Use of Neuroimaging to Inform Optimal Neurocognitive Criteria for Detecting HIV-Associated Brain Abnormalities.

Published on Feb 1, 2020in Journal of The International Neuropsychological Society2.576
· DOI :10.1017/S1355617719000985
Laura M Campbell7
Estimated H-index: 7
(UCSD: University of California, San Diego),
Christine Fennema-Notestine56
Estimated H-index: 56
(UCSD: University of California, San Diego)
+ 15 AuthorsRobert K. Heaton119
Estimated H-index: 119
Objective: Frascati international research criteria for HIV-associated neurocognitive disorders (HAND) are controversial; some investigators have argued that Frascati criteria are too liberal, resulting in a high false positive rate. Meyer et al. recommended more conservative revisions to HAND criteria, including exploring other commonly used methodologies for neurocognitive impairment (NCI) in HIV including the global deficit score (GDS). This study compares NCI classifications by Frascati, Meyer, and GDS methods, in relation to neuroimaging markers of brain integrity in HIV. Method: Two hundred forty-one people living with HIV (PLWH) without current substance use disorder or severe (confounding) comorbid conditions underwent comprehensive neurocognitive testing and brain structural magnetic resonance imaging and magnetic resonance spectroscopy. Participants were classified using Frascati criteria versus Meyer criteria: concordant unimpaired [Frascati(Un)/Meyer(Un)], concordant impaired [Frascati(Imp)/Meyer(Imp)], or discordant [Frascati(Imp)/Meyer(Un)] which were impaired via Frascati criteria but unimpaired via Meyer criteria. To investigate the GDS versus Meyer criteria, the same groupings were utilized using GDS criteria instead of Frascati criteria. Results: When examining Frascati versus Meyer criteria, discordant Frascati(Imp)/Meyer(Un) individuals had less cortical gray matter, greater sulcal cerebrospinal fluid volume, and greater evidence of neuroinflammation (i.e., choline) than concordant Frascati(Un)/Meyer(Un) individuals. GDS versus Meyer comparisons indicated that discordant GDS(Imp)/Meyer(Un) individuals had less cortical gray matter and lower levels of energy metabolism (i.e., creatine) than concordant GDS(Un)/Meyer(Un) individuals. In both sets of analyses, the discordant group did not differ from the concordant impaired group on any neuroimaging measure. Conclusions: The Meyer criteria failed to capture a substantial portion of PLWH with brain abnormalities. These findings support continued use of Frascati or GDS criteria to detect HIV-associated CNS dysfunction.
📖 Papers frequently viewed together
255 Citations
3 Citations
4 Citations
#1Jennifer E. Iudicello (UCSD: University of California, San Diego)H-Index: 23
#2Erin E. Morgan (UCSD: University of California, San Diego)H-Index: 27
Last. Robert K. Heaton (UCSD: University of California, San Diego)H-Index: 119
view all 5 authors...
2 CitationsSource
#1Rowan Saloner (UCSD: University of California, San Diego)H-Index: 6
#2Robert K. Heaton (UCSD: University of California, San Diego)H-Index: 119
view all 16 authors...
Author(s): Saloner, Rowan; Heaton, Robert K; Campbell, Laura M; Chen, Anna; Franklin, Donald; Ellis, Ronald J; Collier, Ann C; Marra, Christina; Clifford, David B; Gelman, Benjamin; Sacktor, Ned; Morgello, Susan; McCutchan, J Allen; Letendre, Scott; Grant, Igor; Fennema-Notestine, Christine; CHARTER Study Group | Abstract: OBJECTIVE:The influence of confounding neurocognitive comorbidities in people living with HIV (PLWH) on neuroimaging has not been systematically evaluated. We determined assoc...
13 CitationsSource
#1Aljoharah Alakkas (UCSD: University of California, San Diego)H-Index: 1
#2Ronald J. Ellis (UCSD: University of California, San Diego)H-Index: 89
Last. Christine Fennema-Notestine (UCSD: University of California, San Diego)H-Index: 56
view all 19 authors...
HIV-associated neurocognitive disorders (HANDs) persist even with virologic suppression on combination antiretroviral therapy (cART), and the underlying pathophysiological mechanisms are not well understood. We performed structural magnetic resonance imaging and MR spectroscopy (MRS) in HIV+ individuals without major neurocognitive comorbidities. Study participants were classified as neurocognitively unimpaired (NU), asymptomatic (ANI), mild neurocognitive disorder (MND), or HIV­associated demen...
38 CitationsSource
#1Madeleine Nichols (NeuRA: Neuroscience Research Australia)H-Index: 1
#2Thomas M. Gates (St. Vincent's Health System)H-Index: 10
Last. Lucette A. Cysique (NeuRA: Neuroscience Research Australia)H-Index: 33
view all 7 authors...
Objective:There is a lack of evidence for the neurobiological underpinning of asymptomatic neurocognitive impairment (ANI) and mild neurocognitive disorders (MNDs) in virally suppressed HIV-positive persons. We hypothesized that such mild impairment would be associated with focal brain atrophy.Desig
18 CitationsSource
#1Mona A. MohamedH-Index: 14
#2Peter B. Barker (ICSCI: Kennedy Krieger Institute)H-Index: 57
Last. Ned SacktorH-Index: 65
view all 4 authors...
BACKGROUND AND PURPOSE: Validated neuroimaging markers of HIV-associated neurocognitive disorder in patients on antiretroviral therapy are urgently needed for clinical trials. The purpose of this study was to explore the relationship between cognitive impairment and brain metabolism in older subjects with HIV infection. It was hypothesized that MR spectroscopy measurements related to neuronal health and function (particularly N -acetylaspartate and glutamate) would be lower in HIV-positive subje...
8 CitationsSource
#1Erin E. O'Connor (University of Maryland Medical System)H-Index: 9
#2Timothy ZeffiroH-Index: 3
Last. Thomas A. ZeffiroH-Index: 8
view all 3 authors...
BACKGROUND: Numerous studies have used structural neuroimaging to measure HIV effects on brain macroarchitecture. While many have reported changes in total brain volume, gray matter volume, white matter volume, CSF volume, and basal ganglia volume following HIV infection, quantitative inconsistencies observed across studies are large. PURPOSE: Our aim was to evaluate the consistency and temporal stability of serostatus effects on a range of structural neuroimaging measures. DATA SOURCES: PubMed,...
25 CitationsSource
#1Lindie du Plessis (UCT: University of Cape Town)H-Index: 3
#2Robert H. Paul (MU: University of Missouri)H-Index: 68
Last. John A. Joska (UCT: University of Cape Town)H-Index: 32
view all 7 authors...
Neuroimaging abnormalities are common in chronically infected HIV-positive individuals. The majority of studies have focused on structural or functional brain outcomes in samples infected with clade B HIV. While preliminary work reveals a similar structural imaging phenotype in patients infected with clade C HIV, no study has examined functional connectivity (FC) using resting-state functional magnetic resonance imaging (rs-fMRI) in clade C HIV. In particular, we were interested to explore HIV-o...
12 CitationsSource
#1Rowan Saloner (UCSD: University of California, San Diego)H-Index: 6
#2Lucette A. Cysique (UNSW: University of New South Wales)H-Index: 33
The present review on HIV-associated neurocognitive disorders (HAND) provides a worldwide overview of studies that have investigated the rate and neuropsychological (NP) profile of HAND research since the inception of the 2007 HAND diagnostic nomenclature. In the first part, the review highlights some of the current controversies around HAND prevalence rates. In the second part, the review critically assesses some solutions to move the field forward. In the third part, we present the cross-secti...
45 CitationsSource
#1Lucette A. Cysique (UNSW: University of New South Wales)H-Index: 33
#2James R. Soares (NeuRA: Neuroscience Research Australia)H-Index: 2
Last. Caroline Rae (UNSW: University of New South Wales)H-Index: 42
view all 9 authors...
The objective of the current study was to quantify the degree of white matter (WM) abnormalities in chronic and virally suppressed HIV-infected (HIV+) persons while carefully taking into account demographic and disease factors. Diffusion tensor imaging (DTI) was conducted in 40 HIV− and 82 HIV+ men with comparable demographics and life style factors. The HIV+ sample was clinically stable with successful viral control. Diffusion was measured across 32 non-colinear directions with a b-value of 100...
22 CitationsSource
#1Jordan E. Lake (UCLA: University of California, Los Angeles)H-Index: 21
#2Mikhail Popov (University of Pittsburgh)H-Index: 2
Last. James T. Becker (University of Pittsburgh)H-Index: 109
view all 8 authors...
The combined effects of human immunodeficiency virus (HIV), obesity, and elevated visceral adipose tissue (VAT) on brain structure are unknown. In a cross-sectional analysis of Multicenter AIDS Cohort Study (MACS) participants, we determined associations between HIV serostatus, adiposity, and brain structure. Men (133 HIV+, 84 HIV–) in the MACS Cardiovascular 2 and magnetic resonance imaging (MRI) sub-studies with CT-quantified VAT and whole brain MRI measured within 1 year were assessed. Voxel-...
11 CitationsSource
Cited By4
#1Anna J. Dreyer (UCT: University of Cape Town)H-Index: 3
#2Sam Nightingale (UCT: University of Cape Town)H-Index: 2
Last. John A. Joska (UCT: University of Cape Town)H-Index: 32
view all 8 authors...
There is wide variation in the reported prevalence of cognitive impairment in people with HIV (PWH). Part of this variation may be attributable to different studies using different methods of combining neuropsychological test scores to classify participants as either cognitively impaired or unimpaired. Our aim was to determine, in a South African cohort of PWH (N = 148), (a) how much variation in reported rates was due to method used to define cognitive impairment and (b) which method correlated...
#1Mirella Díaz-Santos (Semel Institute for Neuroscience and Human Behavior)H-Index: 3
#2Paola Suarez (Semel Institute for Neuroscience and Human Behavior)H-Index: 15
Last. Mariana Cherner (UCSD: University of California, San Diego)H-Index: 35
view all 8 authors...
We generated demographically adjusted norms for the Brief Visuospatial Memory Test-revised (BVMT-R) and the Hopkins Verbal Learning Test-revised (HVLT-R) for Spanish-speakers from the U.S.-Mexico b...
11 CitationsSource
#1Dan Liu (Capital Medical University)
#2Cui Zhao (Capital Medical University)H-Index: 2
Last. Hongjun Li (Beihang University)
view all 11 authors...
People living with human immunodeficiency virus (HIV) (PLWH) are at high risk of neurocognitive impairment. The pathogenesis of neurocognitive impairment remains unclear, and there is still no diagnostic biomarker. By coupling three-dimensional T1-weighted imaging and resting-state functional imaging, we explored structural and functional alterations in PLWH and examined whether such imaging alterations had the potential to denote neurocognitive function. A total of 98 PLWH and 47 seronegative c...
1 CitationsSource