Cocaine dependence does not contribute substantially to white matter abnormalities in HIV infection

J Neurovirol. 2017 Jun;23(3):441-450. doi: 10.1007/s13365-017-0512-5. Epub 2017 Mar 1.


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.

Keywords: Cocaine; Diffusion tensor imaging (DTI); HIV infection; Magnetic resonance imaging (MRI); Neurocognitive function; White matter.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Anisotropy
  • CD4 Lymphocyte Count
  • CD4-Positive T-Lymphocytes / immunology
  • CD4-Positive T-Lymphocytes / virology
  • Case-Control Studies
  • Cerebral Cortex / diagnostic imaging
  • Cerebral Cortex / pathology*
  • Cerebral Cortex / virology
  • Cocaine-Related Disorders / complications
  • Cocaine-Related Disorders / diagnostic imaging
  • Cocaine-Related Disorders / immunology
  • Cocaine-Related Disorders / pathology*
  • Corpus Callosum / diagnostic imaging
  • Corpus Callosum / pathology*
  • Corpus Callosum / virology
  • Diffusion Tensor Imaging
  • Female
  • HIV Infections / complications
  • HIV Infections / diagnostic imaging
  • HIV Infections / immunology
  • HIV Infections / pathology*
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Thalamus / diagnostic imaging
  • Thalamus / pathology*
  • Thalamus / virology
  • White Matter / diagnostic imaging
  • White Matter / pathology*
  • White Matter / virology