title: Review of functional MRI in HIV: effects of aging and medication.
abstract: HIV-associated neurocognitive disorder (HAND) is a frequently occurring comorbidity of HIV infection. Evidence suggests this condition starts subclinical before a progression to a symptomatic stage. Blood oxygenated level dependent (BOLD) fMRI has shown to be a sensitive tool to detect abnormal brain function in an early stage and might therefore be useful to evaluate the effect of HIV infection on brain function. An extensive literature search was performed in June 2015. Eligibility criteria for included studies were as follows: (1) conducting with HIV-positive patients, (2) using BOLD fMRI, and (3) including a HIV-negative control group. A total of 19 studies were included in the review including 931 participants. Differences in activation between HIV-positive and -negative participants were found when testing multiple domains, i.e., attention, (working) memory, and especially executive functioning. Overall, HIV-positive patients showed hyperactivation in task-related brain regions despite equal performances as controls. Task performance was degraded only for the most complex tasks. A few studies investigated the effect of aging on fMRI, and most of them found no interaction with HIV infection. Only three studies evaluated the effect of combination antiretroviral therapy (cART) on functional data suggesting an increase in activation with the use of cART. fMRI is a sensitive instrument to detect subtle cognitive changes in HIV patients. Open questions remain regarding the effects of cART on fMRI and the effects of aging on fMRI.
authors.affiliation: Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Heidelberglaan 100, 3508 GA, Utrecht, The Netherlands. c.s.hakkers@umcutrecht.nl.
authors.forename: C S
authors.initials: CS
authors.lastname: Hakkers
authors.affiliation: Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Heidelberglaan 100, 3508 GA, Utrecht, The Netherlands.
authors.forename: J E
authors.initials: JE
authors.lastname: Arends
authors.affiliation: Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Heidelberglaan 100, 3508 GA, Utrecht, The Netherlands.
authors.forename: R E
authors.initials: RE
authors.lastname: Barth
authors.affiliation: Department of Psychiatry, University of Stellenbosch, Cape Town, South Africa.
authors.forename: S
authors.initials: S
authors.lastname: Du Plessis
authors.affiliation: Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Heidelberglaan 100, 3508 GA, Utrecht, The Netherlands.
authors.forename: A I M
authors.initials: AI
authors.lastname: Hoepelman
authors.affiliation: Department of Psychiatry, University Medical Center Utrecht, Heidelberglaan 100, 3508 GA, Utrecht, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Vink
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D000998:Antiviral Agents / Q000627:therapeutic use; D001921:Brain / Q000503:physiopathology; D001931:Brain Mapping; D016022:Case-Control Studies; D060825:Cognitive Dysfunction / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology; D056344:Executive Function / Q000502:physiology; D015658:HIV Infections / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008570:Memory, Short-Term / Q000502:physiology; D009483:Neuropsychological Tests; D012720:Severity of Illness Index; D013647:Task Performance and Analysis
chemical_list: D000998:Antiviral Agents
keywords: BOLD; HAND; Systematic review; fMRI