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Increased posterior cingulate cortex efficiency may predict cognitive impairment in asymptomatic HIV patients
Nina Ventura1,2, Linda Douw3,4, Diogo G Correa1,2
11 Department of Radiology, Federal University of Rio de Janeiro, Brazil.
The Neuroradiology Journal
|June 14, 2018
Summary
Individuals without HIV-associated neurocognitive disorder (HAND) show increased posterior cingulate cortex (PCC) efficiency, suggesting brain network compensation. This compensatory mechanism aids in maintaining cognitive function despite potential neurological changes.
Area of Science:
- Neuroscience
- Medical Imaging
- Cognitive Science
Background:
- Antiretroviral therapy (ART) is standard for HIV management, yet approximately 50% of individuals develop HIV-associated neurocognitive disorder (HAND).
- Cognitive function relies heavily on the efficiency of brain networks, which can reorganize to compensate for damage and preserve cognition.
- The posterior cingulate cortex (PCC) plays a crucial role in brain network efficiency and cognitive performance.
Purpose of the Study:
- To compare the posterior cingulate cortex (PCC) network efficiency between individuals with HAND, those without HAND, and healthy controls.
- To investigate the relationship between PCC efficiency and cognitive performance across different domains in HIV-infected individuals.
- To test the hypothesis that individuals without HAND exhibit higher PCC efficiency than those with HAND.
Main Methods:
- Resting-state functional MRI (fMRI) was utilized with a 3 Tesla scanner to acquire brain imaging data.
- Local efficiency, a metric for network functioning, was calculated for the PCC in all participants.
- Statistical analyses compared PCC efficiency among HAND+, HAND- patients, and controls, and correlated network parameters with cognitive test results.
Main Results:
- Individuals without HAND demonstrated significantly higher PCC efficiency compared to healthy controls (p=0.015).
- No significant differences in PCC efficiency were found between HAND+ patients and controls (p=0.327) or between HAND+ and HAND- patients (p=0.152).
- In HAND- patients, higher PCC efficiency correlated positively with attention/working memory performance (p=0.003). In HAND+ patients, PCC efficiency negatively correlated with abstraction/executive function (p=0.002).
Conclusions:
- Individuals without HAND exhibit enhanced PCC efficiency relative to healthy subjects, supporting the functional reorganization hypothesis.
- Increased PCC efficiency appears to be a compensatory mechanism employed to maintain cognitive function in the absence of overt HAND.
- The distinct correlations between PCC efficiency and cognitive domains in HAND- versus HAND+ patients highlight differential network engagement and compensatory strategies.
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