Altered structural brain changes and neurocognitive performance in pediatric HIV

Abstract

Pediatric HIV patients often suffer with neurodevelopmental delay and subsequently cognitive impairment. While tissue injury in cortical and subcortical regions in the brain of adult HIV patients has been well reported there is sparse knowledge about these changes in perinatally HIV infected pediatric patients. We analyzed cortical thickness, subcortical volume, structural connectivity, and neurocognitive functions in pediatric HIV patients and compared with those of pediatric healthy controls. With informed consent, 34 perinatally infected pediatric HIV patients and 32 age and gender matched pediatric healthy controls underwent neurocognitive assessment and brain magnetic resonance imaging (MRI) on a 3 T clinical scanner. Altered cortical thickness, subcortical volumes, and abnormal neuropsychological test scores were observed in pediatric HIV patients. The structural network connectivity analysis depicted lower connection strengths, lower clustering coefficients, and higher path length in pediatric HIV patients than healthy controls. The network betweenness and network hubs in cortico-limbic regions were distorted in pediatric HIV patients. The findings suggest that altered cortical and subcortical structures and regional brain connectivity in pediatric HIV patients may contribute to deficits in their neurocognitive functions. Further, longitudinal studies are required for better understanding of the effect of HIV pathogenesis on brain structural changes throughout the brain development process under standard ART treatment.

Neurodevelopment in Young Children Born to HIV-Infected Mothers: A Meta-analysis

“…HIV+ children have been found to have differences in their brain structure and function, including alterations in cortical thickness, subcortical volumes, regional connectivity, and neurometabolites. 38,39 These changes have been associated with lower cognitive functioning. 38,39 Although HIV exposure having negative impacts on HIV+ and HEU children is supported in the results of our study, the assessments used throughout the…”

Clinico-Immunological Status and Neurocognitive Function of Perinatally Acquired HIV-Positive Children on cART: A Cross-Sectional Correlational Study in South Africa

“…Some research reported that children with perinatally acquired HIV (PHIV) present more frequently than adults with central nervous system opportunistic infection resulting from HIV immunosuppression due to the vulnerability of the child's developing brain (9). Neurological manifestations in perinatally HIV infected children include cortical and subcortical structural changes (10) that is associated with neurocognitive impairments in PHIV children and is argued to contribute to the overall burden of neurodevelopmental disabilities that persist throughout childhood, adolescence, and beyond (11). Domain-specific neurocognitive impairments have been found in children with HIV even on cART (12).…”

Aberrant brain structural large‐scale connectome in Crohn’s disease

“…20 Accumulating neuroimaging evidence suggests structural large-scale connectivity alterations not only in primary brain disorders such as Alzheimer's disease, 21,22 epilepsy, 23,24 or schizophrenia, 25,26 but also in diseases with a rather secondary influence on the central nervous system, for example, breast cancer, 27 type 1 diabetes, 28 or HIV infection. 29 Whether these changes in network architecture and effectiveness reflect the general mental burden of illness or are associated with disease-specific aspects has not been well investigated so far.…”