title: White matter hyperintensities correlate to cognition and fiber tract integrity in older adults with HIV.
abstract: Our aim was to examine the clinical relevance of white matter hyperintensities (WMH) in HIV. We used an automated approach to quantify WMH volume in HIV seropositive (HIV+; n = 65) and HIV seronegative (HIV-; n = 29) adults over age 60. We compared WMH volumes between HIV+ and HIV- groups in cross-sectional and multiple time-point analyses. We also assessed correlations between WMH volumes and cardiovascular, HIV severity, cognitive scores, and diffusion tensor imaging variables. Serostatus groups did not differ in WMH volume, but HIV+ participants had less cerebral white matter (mean: 470.95 [43.24] vs. 497.63 [49.42] mL, p = 0.010). The distribution of WMH volume was skewed in HIV+ with a high proportion (23%) falling above the 95th percentile of WMH volume defined by the HIV- group. Serostatus groups had similar amount of WMH volume growth over time. Total WMH volume directly correlated with measures of hypertension and inversely correlated with measures of global cognition, particularly in executive functioning, and psychomotor speed. Greater WMH volume was associated with poorer brain integrity measured from diffusion tensor imaging (DTI) in the corpus callosum and sagittal stratum. In this group of HIV+ individuals over 60, WMH burden was associated with cardiovascular risk and both worse diffusion MRI and cognition. The median total burden did not differ by serostatus; however, a subset of HIV+ individuals had high WMH burden.
authors.affiliation: Memory and Aging Center, Department of Neurology, University of California, 675 Nelson Rising Lane, Suite 190, MC: 1207, San Francisco, CA, 94158, USA. christa.watson@ucsf.edu.
authors.forename: Christa
authors.identifier: 0000-0003-3970-2029
authors.initials: C
authors.lastname: Watson
authors.affiliation: Memory and Aging Center, Department of Neurology, University of California, 675 Nelson Rising Lane, Suite 190, MC: 1207, San Francisco, CA, 94158, USA.|Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Edgar
authors.initials: E
authors.lastname: Busovaca
authors.affiliation: Memory and Aging Center, Department of Neurology, University of California, 675 Nelson Rising Lane, Suite 190, MC: 1207, San Francisco, CA, 94158, USA.
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Foley
authors.affiliation: Department of Biostatistics and Epidemiology, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: I Elaine
authors.initials: IE
authors.lastname: Allen
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, MN, USA.|Center for Neuroscience, Department of Neurology, University of California, Davis, Davis, CA, USA.
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Schwarz
authors.affiliation: Imaging Genetics Center, Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, Los Angeles, CA, USA.
authors.forename: Neda
authors.initials: N
authors.lastname: Jahanshad
authors.affiliation: Imaging Genetics Center, Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, Los Angeles, CA, USA.
authors.forename: Talia M
authors.initials: TM
authors.lastname: Nir
authors.affiliation: Memory and Aging Center, Department of Neurology, University of California, 675 Nelson Rising Lane, Suite 190, MC: 1207, San Francisco, CA, 94158, USA.
authors.forename: Pardis
authors.initials: P
authors.lastname: Esmaeili-Firidouni
authors.affiliation: Memory and Aging Center, Department of Neurology, University of California, 675 Nelson Rising Lane, Suite 190, MC: 1207, San Francisco, CA, 94158, USA.
authors.forename: Benedetta
authors.initials: B
authors.lastname: Milanini
authors.affiliation: Memory and Aging Center, Department of Neurology, University of California, 675 Nelson Rising Lane, Suite 190, MC: 1207, San Francisco, CA, 94158, USA.
authors.forename: Howard
authors.initials: H
authors.lastname: Rosen
authors.affiliation: Biomedical Imaging Center, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA.
authors.forename: Owen T
authors.initials: OT
authors.lastname: Carmichael
authors.affiliation: Imaging Genetics Center, Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, Los Angeles, CA, USA.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Thompson
authors.affiliation: Memory and Aging Center, Department of Neurology, University of California, 675 Nelson Rising Lane, Suite 190, MC: 1207, San Francisco, CA, 94158, USA.
authors.forename: Victor G
authors.initials: VG
authors.lastname: Valcour
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000473:pathology* / Q000821:virology; D003071:Cognition / Q000502:physiology; D003337:Corpus Callosum / Q000000981:diagnostic imaging / Q000473:pathology* / Q000821:virology; D003430:Cross-Sectional Studies; D056324:Diffusion Tensor Imaging; D056344:Executive Function / Q000502:physiology; D005260:Female; D015658:HIV Infections / Q000000981:diagnostic imaging / Q000473:pathology* / Q000821:virology; D015497:HIV-1 / Q000472:pathogenicity / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000473:pathology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012367:RNA, Viral / Q000097:blood*; D012720:Severity of Illness Index; D066127:White Matter / Q000000981:diagnostic imaging / Q000473:pathology* / Q000821:virology
chemical_list: D012367:RNA, Viral
keywords: Aging; Cerebrovascular; Diffusion tensor imaging; HIV; Leukoaraiosis; White matter