title: High early life stress and aberrant amygdala activity: risk factors for elevated neuropsychiatric symptoms in HIV+ adults.
abstract: Relative to HIV-negative adults, HIV+ adults report elevated levels of early life stress (ELS). In non-HIV samples, high ELS has been linked to abnormalities in brain structure and function, as well as increased risk of neuropsychiatric symptoms. Yet, little is known about the neural effects of high ELS, and their relation to elevated neuropsychiatric symptoms, in HIV+ adults. Recent studies have revealed combined effects of HIV and high ELS on amygdala morphometry. Aberrant amygdala activity is prominently implicated in studies of neuropsychiatric symptomology in non-HIV samples. Hence, this preliminary study examined: 1) the combined effects of HIV and high ELS on amygdala activity, and 2) the relation between amygdala activity and neuropsychiatric symptoms in HIV+ adults. We included 28 HIV+ adults and 25 demographically-matched HIV-negative control (HC) adults. ELS exposure was quantified using a retrospective ELS questionnaire, which defined four groups: HIV+ Low-ELS (N = 15); HIV+ High-ELS (N = 13); HC Low-ELS (N = 16); and HC High-ELS (N = 9). Participants completed a battery of neuropsychiatric measures. BOLD fMRI assessed amygdala reactivity during explicit observation of fearful/angry faces. High-ELS participants demonstrated reduced levels of amygdala reactivity relative to Low-ELS participants. HIV+ High-ELS participants reported higher levels of neuropsychiatric symptoms than all other groups. In the HIV+ group, lower amygdala responses were associated with higher neuropsychiatric symptoms, particularly depression, anxiety, and alexithymia. Collectively, these results suggest that high ELS exposure is a significant risk factor for neuropsychiatric symptoms in HIV+ adults. Furthermore, our results implicate ELS-related abnormalities in amygdala activity in the etiology of neuropsychiatric symptoms in HIV+ adults.
authors.affiliation: Department of Neurology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1052, New York, NY, 10029, USA. uraina.clark@mssm.edu.
authors.forename: Uraina S
authors.initials: US
authors.lastname: Clark
authors.affiliation: Department of Psychology, University of Georgia, Athens, GA, USA.|Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA.
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Sweet
authors.affiliation: Department of Neurology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1052, New York, NY, 10029, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Morgello
authors.affiliation: Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA.|Providence VA Medical Center, Providence, RI, USA.
authors.forename: Noah S
authors.initials: NS
authors.lastname: Philip
authors.affiliation: Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA.|Departments of Aging and Geriatric Research, Neurology, and Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA.
authors.forename: Ronald A
authors.initials: RA
authors.lastname: Cohen
mesh_terms: D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D000679:Amygdala / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001931:Brain Mapping; D002560:Cerebrovascular Circulation; D004644:Emotions / Q000502:physiology; D000066499:Facial Recognition / Q000502:physiology; D005260:Female; D015658:HIV Infections / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D001523:Mental Disorders / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D012189:Retrospective Studies; D012307:Risk Factors; D013315:Stress, Psychological / Q000453:epidemiology* / Q000503:physiopathology; D011795:Surveys and Questionnaires
chemical_list: D010100:Oxygen
keywords: Adverse childhood experiences; Alexithymia; Amygdala; Anxiety; Childhood abuse; Childhood trauma; Depression