Altered Brain Functional Connectome Hierarchical Organization in HIV Patients

Abstract

Background Research from the past has shown that the human immunodeficiency virus (HIV) can quickly enter the central nervous system after seroconversion, and that roughly 50% of HIV patients may experience neurological problems. Application of combined antiretroviral therapy (cART) can systemically inhibit viral replication, partially restoring immune functions, but it is unable to entirely eradicate viral proteins in the brain. The influence of HIV on brain functioning and behavioral symptoms is still completely unknown, despite extensive research into the functional and anatomical abnormalities in the brainof HIV patients. Methods We gathered resting-state functional MRI data from 77 individuals (42 HIV patients (with behavioral data) and 35 healthy controls) from Beijing YouAn Hospital, Capital Medical University. We identified a constrained primary-to-transmodal gradient and an extended sensorimotor-to-visual gradient using functional connectome gradient analysis. Results According to group comparison analysis, the HIV patients had higher sensorimotor-to-visual and sensorimotor-to-visual spatial variation in the posterior cingulate cortex and a lower gradient score of primary-to-transmodal in the middle frontal gyrus. These two abnormal functional gradients of HIV patients were related to individual decreased abstract/executive processing abilities (planning, reasoning, set switching, flexible thinking, and updating, etc.) and clinical symptoms (CD4), as well as topological efficiency of brain functional network. Conclusion When taken as a whole, our findings describe the failure of the brain's functional hierarchical architecture in HIV patients, offering a novel perspective on the neurological mechanisms driving the virus.