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Neuroimage Clin. 2019;23:101810. doi: 10.1016/j.nicl.2019.101810. Epub 2019 Apr 2.

Mapping abnormal subcortical neurodevelopment in a cohort of Thai children with HIV.

Author information

1
Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA; Ahmanson-Lovelace Brain Mapping Center University of California, Los Angeles, Los Angeles, CA, USA; Missouri Institute of Mental Health, University of Missouri St. Louis, St. Louis, USA.
2
Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA.
3
HIV-NAT, the Thai Red Cross AIDS Research Centre, Bangkok, Thailand.
4
Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA.
5
Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA.
6
RIHES, Chiang Mai University, Chiang Mai, Thailand.
7
Department of Pediatrics, Khon Kaen University, Khon Kaen, Thailand.
8
Chiang Rai Prachanukroh Hospital, Chiang Rai, Thailand.
9
Department of Radiology, Chulalongkorn University Medical Center, Bangkok, Thailand.
10
Department of Radiology, Chiang Mai University, Chiang Mai, Thailand.
11
Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
12
Ahmanson-Lovelace Brain Mapping Center University of California, Los Angeles, Los Angeles, CA, USA.
13
HIV-NAT, the Thai Red Cross AIDS Research Centre, Bangkok, Thailand; U.S. Military HIV Research Program, Walter Reed Army Institute of Research, MD, USA; Department of Global Health, University of Amsterdam, Amsterdam, the Netherlands; Henry M. Jackson Foundation for the Advancement of Military Medicine, MD, USA.
14
Missouri Institute of Mental Health, University of Missouri St. Louis, St. Louis, USA.
15
Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA. Electronic address: neda.jahanshad@usc.edu.

Abstract

Alterations in subcortical brain structures have been reported in adults with HIV and, to a lesser extent, pediatric cohorts. The extent of longitudinal structural abnormalities in children with perinatal HIV infection (PaHIV) remains unclear. We modeled subcortical morphometry from whole brain structural magnetic resonance imaging (1.5 T) scans of 43 Thai children with PaHIV (baseline age = 11.09±2.36 years) and 50 HIV- children (11.26±2.80 years) using volumetric and surface-based shape analyses. The PaHIV sample were randomized to initiate combination antiretroviral treatment (cART) when CD4 counts were 15-24% (immediate: n = 22) or when CD4 < 15% (deferred: n = 21). Follow-up scans were acquired approximately 52 weeks after baseline. Volumetric and shape descriptors capturing local thickness and surface area dilation were defined for the bilateral accumbens, amygdala, putamen, pallidum, thalamus, caudate, and hippocampus. Regression models adjusting for clinical and demographic variables examined between and within group differences in morphometry associated with HIV. We assessed whether baseline CD4 count and cART status or timing associated with brain maturation within the PaHIV group. All models were adjusted for multiple comparisons using the false discovery rate. A pallidal subregion was significantly thinner in children with PaHIV. Regional thickness, surface area, and volume of the pallidum was associated with CD4 count in children with PaHIV. Longitudinal morphometry was not associated with HIV or cART status or timing, however, the trajectory of the left pallidum volume was positively associated with baseline CD4 count. Our findings corroborate reports in adult cohorts demonstrating a high predilection for HIV-mediated abnormalities in the basal ganglia, but suggest the effect of stable PaHIV infection on morphological aspects of brain development may be subtle.

KEYWORDS:

Brain development; MRI; Neuro HIV; Pediatric HIV; Subcortical shape analysis

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