Auditory neural processing in children living with HIV uncovers underlying central nervous system dysfunction

Area of Science:

• Neuroscience
• Pediatrics
• Infectious Diseases

Background:

• Central nervous system (CNS) damage in children living with HIV (CLWH) can cause developmental delays and impact educational outcomes.
• Early detection of CNS dysfunction is crucial for timely interventions and preventing long-term disability in CLWH.
• The frequency following response (FFR) is an auditory electrophysiology measure that can reflect CNS health.

Purpose of the Study:

• To investigate whether the FFR can identify auditory CNS dysfunction in CLWH.
• To explore the utility of FFR as an objective marker for CNS health in this population.

Main Methods:

• A cross-sectional analysis was conducted on data from the first visit of an ongoing cohort study.
• The FFR was recorded from 151 CLWH and 151 HIV-negative children in Dar es Salaam, Tanzania.
• Auditory stimuli (speech syllables /da/, /ba/, /ga/) were presented, and response measures included neural timing, encoding strength, consistency, and precision.

Main Results:

• CLWH exhibited significantly weaker first formant amplitudes, inter-response consistencies, and stimulus-to-response correlations compared to HIV-negative children (P < 0.0001 for all).
• These differences were consistent across all three speech stimuli, with moderate effect sizes.
• The findings indicate less robust, more variable, and less accurate neural encoding of auditory stimuli in CLWH.

Conclusions:

• The FFR effectively demonstrates auditory central nervous system dysfunction in CLWH.
• The FFR serves as a passive and objective tool for assessing CNS function in children living with HIV.
• This electrophysiological measure holds promise for early detection and monitoring of CNS health in CLWH.