HIV.
authors: aDepartment of Neurology bDepartment of Radiology cDepartment of Biomedical Engineering dDepartment of Microbiology eHope Center for Neurological Disorders, Washington University in St Louis, Missouri, USA.
authors: Mario
authors: M
authors: Ortega
authors: Matthew R
authors: MR
authors: Brier
authors: Beau M
authors: BM
authors: Ances
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D002540:Cerebral Cortex / Q000187:drug effects / Q000503:physiopathology*; D003342:Corpus Striatum / Q000187:drug effects / Q000503:physiopathology*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009434:Neural Pathways / Q000187:drug effects / Q000503:physiopathology*; D059906:Neuroimaging; D009483:Neuropsychological Tests
chemical_list: D044966:Anti-Retroviral Agents