title: Age exacerbates HIV-associated white matter abnormalities.
abstract: Both HIV disease and advanced age have been associated with alterations to cerebral white matter, as measured with white matter hyperintensities (WMH) on fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI), and more recently with diffusion tensor imaging (DTI). This study investigates the combined effects of age and HIV serostatus on WMH and DTI measures, as well as the relationships between these white matter measures, in 88 HIV seropositive (HIV+) and 49 seronegative (HIV-) individuals aged 23-79 years. A whole-brain volumetric measure of WMH was quantified from FLAIR images using a semi-automated process, while fractional anisotropy (FA) was calculated for 15 regions of a whole-brain white matter skeleton generated using tract-based spatial statistics (TBSS). An age by HIV interaction was found indicating a significant association between WMH and older age in HIV+ participants only. Similarly, significant age by HIV interactions were found indicating stronger associations between older age and decreased FA in the posterior limbs of the internal capsules, cerebral peduncles, and anterior corona radiata in HIV+ vs. HIV- participants. The interactive effects of HIV and age were stronger with respect to whole-brain WMH than for any of the FA measures. Among HIV+ participants, greater WMH and lower anterior corona radiata FA were associated with active hepatitis C virus infection, a history of AIDS, and higher current CD4 cell count. Results indicate that age exacerbates HIV-associated abnormalities of whole-brain WMH and fronto-subcortical white matter integrity.
authors.affiliation: Center for Cognitive Aging and Memory (CAM), Institute on Aging, Department of Aging and Geriatric Research, University of Florida, 2004 Mowry Road, Gainesville, FL, 32610, USA.|Department of Clinical and Healthy Psychology, University of Florida, Gainesville, FL, 32611, USA.
authors.forename: Talia R
authors.initials: TR
authors.lastname: Seider
authors.affiliation: Department of Psychiatry, University of California San Diego, La Jolla, CA, 92093, USA.|Department of Psychiatry and Human Behavior, Brown University, Providence, RI, 02912, USA.
authors.forename: Assawin
authors.initials: A
authors.lastname: Gongvatana
authors.affiliation: Center for Cognitive Aging and Memory (CAM), Institute on Aging, Department of Aging and Geriatric Research, University of Florida, 2004 Mowry Road, Gainesville, FL, 32610, USA.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Woods
authors.affiliation: Department of Biostatistics, University of Florida, Gainesville, FL, 32610, USA.
authors.forename: Huaihou
authors.initials: H
authors.lastname: Chen
authors.affiliation: Center for Cognitive Aging and Memory (CAM), Institute on Aging, Department of Aging and Geriatric Research, University of Florida, 2004 Mowry Road, Gainesville, FL, 32610, USA.
authors.forename: Eric C
authors.initials: EC
authors.lastname: Porges
authors.affiliation: Center for Cognitive Aging and Memory (CAM), Institute on Aging, Department of Aging and Geriatric Research, University of Florida, 2004 Mowry Road, Gainesville, FL, 32610, USA.|Department of Clinical and Healthy Psychology, University of Florida, Gainesville, FL, 32611, USA.
authors.forename: Tiffany
authors.initials: T
authors.lastname: Cummings
authors.affiliation: Department of Psychiatry and Human Behavior, Brown University, Providence, RI, 02912, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Correia
authors.affiliation: Department of Medicine, Brown University, Providence, RI, 02903, USA.|AIDS Clinical Trial Unit, The Miriam Hospital, Providence, RI, 02903, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Tashima
authors.affiliation: Center for Cognitive Aging and Memory (CAM), Institute on Aging, Department of Aging and Geriatric Research, University of Florida, 2004 Mowry Road, Gainesville, FL, 32610, USA. roncohen@ufl.edu.|Department of Clinical and Healthy Psychology, University of Florida, Gainesville, FL, 32611, USA. roncohen@ufl.edu.
authors.forename: Ronald A
authors.initials: RA
authors.lastname: Cohen
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000375:Aging / Q000276:immunology / Q000473:pathology*; D016880:Anisotropy; D001921:Brain / Q000276:immunology / Q000473:pathology* / Q000821:virology; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology / Q000473:pathology; D016022:Case-Control Studies; D060085:Coinfection; D056324:Diffusion Tensor Imaging; D005260:Female; D015658:HIV Infections / Q000276:immunology / Q000473:pathology* / Q000821:virology; D015497:HIV-1 / Q000472:pathogenicity / Q000502:physiology; D016174:Hepacivirus / Q000472:pathogenicity / Q000502:physiology; D006526:Hepatitis C / Q000276:immunology / Q000473:pathology* / Q000821:virology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D066127:White Matter / Q000276:immunology / Q000473:pathology* / Q000821:virology
keywords: Aging; Diffusion tensor imaging; Fractional anisotropy; HIV; White matter; White matter hyperintensities