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HIV infection and the fronto-striatal system: a systematic review and meta-analysis of fMRI studies
Stéfan Du Plessis1, Matthijs Vink, John A Joska
1aDepartment of Psychiatry, University of Stellenbosch, Cape Town, South Africa bRudolf Magnus Institute of Neuroscience, University of Utrecht, Utrecht, The Netherlands cInstitute for Virology and Immunobiology, University of Würzburg, Würzburg, Germany dMedical Research Council (Unit on Anxiety and Stress Disorders) eDepartment of Psychiatry, University of Cape Town, Cape Town, South Africa.
Abstract:
Functional MRI studies investigating the impact of HIV on the brain have implicated the involvement of fronto-striatal circuitry. However, to date there is no review and meta-analysis of this work. We systematically reviewed the literature and performed a meta-analysis of functional magnetic resonance imaging (fMRI) studies in HIV-infected individuals using a well validated tool recently developed for use in fMRI, 'GingerALE'. Twenty-one studies (468 HIV+, 270 HIV- controls) were qualitatively reviewed, of which six (105 HIV+, 102 controls) utilized fMRI paradigms engaging the fronto-striatal-parietal network, making a quantitative analysis possible. Our meta-analysis revealed consistent functional differences in the left inferior frontal gyrus and caudate nucleus between infected participants and controls across these studies. This fronto-striatal dysfunction was qualitatively related to cognitive impairment, disease progression and treatment effects. Although further work needs to be done to further delineate the potentially confounding influence of substance abuse and HIV-related comorbidities, as well as HIV's effect on functional haemodynamic vascular coupling, these findings indicate that further investigation of the fronto-striatal sub-networks in HIV-infected patients is warranted.
Insights
This meta-analysis reveals consistent functional brain differences in the fronto-striatal circuitry of individuals with Human Immunodeficiency Virus (HIV). These findings highlight altered brain activity in HIV patients, particularly in the left inferior frontal gyrus and caudate nucleus.
Area of Science:
- Neuroimaging
- Neuroscience
- Public Health
Background:
- Human Immunodeficiency Virus (HIV) infection impacts brain function, particularly fronto-striatal circuitry.
- Previous functional MRI (fMRI) studies suggest alterations in brain activity in HIV-infected individuals.
- A comprehensive review and meta-analysis of these fMRI studies is lacking.
Purpose of the Study:
- To systematically review and perform a meta-analysis of fMRI studies examining brain function in HIV-infected individuals.
- To identify consistent patterns of altered brain activity within the fronto-striatal network.
- To explore the relationship between observed functional brain differences and clinical factors.
Main Methods:
- Systematic literature review of fMRI studies in HIV.
- Meta-analysis using the GingerALE tool on studies engaging the fronto-striatal-parietal network.
- Qualitative review of 21 studies and quantitative analysis of 6 studies (105 HIV+, 102 controls).
Main Results:
- Consistent functional differences identified in the left inferior frontal gyrus and caudate nucleus between HIV-infected individuals and controls.
- These fronto-striatal dysfunctions correlate with cognitive impairment, disease progression, and treatment effects.
- Significant alterations in fronto-striatal circuitry are evident in HIV infection.
Conclusions:
- The fronto-striatal network is consistently affected in HIV infection, as shown by fMRI meta-analysis.
- Further research is warranted to investigate fronto-striatal sub-networks in HIV patients.
- Future studies should address confounding factors like substance abuse and comorbidities.
