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Multishell diffusion MRI reveals whole-brain white matter changes in HIV.

Silvia Minosse1, Eliseo Picchi1,2, Allegra Conti2

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|August 30, 2023
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Summary

Combined Hindered and Restricted Model of Diffusion (CHARMED) and diffusion kurtosis imaging (DKI) reveal widespread white matter changes in HIV infection, outperforming diffusion tensor imaging (DTI) in detecting microstructural differences.

Keywords:
SHAPexplainabilitymachine learningmultishell diffusionwhite matter in HIV

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Area of Science:

  • Neuroimaging
  • Biophysics
  • Medical Science

Background:

  • Diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI) have limitations in specificity for detecting white matter alterations in HIV infection.
  • The Combined Hindered and Restricted Model of Diffusion (CHARMED) offers enhanced microstructural specificity.

Purpose of the Study:

  • To evaluate microstructural differences in white matter between HIV-positive patients and healthy controls using DTI, DKI, and CHARMED.
  • To assess the utility of these diffusion models, particularly CHARMED and DKI, in identifying widespread brain changes associated with HIV.
  • To employ machine learning for discriminating HIV patients from controls using diffusion imaging metrics.

Main Methods:

  • Diffusion-weighted imaging with three b-values was performed on 35 HIV-positive patients and 20 healthy controls.
  • Analysis included DTI, DKI, and CHARMED models to assess white matter microstructural integrity.
  • An XGBoost machine learning algorithm with Shapley Explanation values was used for classification and feature importance analysis.

Main Results:

  • Significant group differences in diffusion metrics were observed across all models.
  • CHARMED and DKI revealed broader white matter tract involvement (80%) in HIV infection compared to DTI (20%).
  • Restricted fraction analysis identified specific tract differences, impacting functions like motor control, proprioception, and equilibrium.
  • CHARMED and DKI metrics, analyzed via machine learning, demonstrated superior performance in discriminating HIV patients from controls.

Conclusions:

  • Biophysical multishell imaging, particularly CHARMED and DKI, provides greater sensitivity and specificity for detecting microstructural brain changes in HIV infection.
  • These advanced diffusion models highlight widespread white matter alterations affecting cognitive and attentive networks often impaired in HIV.
  • CHARMED and DKI show promise as advanced neuroimaging biomarkers for understanding and potentially managing HIV-associated neurological complications.