Brain Volumetric Alterations in Preclinical HIV-Associated Neurocognitive Disorder Using Automatic Brain Quantification and Segmentation Tool

PurposeThis study aimed to determine if people living with HIV (PLWH) in preclinical human immunodeficiency virus (HIV)-associated neurocognitive disorder (HAND), with no clinical symptoms and without decreased daily functioning, suffer from brain volumetric alterations and its patterns.MethodFifty-nine male PLWH at the HAND preclinical stage were evaluated, including 19 subjects with asymptomatic neurocognitive impairment (ANI), 17 subjects with cognitive abnormality that does not reach ANI (Not reach ANI), and 23 subjects with cognitive integrity. Moreover, 23 healthy volunteers were set as the seronegative normal controls (NCs). These individuals underwent sagittal three-dimensional T1-weighted imaging (3D T1WI). Quantified data and volumetric measures of brain structures were automatically segmented and extracted using AccuBrain®. In addition, the multiple linear regression analysis was performed to analyze the relationship of volumes of brain structures and clinical variables in preclinical HAND, and the correlations of the brain volume parameters with different cognitive function states were assessed by Pearson’s correlation analysis.ResultsThe significant difference was shown in the relative volumes of the ventricular system, bilateral lateral ventricle, thalamus, caudate, and left parietal lobe gray matter between the preclinical HAND and NCs. Furthermore, the relative volumes of the bilateral thalamus in preclinical HAND were negatively correlated with attention/working memory (left: r = −0.271, p = 0.042; right: r = −0.273, p = 0.040). Higher age was associated with increased relative volumes of the bilateral lateral ventricle and ventricular system and reduced relative volumes of the left thalamus and parietal lobe gray matter. The lower CD4+/CD8+ ratio was associated with increased relative volumes of the left lateral ventricle and ventricular system. Longer disease course was associated with increased relative volumes of the bilateral thalamus. No significant difference was found among preclinical HAND subgroups in all indices, and the difference between the individual groups (Not reach ANI and Cognitive integrity groups) and NCs was also insignificant. However, there was a significant difference between ANI and NCs in the relative volumes of the bilateral caudate and lateral ventricle.ConclusionMale PLWH at the HAND preclinical stage suffer from brain volumetric alterations. AccuBrain® provides potential value in evaluating HIV-related neurocognitive dysfunction.

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Can Individualized-Targeted Computerized Cognitive Training Benefit Adults with HIV-Associated Neurocognitive Disorder? The Training on Purpose Study (TOPS)

AIDS and Behavior ◽

10.1007/s10461-021-03230-y ◽

2021 ◽

Author(s):

David E. Vance ◽

Pariya L. Fazeli ◽

Andres Azuero ◽

Virginia G. Wadley ◽

James L. Raper ◽

...

Keyword(s):

Cognitive Training ◽

Neurocognitive Disorder ◽

Computerized Cognitive Training ◽

Hiv Associated Neurocognitive Disorder

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Scaling Up Information Sharing on HIV-Associated Neurocognitive Disorder: Raising Awareness and Knowledge Among Key Stakeholders

SAGE Open ◽

10.1177/21582440211016898 ◽

2021 ◽

Vol 11 (2) ◽

pp. 215824402110168

Author(s):

Renato M. Liboro ◽

Paul A. Shuper ◽

Lori E. Ross

Keyword(s):

Health Care ◽

Information Sharing ◽

Service Providers ◽

Scale Up ◽

People Living With Hiv ◽

Neurocognitive Disorder ◽

Public Health Informatics ◽

Raising Awareness ◽

Hiv Associated Neurocognitive Disorder ◽

Hiv Aids

Although the majority of specialists and researchers in the field of HIV/AIDS are aware and knowledgeable about HIV-associated neurocognitive disorder (HAND) as a condition that affects as much as 50% of people living with HIV/AIDS (PLWH), research has documented that many health care and service providers who work directly with PLWH are either unaware of HAND or believe they do not know enough information about HAND to effectively support their clients experiencing neurocognitive challenges. Based on the findings of a qualitative study that interviewed 33 health care and service providers in HIV/AIDS services to identify and examine their awareness and knowledge on HAND, this article argues for utilizing a combination of Public Health Informatics principles; communication techniques, propagation strategies, and recognized approaches from Implementation and Dissemination Science; and social media and online discussion platforms, in addition to traditional Knowledge Mobilization strategies, to scale up information sharing on HAND among all relevant stakeholders. Increasing information sharing among stakeholders would be an important step to raising awareness and knowledge on HAND, and consequently, improving care, services, and support for PLWH and neurocognitive issues.

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MR-Based Correction of Brain PET Measurements for Heterogeneous Gray Matter Radioactivity Distribution

Journal of Cerebral Blood Flow & Metabolism ◽

10.1097/00004647-199607000-00016 ◽

1996 ◽

Vol 16 (4) ◽

pp. 650-658 ◽

Cited By ~ 96

Author(s):

Carolyn Cidis Meltzer ◽

Jon Kar Zubieta ◽

Jonathan M. Links ◽

Paul Brakeman ◽

Martin J. Stumpf ◽

...

Keyword(s):

Gray Matter ◽

Accurate Determination ◽

Brain Structures ◽

Volume Averaging ◽

Partial Volume Correction ◽

Sampling Errors ◽

Partial Volume ◽

Volume Correction ◽

Healthy Elderly ◽

Wide Range

Partial volume and mixed tissue sampling errors can cause significant inaccuracy in quantitative positron emission tomographic (PET) measurements. We previously described a method of correcting PET data for the effects of partial volume averaging on gray matter (GM) quantitation; however, this method may incompletely correct GM structures when local tissue concentrations are highly heterogeneous. We have extended this three-compartment algorithm to include a fourth compartment: a GM volume of interest (VOI) that can be delineated on magnetic resonance (MR) imaging. Computer simulations of PET images created from human MR data demonstrated errors of up to 120% in assigned activity values in small brain structures in uncorrected data. Four-compartment correction achieved full recovery of a wide range of coded activity in GM VOIs such as the amygdala, caudate, and thalamus. Further validation was performed in an agarose brain phantom in actual PET acquisitions. Implementation of this partial volume correction approach in [18F]fluorodeoxyglucose and [11C]-carfentanil PET data acquired in a healthy elderly human subject was also performed. This newly developed MR-based partial volume correction algorithm permits the accurate determination of the true radioactivity concentration in specific structures that can be defined by MR by accounting for the influence of heterogeneity of GM radioactivity.

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Genetic variation of matrix metalloproteinase enzyme in HIV-associated neurocognitive disorder

Gene ◽

10.1016/j.gene.2019.02.057 ◽

2019 ◽

Vol 698 ◽

pp. 41-49 ◽

Cited By ~ 1

Author(s):

HariOm Singh ◽

Sumitra Nain ◽

Asha Krishnaraj ◽

Sonam Lata ◽

T.N. Dhole

Keyword(s):

Genetic Variation ◽

Matrix Metalloproteinase ◽

Neurocognitive Disorder ◽

Hiv Associated Neurocognitive Disorder

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Neuroendoscopic fenestration of glioependymal cysts to the ventricle: report of 3 cases

Journal of Neurosurgery ◽

10.3171/2018.7.jns172501 ◽

2019 ◽

Vol 131 (5) ◽

pp. 1615-1619

Author(s):

Anthony M. Alvarado ◽

Kyle A. Smith ◽

Roukoz B. Chamoun

Keyword(s):

Minimally Invasive ◽

Lateral Ventricle ◽

Mass Effect ◽

Ventricular System ◽

Open Resection ◽

Presenting Symptoms ◽

Glioependymal Cyst ◽

The Central Nervous System ◽

Surgical Treatments ◽

Endoscopic Fenestration

Glioependymal cysts are rare congenital lesions of the central nervous system. Reported surgical treatments of these lesions have varied and yielded mixed results, and the optimal surgical strategy is still controversial. The authors here report the clinical and surgical outcomes for three adult patients successfully treated with neuroendoscopic fenestration into the ventricular system. The patients had presented with symptomatic glioependymal cysts in the period from 2013 to 2016 at the authors’ institution. All underwent minimally invasive neuroendoscopic fenestration of the glioependymal cyst into the lateral ventricle via a stereotactically guided burr hole. Presenting clinical and radiological findings, operative courses, and postintervention outcomes were evaluated.All three patients initially presented with symptoms related to regional mass effect of the underlying glioependymal cyst, including headaches, visual disturbances, and hemiparesis. All patients were successfully treated with endoscopic fenestration of the cyst wall into the lateral ventricle, where the wall was thinnest. Postoperatively, all patients reported improvement in their presenting symptoms, and neuroimaging demonstrated decompression of the cyst. Clinical follow-up ranged from 4 months to 5 years without evidence of reexpansion of the cyst or shunt requirement.Compared to open resection and shunting of the cyst contents, minimally invasive endoscopic fenestration of a glioependymal cyst into the ventricular system is a safe and effective surgical option. This approach is practical, is less invasive than open resection, and appears to provide a long-term solution.

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Sleep Duration, Sleep Apnea, and Gray Matter Volume

Journal of Geriatric Psychiatry and Neurology ◽

10.1177/0891988720988918 ◽

2021 ◽

pp. 089198872098891

Author(s):

Regina Eun Young Kim ◽

Robert Douglas Abbott ◽

Soriul Kim ◽

Robert Joseph Thomas ◽

Chang-Ho Yun ◽

...

Keyword(s):

Sleep Apnea ◽

Sleep Duration ◽

Gray Matter ◽

Gray Matter Volume ◽

Brain Structures ◽

Brain Regions ◽

Population Based ◽

Older Individuals ◽

Bootstrap Sampling ◽

Matter Volume

This study aimed to evaluate the effect of sleep duration on brain structures in the presence versus absence of sleep apnea in middle-aged and older individuals. The study investigated a population-based sample of 2,560 individuals, aged 49-80 years. The presence of sleep apnea and self-reported sleep duration were examined in relation to gray matter volume (GMV) in total and lobar brain regions. We identified ranges of sleep duration associated with maximal GMV using quadratic regression and bootstrap sampling. A significant quadratic association between sleep duration and GMV was observed in total and lobar brain regions of men with sleep apnea. In the fully adjusted model, optimal sleep durations associated with peak GMV between brain regions ranged from 6.7 to 7.0 hours. Shorter and longer sleep durations were associated with lower GMV in total and 4 sub-regions of the brain in men with sleep apnea.

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Effects of a 12-week aerobic exercise programme on HIV-associated neurocognitive disorder in Nigeria: A protocol for randomized controlled trial (Preprint)

10.2196/preprints.29230 ◽

2021 ◽

Author(s):

Martins Nweke ◽

Nombeko Mshunqane ◽

Nalini Govender ◽

Aderonke Akineplu ◽

Adesola Oginniyi

Keyword(s):

Aerobic Exercise ◽

Repeated Measures ◽

Controlled Trial ◽

Exercise Programme ◽

Moderate Intensity ◽

Behavioural Intervention ◽

Neurocognitive Disorder ◽

Neurocognitive Performance ◽

Southeastern Nigeria ◽

Hiv Associated Neurocognitive Disorder

BACKGROUND The introduction of antiretroviral therapy (ART) has led to a drastic fall in the incidence of HIV-associated dementia. However, less severe but limiting forms of HIV-associated neurocognitive disorder (HAND) continues to be prevalent even with the use of ART. Aerobic exercise, a behavioural intervention may be a beneficial and effective complement to ART in the management of HAND. In HIV-negative individuals, aerobic exercise mitigates pathogenic changes similar to those of HAND. OBJECTIVE This protocol describes a randomized clinical trial designed to determine the effect of a 12-week aerobic exercise programme on HAND in Southeastern Nigeria. METHODS A minimum of seventy-six patients diagnosed with HAND will be randomized into aerobic exercise and control groups. Aerobic exercise will be carried out on a stationary bicycle ergometer at moderate intensity, three times a week for 12-weeks. Primary outcomes are neurocognitive performance, CD4-count and viral load. Evaluation of post-exercise neurocognitive performance will be undertaken using reliable neuropsychological tests relevant to PLWHIV, in line with Frascati criteria. Secondary outcomes such as quality of life, and activity limitation and social participation will be assessed using the WHOQOL-Bref, and the Oxford Participation and Activities questionnaire respectively. Data will be subjected to exploratory statistics to test for normality and homogeneity. The effect of the exercise programme on HAND will be analysed using two-way repeated-measures ANOVA, with Bonferroni’s correction. Within-group comparison will be undertaken using paired sampled t-test. RESULTS Enrollment began on 18th January 2021. Recruitment has been completed. The trial is ongoing and will be completed in July 2021 CONCLUSIONS The study will provide valuable information about the effect of aerobic exercise on HAND thus verifying the suitability of aerobic exercise as a complementary therapy for mitigating neurocognitive disorder among PLWHIV. Data from the study will be useful in pursuit of debate on the necessity of a sponsored rehabilitation arm in ART clinics. CLINICALTRIAL The study was registered with the PAN African Trial Registry (PACTR) on the 1stth September 2020. The registration ID is PACTR202009483415745.

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