| Publication Abstract Display | | Type: Poster | | Title: Cerebral volumetric and metabolic abnormalities in HIVassociated
neurocognitive disorders
(HAND). | | Authors: Alakkas A, Ellis R, Watson W, Heaton R, Letendre S, Collier A, Marra C, Clifford D, Gelmen B, Sacktor N, Morgello S, Simpson D, McCutchan A, Kallianpur A, Gianella S, Vaida F, Marcotte T, Grant I, Fennema-Notestine C | | Date: 10-15-2017 | | Abstract:Objectives: We evaluated structural magnetic resonance (MR) imaging (sMRI) and MR
spectroscopy (MRS) in HIVassociated
neurocognitive disorders (HAND).
Methods: In HIV+ individuals without major neurocognitive (NC) comorbidities, impairment
(NCI) was classified as asymptomatic neurocognitive impairment (ANI), mild neurocognitive
disorder (MND) or HIVassociated
dementia (HAD). We measured volumes of cortical,
subcortical and cerebellar gray matter (CGM; SGM; CeGM), abnormal white matter (aWM),
and cerebrospinal fluid (CSF). MRS measured Nacetyl
aspartate (NAA), choline (Cho),
myoinositol (MI) and creatine (Cr) in frontal (FGM) and basal ganglia (BG) gray and WM
(FWM). Adjusted odds ratios compared HAND to unimpaired (NCU).
Results: Among 253 participants, HAND diagnoses were 54 ANI, 37 MND and 10 HAD.
Higher NCI odds was associated with increased AbWM. HAD showed smaller CGM, SGM and
increased CSF. MND had reduced CGM. ANI and MND did not differ. MND showed decreased
FWMCR
and increased FGMCHO.
HAD and ANI had reduced BGNAA.
Conclusions: HAND showed specific alterations (increased aWM and inflammation, reduced
GM and neuronal integrity), in some cases differentiating milder HAND. Alterations may
represent legacy effects (prior injury) or accumulating changes, possibly related to medical
comorbidities, antiretroviral therapy or chronic HIV |
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