title: Compensatory activation in fronto-parietal cortices among HIV-infected persons during a monetary decision-making task.
abstract: HIV infection can cause direct and indirect damage to the brain and is consistently associated with neurocognitive disorders, including impairments in decision-making capacities. The tendency to devalue rewards that are delayed (temporal discounting) is relevant to a range of health risk behaviors. Making choices about delayed rewards engages the executive control network of the brain, which has been found to be affected by HIV. In this case-control study of 18 HIV-positive and 17 HIV-negative adults, we examined the effects of HIV on brain activation during a temporal discounting task. Functional MRI (fMRI) data were collected while participants made choices between smaller, sooner rewards and larger, delayed rewards. Choices were individualized based on participants' unique discount functions, so each participant experienced hard (similarly valued), easy (disparately valued), and control choices. fMRI data were analyzed using a mixed-effects model to identify group-related differences associated with choice difficulty. While there was no difference between groups in behavioral performance, the HIV-positive group demonstrated significantly larger increases in activation within left parietal regions and bilateral prefrontal regions during easy trials and within the right prefrontal cortex and anterior cingulate during hard trials. Increasing activation within the prefrontal regions was associated with lower nadir CD4 cell count and risk-taking propensity. These results support the hypothesis that HIV infection can alter brain functioning in regions that support decision making, providing further evidence for HIV-associated compensatory activation within fronto-parietal cortices. A history of immunosuppression may contribute to these brain changes. Hum Brain Mapp 37:2455-2467, 2016. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina.|Duke Global Health Institute, Durham, North Carolina.|Department of Psychology & Neuroscience, Duke University, Durham, North Carolina.
authors.forename: Christina S
authors.initials: CS
authors.lastname: Meade
authors.affiliation: Duke Global Health Institute, Durham, North Carolina.
authors.forename: Daniella M
authors.initials: DM
authors.lastname: Cordero
authors.affiliation: Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina.|Duke Global Health Institute, Durham, North Carolina.
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Hobkirk
authors.affiliation: Duke Global Health Institute, Durham, North Carolina.
authors.forename: Brandon M
authors.initials: BM
authors.lastname: Metra
authors.affiliation: Brain Imaging and Analysis Center, Duke University Medical Center, Durham, North Carolina.|Department of Radiology, Duke University School of Medicine, Durham, North Carolina.
authors.forename: Nan-Kuei
authors.initials: NK
authors.lastname: Chen
authors.affiliation: Department of Psychology & Neuroscience, Duke University, Durham, North Carolina.|Brain Imaging and Analysis Center, Duke University Medical Center, Durham, North Carolina.|Center for Cognitive Neuroscience, Duke University, Durham, North Carolina.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Huettel
mesh_terms: D000293:Adolescent; D000328:Adult; D001931:Brain Mapping; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D003657:Decision Making / Q000502:physiology*; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000503:physiopathology*; D015658:HIV Infections / Q000503:physiopathology* / Q000523:psychology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009483:Neuropsychological Tests; D010296:Parietal Lobe / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012309:Risk-Taking; D055815:Young Adult
keywords: HIV; decision making; executive function; functional magnetic resonance imaging; temporal discounting