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Micro-structural brain alterations in aviremic HIV+ patients with minor neurocognitive disorders: a multi-contrast
Cristina Granziera1, Alessandro Daducci, Samanta Simioni
1Department of Clinical Neurosciences, Neuroimmunology Unit, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Vaud, Switzerland ; Department of Clinical Neurosciences, Laboratoire de Recherche En Neuroimagerie (LREN), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Vaud, Switzerland ; Advanced Clinical Imaging Technology, Centre d'imagerie biomédical, École Polytechnique Fédérale de Lausanne, Lausanne, Vaud, Switzerland.
Objective:
Mild neurocognitive disorders (MND) affect a subset of HIV+ patients under effective combination antiretroviral therapy (cART). In this study, we used an innovative multi-contrast magnetic resonance imaging (MRI) approach at high-field to assess the presence of micro-structural brain alterations in MND+ patients.
Methods:
We enrolled 17 MND+ and 19 MND- patients with undetectable HIV-1 RNA and 19 healthy controls (HC). MRI acquisitions at 3T included: MP2RAGE for T1 relaxation times, Magnetization Transfer (MT), T2* and Susceptibility Weighted Imaging (SWI) to probe micro-structural integrity and iron deposition in the brain. Statistical analysis used permutation-based tests and correction for family-wise error rate. Multiple regression analysis was performed between MRI data and (i) neuropsychological results (ii) HIV infection characteristics. A linear discriminant analysis (LDA) based on MRI data was performed between MND+ and MND- patients and cross-validated with a leave-one-out test.
Results:
Our data revealed loss of structural integrity and micro-oedema in MND+ compared to HC in the global white and cortical gray matter, as well as in the thalamus and basal ganglia. Multiple regression analysis showed a significant influence of sub-cortical nuclei alterations on the executive index of MND+ patients (p = 0.04 he and R² = 95.2). The LDA distinguished MND+ and MND- patients with a classification quality of 73% after cross-validation.
Conclusion:
Our study shows micro-structural brain tissue alterations in MND+ patients under effective therapy and suggests that multi-contrast MRI at high field is a powerful approach to discriminate between HIV+ patients on cART with and without mild neurocognitive deficits.
