Altered intrinsic local activity and cognitive dysfunction in HIV patients: A resting-state fMRI study

To characterize resting-state brain activation patterns and investigate altered areas for cognitive decline in HIV patients.

Twelve male HIV patients with intact cognition (HIV-IC), 10 with HIV-associated neurocognitive disorder (HAND), and 11 male healthy controls (HC) underwent resting-state functional MRI (rsfMRI). Three rsfMRI values, regional homogeneity (ReHo), amplitude of low-frequency fluctuation (ALFF), and fractional ALFF (fALFF) were calculated and compared between groups. Correlation analyses were performed between rsfMRI values and neuropsychological tests.

rsfMRI analyses revealed decreased rsfMRI values in the frontal areas, and increases in the posterior brain regions for both HIV-IC and HAND compared to HC. When directly compared to HIV-IC, HAND showed lower fALFF in the orbitofrontal cortex and higher ReHo in the primary sensorimotor area. Additionally, decreased orbitofrontal fALFF, increased sensorimotor ReHo, and a larger difference between the two values were highly correlated with decreased verbal memory and executive function in HIV patients.

Regardless of cognitive status, altered local intrinsic activities were found in HIV patients. The orbitofrontal cortex and primary sensorimotor area were more disrupted in HAND relative to HIV-IC and correlated with behavioral performance, suggesting these areas are relevant to cognitive impairment in HIV patients.