White matter hyperintensities correlate to cognition and fiber tract integrity in older adults with HIV

J Neurovirol. 2017 Jun;23(3):422-429. doi: 10.1007/s13365-016-0509-5. Epub 2017 Jan 18.

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.

Keywords: Aging; Cerebrovascular; Diffusion tensor imaging; HIV; Leukoaraiosis; White matter.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cerebral Cortex / diagnostic imaging
  • Cerebral Cortex / pathology*
  • Cerebral Cortex / virology
  • Cognition / physiology
  • Corpus Callosum / diagnostic imaging
  • Corpus Callosum / pathology*
  • Corpus Callosum / virology
  • Cross-Sectional Studies
  • Diffusion Tensor Imaging
  • Executive Function / physiology
  • Female
  • HIV Infections / diagnostic imaging
  • HIV Infections / pathology*
  • HIV Infections / virology
  • HIV-1 / pathogenicity
  • HIV-1 / physiology
  • Humans
  • Hypertension / diagnostic imaging
  • Hypertension / pathology*
  • Hypertension / virology
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • RNA, Viral / blood*
  • Severity of Illness Index
  • White Matter / diagnostic imaging
  • White Matter / pathology*
  • White Matter / virology

Substances

  • RNA, Viral