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Altered structural brain changes and neurocognitive performance in pediatric HIV.

Santosh K Yadav1, Rakesh K Gupta2, Ravindra K Garg3

  • 1Division of Translational Medicine, Research Branch, Sidra Medical and Research Center, Doha, Qatar.

Neuroimage. Clinical
|February 23, 2017
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Summary

Pediatric HIV patients show altered brain structure and connectivity, impacting neurocognitive functions. These changes may explain developmental delays and cognitive impairments in children living with HIV.

Keywords:
AIDS, acquired immunodeficiency syndromeC, clustering coefficientCortical thicknessELISA, enzyme-linked immunosorbent assayFA, flip angelFLAIR, fluid attenuation inversion recoveryFOV, field of viewFSPGR, fast spoiled gradient echoGAT, graph-theoretical analysis toolboxHIV, human immunodeficiency virusHuman immunodeficiency virusL, characteristic path lengthMRI, magnetic resonance imagingMagnetic resonance imagingNeurocognitive functionsRAKIT, revised Amsterdamse kinder intelligenceROIs, regions of interestSW, small-world indexStructural connectivitySubcortical volumeTBM, tensor based morphometryTE, echo timeTR, repetition time

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Area of Science:

  • Neuroscience
  • Pediatric Neurology
  • Infectious Diseases

Background:

  • Pediatric HIV infection is linked to neurodevelopmental delays and cognitive impairment.
  • Brain tissue injury is documented in adult HIV patients, but less is known about pediatric cases.
  • Understanding brain changes in perinatally HIV-infected children is crucial for effective management.

Purpose of the Study:

  • To investigate structural brain changes and neurocognitive function in perinatally HIV-infected children.
  • To compare brain structure and connectivity between pediatric HIV patients and healthy controls.
  • To explore the relationship between brain alterations and cognitive deficits in pediatric HIV.

Main Methods:

  • 34 perinatally HIV-infected children and 32 healthy controls underwent neurocognitive assessment.
  • Brain magnetic resonance imaging (MRI) was performed on a 3T clinical scanner.
  • Analysis included cortical thickness, subcortical volume, and structural network connectivity.

Main Results:

  • Pediatric HIV patients exhibited altered cortical thickness and subcortical volumes.
  • Neuropsychological test scores were significantly abnormal in the HIV-infected group.
  • Structural network analysis revealed reduced connection strengths, lower clustering, and increased path length in HIV patients.
  • Cortico-limbic network hubs and betweenness were distorted in pediatric HIV patients.

Conclusions:

  • Altered brain structures and regional connectivity in pediatric HIV patients correlate with neurocognitive deficits.
  • These findings highlight the impact of HIV on brain development and function in children.
  • Longitudinal studies are needed to track HIV's effects on brain development under ART treatment.