title: Cocaine dependence does not contribute substantially to white matter abnormalities in HIV infection.
abstract: This study investigated the association of HIV infection and cocaine dependence with cerebral white matter integrity using diffusion tensor imaging (DTI). One hundred thirty-five participants stratified by HIV and cocaine status (26 HIV+/COC+, 37 HIV+/COC-, 37 HIV-/COC+, and 35 HIV-/COC-) completed a comprehensive substance abuse assessment, neuropsychological testing, and MRI with DTI. Among HIV+ participants, all were receiving HIV care and 46% had an AIDS diagnosis. All COC+ participants were current users and met criteria for cocaine use disorder. We used tract-based spatial statistics (TBSS) to assess the relation of HIV and cocaine to fractional anisotropy (FA) and mean diffusivity (MD). In whole-brain analyses, HIV+ participants had significantly reduced FA and increased MD compared to HIV- participants. The relation of HIV and FA was widespread throughout the brain, whereas the HIV-related MD effects were restricted to the corpus callosum and thalamus. There were no significant cocaine or HIV-by-cocaine effects. These DTI metrics correlated significantly with duration of HIV disease, nadir CD4+ cell count, and AIDS diagnosis, as well as some measures of neuropsychological functioning. These results suggest that HIV is related to white matter integrity throughout the brain, and that HIV-related effects are more pronounced with increasing duration of infection and greater immune compromise. We found no evidence for independent effects of cocaine dependence on white matter integrity, and cocaine dependence did not appear to exacerbate the effects of HIV.
authors.affiliation: Duke Global Health Institute, Duke University, Durham, NC, 27708, USA.
authors.forename: Daniella M
authors.initials: DM
authors.lastname: Cordero
authors.affiliation: Duke Global Health Institute, Duke University, Durham, NC, 27708, USA.|Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27705, USA.
authors.forename: Sheri L
authors.initials: SL
authors.lastname: Towe
authors.affiliation: Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC, 27710, USA.|Department of Radiology, Duke University School of Medicine, Durham, NC, 27705, USA.
authors.forename: Nan-Kuei
authors.initials: NK
authors.lastname: Chen
authors.affiliation: Department of Neurology, Physicians Office Building, University of North Carolina School of Medicine, Chapel Hill, NC, 27599, USA.
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Robertson
authors.affiliation: Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27705, USA.|Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC, 27710, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Madden
authors.affiliation: Center for Cognitive Neuroscience, Duke University, Durham, NC, 27708, USA.|Department of Psychology & Neuroscience, Duke University, Durham, NC, 27708, USA.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Huettel
authors.affiliation: Duke Global Health Institute, Duke University, Durham, NC, 27708, USA. christina.meade@duke.edu.|Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27705, USA. christina.meade@duke.edu.
authors.forename: Christina S
authors.initials: CS
authors.lastname: Meade
mesh_terms: D000328:Adult; D016880:Anisotropy; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology / Q000821:virology; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000473:pathology* / Q000821:virology; D019970:Cocaine-Related Disorders / Q000150:complications / Q000000981:diagnostic imaging / Q000276:immunology / Q000473:pathology*; D003337:Corpus Callosum / Q000000981:diagnostic imaging / Q000473:pathology* / Q000821:virology; D056324:Diffusion Tensor Imaging; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000000981:diagnostic imaging / Q000276:immunology / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D013788:Thalamus / Q000000981:diagnostic imaging / Q000473:pathology* / Q000821:virology; D066127:White Matter / Q000000981:diagnostic imaging / Q000473:pathology* / Q000821:virology
keywords: Cocaine; Diffusion tensor imaging (DTI); HIV infection; Magnetic resonance imaging (MRI); Neurocognitive function; White matter