White matter hyperintensities correlate to cognition and fiber tract integrity in older adults with HIV

Christa Watson, Memory and Aging Center, Department of Neurology, University of California, 675 Nelson Rising Lane, Suite 190, MC: 1207, San Francisco, CA, 94158, USA. christa.watson@ucsf.edu.
Edgar Busovaca, Memory and Aging Center, Department of Neurology, University of California, 675 Nelson Rising Lane, Suite 190, MC: 1207, San Francisco, CA, 94158, USA.
Jessica M. Foley, Memory and Aging Center, Department of Neurology, University of California, 675 Nelson Rising Lane, Suite 190, MC: 1207, San Francisco, CA, 94158, USA.
I Elaine Allen, Department of Biostatistics and Epidemiology, University of California, San Francisco, San Francisco, CA, USA.
Christopher G. Schwarz, Department of Radiology, Mayo Clinic, Rochester, MN, USA.
Neda Jahanshad, Imaging Genetics Center, Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, Los Angeles, CA, USA.
Talia M. Nir, Imaging Genetics Center, Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, Los Angeles, CA, USA.
Pardis Esmaeili-Firidouni, Department of Psychology, Florida State University.
Bruno Chiurliza, Department of Psychology, Florida State University.
Fallon B. Ringer, Department of Psychology, Florida State University.
Matthew S. Michaels, Department of Psychology, Florida State University.
Connor H. Patros, Department of Psychology, Temple University.
Thomas E. Joiner, Department of Psychology, Florida State University.

Document Type

Article

Publication Date

6-1-2017

Abstract

Our aim was to examine the clinical relevance of white matter hyperintensities (WMH) in HIV. We used an automated approach to quantify WMH volume in HIV seropositive (HIV+; n = 65) and HIV seronegative (HIV-; n = 29) adults over age 60. We compared WMH volumes between HIV+ and HIV- groups in cross-sectional and multiple time-point analyses. We also assessed correlations between WMH volumes and cardiovascular, HIV severity, cognitive scores, and diffusion tensor imaging variables. Serostatus groups did not differ in WMH volume, but HIV+ participants had less cerebral white matter (mean: 470.95 [43.24] vs. 497.63 [49.42] mL, p = 0.010). The distribution of WMH volume was skewed in HIV+ with a high proportion (23%) falling above the 95th percentile of WMH volume defined by the HIV- group. Serostatus groups had similar amount of WMH volume growth over time. Total WMH volume directly correlated with measures of hypertension and inversely correlated with measures of global cognition, particularly in executive functioning, and psychomotor speed. Greater WMH volume was associated with poorer brain integrity measured from diffusion tensor imaging (DTI) in the corpus callosum and sagittal stratum. In this group of HIV+ individuals over 60, WMH burden was associated with cardiovascular risk and both worse diffusion MRI and cognition. The median total burden did not differ by serostatus; however, a subset of HIV+ individuals had high WMH burden.

Publication Source (Journal or Book title)

Journal of neurovirology

First Page

422

Last Page

429

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