Accelerated and Premature Aging Characterizing Regional Cortical Volume Loss in Human Immunodeficiency Virus Infection: Contributions From Alcohol, Substance Use, and Hepatitis C Coinfection

Abstract

HIV infection itself may confer a heightened risk of accelerated brain aging, potentially exacerbated by HCV coinfection and substance dependency. Confirmation would require a prospective study with a preinfection baseline.

Sensitivity of ventrolateral posterior thalamic nucleus to back pain in alcoholism and CD4 nadir in HIV

“…While some brain volumetric studies reported significant contributions of such factors to brain integrity (e.g., Garcia‐Garcia et al, ; Holz, Laucht, & Meyer‐Lindenberg, ; Kesler, Adams, Blasey, & Bigler, ), the current study did not find relations between variables differing among the three groups listed in Table and VLp volume. Similarly, extensive analyses performed in large, longitudinal data sets of AUD (Sullivan et al, ) and HIV (Pfefferbaum et al, ) groups relative to healthy controls did not find significant contributions of such factors to global brain integrity.…”

“…By contrast, in HIV and alcoholism comorbidity, poor performance on tests of explicit (immediate and delayed) and implicit (visuomotor procedural) memory are associated with smaller thalamic volumes (Fama et al, ). Indeed, the thalamus has often been highlighted as a specific target of HIV [volume deficits: (Heaps et al, ; Janssen et al, ; Pfefferbaum et al, ; Pfefferbaum et al, ; Pfefferbaum et al, ); reduced glucose metabolism: (Hammoud et al, )], possibly related to CD4 count (Heaps et al, ).…”

“…The prevalence of HAD on the severe end of the spectrum has declined with antiretroviral therapy (ART) (Baker et al, 2015;Gates & Cysique, 2016), but mild to moderate cognitive deficits in HIV remain an issue (Manji, Jager, & Winston, 2013;Underwood et al, 2017;Vivithanaporn et al, 2010). Accelerated loss of brain tissue, specifically, in frontal and sensorimotor neocortices, thalamus, and hippocampus-related to disease duration and CD4 nadir (Cohen et al, 2010;Pfefferbaum et al, 2014)-may represent a risk factor for premature cognitive compromise if not dementia (Ances, Ortega, Vaida, Heaps, & Paul, 2012;Pfefferbaum et al, 2014;Pfefferbaum et al, 2018;Sanford et al, 2018). In seeking a neural substrate for HAD, an early imaging study in HIV-infected individuals found no relation between neuropsychological test performance and hippocampal volume (Kieburtz et al, 1996); a later stereological study found no statistically significant differences in hippocampal neuronal number between nine HIV/AIDS patients and 10 controls (Korbo & West, 2000).…”

Accelerated aging and motor control deficits are related to regional deformation of central cerebellar white matter in alcohol use disorder

“…Longitudinal studies confirm cross‐sectional reports of regional volume loss that must be taken into account in assessing the effects of pathology in aging adults. When aging is compounded with alcohol use disorder (AUD), controlled studies have identified age‐alcoholism interactions, where age‐related cortical gray matter and white matter volume declines accelerate in alcoholic participants compared with unaffected controls . The age‐alcoholism interaction may also be relevant to motor performance, which declines decidedly with aging (eg,), may accelerate in older alcoholics, and is likely to have a cerebellar substrate …”

“…Accordingly, using a matched subset of T1‐weighted MRIs (N = 263) from reports focused on the cerebral structures of alcoholic and control groups, the cerebellar corpus medullare was subjected to two quantification approaches. The first identified the white matter boundaries of the cerebellum, measuring the full volume of the corpus medullare.…”