Diffusion tensor magnetic resonance imaging of white matter integrity in patients with HIV-associated neurocognitive disorders

Zhao, Tingting; Fang, H; Fu, Danhui; Su, Danke; Zhang, Wei

doi:10.21037/atm-20-6342

Cited by 6 publications

(6 citation statements)

References 37 publications

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“…The virus in the cerebrospinal fluid could penetrate the cerebrospinal fluid brain barrier and directly or indirectly cause damage around the lateral ventricles, which is a possible explanation. White matter damage and disconnection from the cortex may occur in PLWH with milder cognitive impairment, and the pathological changes are likely to be the axonal chronic injury ( Li et al, 2018 ; Zhao et al, 2020 ) and may cause the atrophy of the gray matter, and then the bilateral lateral ventricles expand. Furthermore, in this research, the lower CD4 + /CD8 + ratio was associated with larger left lateral ventricle and ventricular system.…”

Section: Discussionmentioning

confidence: 99%

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

Shi

Wang

et al. 2021

Front. Neurosci.

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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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Section: Discussionmentioning

confidence: 99%

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

Shi

Wang

et al. 2021

Front. Neurosci.

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“…Based on the statistical information in Table 2 , we grouped three studies ( 35 , 41 , 44 ) into older subgroups because their participants were older in several studies. We grouped the two studies ( 40 , 55 ) into the same subgroup because they were the only follow-up studies in the study. Since these three studies ( 39 , 43 , 57 ) were fully tested on the NP and cognitive scales, we assigned them to the same subgroup.…”

Section: Resultsmentioning

confidence: 99%

Application of Diffusion Tensor Imaging (DTI) in the Diagnosis of HIV-Associated Neurocognitive Disorder (HAND): A Meta-Analysis and a System Review

Yang

et al. 2022

Front. Neurol.

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BackgroundThe patients with HIV-associated neurocognitive disorder (HAND) are often accompanied by white matter structure damage. Diffusion tensor imaging (DTI) is an important tool to detect white matter structural damage. However, the changes in DTI values reported in many studies are diverse in different white matter fiber tracts and brain regions.PurposeOur research is dedicated to evaluating the consistency and difference of the correlation between HAND and DTI measures in different studies. Additionally, the value of DTI in HAND evaluation is used to obtain consensus and independent conclusions between studies.MethodsWe searched PubMed and Web of Science to collect relevant studies using DTI for the diagnosis of HAND. After screening and evaluating the search results, meta-analysis is used for quantitative research on data. Articles that cannot collect data but meet the research relevance will be subjected to a system review.ResultsThe meta-analysis shows that the HAND group has lower fractional anisotropy (standardized mean difference = −0.57 p < 0.0001) and higher mean diffusivity (standardized mean difference = 0.04 p < 0.0001) than the healthy control group in corpus callosum. In other white matter fibers, we found similar changes in fractional anisotropy (standardized mean difference = −1.18 p < 0.0001) and mean diffusivity (standardized mean difference = 0.69 p < 0.0001). However, the heterogeneity (represented by I2) between the studies is high (in corpus callosum 94, 88%, in other matter fibers 95, 81%). After subgroup analysis, the heterogeneity is obtained as 19.5, 40.7% (FA, MD in corpus callosum) and 0, 0% (FA, MD among other white matter fibers).ConclusionThe changes in white matter fibers in patients with HAND are statistically significant at the observation level of DTI compared with healthy people. The differences between the studies are mainly derived from demographics, start and maintenance time of antiretroviral therapy, differences in nadir CD4+T cells, and the use of different neurocognitive function scales. As an effective method to detect the changes in white matter fibers, DTI is of great significance for the diagnosis of HAND, but there are still some shortcomings. In the absence of neurocognitive function scales, independent diagnosis remains difficult.Systematic Review Registration:https://inplasy.com/inplasy-2021-10-0079/.

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“…Specifically, using diffusion MRI data obtained from 30 adults with and 31 without HIV disease, we examined mean FA within the corpus callosum, forceps minor, and right uncinate fasciculus, regions commonly known to be affected by HIV disease 1,16,17 . Although the corpus callosum is the most reported region when examining WM differences in PWH, 18 multiple studies have found differences across multiple projection and association fiber tracts including the forceps minor and right uncinate fasciculus 19–21 . These regions were also selected because they differ in size (specifically, the corpus callosum is a large WM tract, the forceps minor is a medium size tract, and the right uncinate fasciculus is a small WM tract), and therefore might benefit differently from local and nonlocal PCA denoising approaches.…”

Section: Introductionmentioning

confidence: 99%

“…1,16,17 Although the corpus callosum is the most reported region when examining WM differences in PWH, 18 multiple studies have found differences across multiple projection and association fiber tracts including the forceps minor and right uncinate fasciculus. [19][20][21] These regions were also selected because they differ in size (specifically, the corpus callosum is a large WM tract, the forceps minor is a medium size tract, and the right uncinate fasciculus is a small WM tract), and therefore might benefit differently from local and nonlocal PCA denoising approaches. Specifically, larger WM tracts are expected to directly benefit from local PCA denoising, whereas smaller WM tracts that are susceptible to partial volume effect might benefit more from nonlocal PCA denoising.…”

Section: Introductionmentioning

confidence: 99%

Principal component analysis denoising improves sensitivity of MR diffusion to detect white matter injury in neuroHIV

Bell

Meade

Gadde

et al. 2022

Journal of Neuroimaging

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Background and Purpose: Diffusion-weighted imaging is able to capture important information about cerebral white matter (WM) structure. However, diffusion data can suffer from MRI and biological noise that degrades the quality of the images and makes finding important features difficult. We investigated how effectively local and nonlocal denoising increased the sensitivity to detect differences in cerebral WM in neuroHIV. Methods:We utilized principal component analysis (PCA) denoising to detect WM differences using fractional anisotropy. Local and nonlocal PCA denoising paradigms were implemented that varied in search area and number of components. We examined different-sized WM tracts that consistently show differences between people living with Human Immunodeficiency Virus (HIV) (PWH) and HIV-negative individuals (corpus callosum, forceps minor, and right uncinate fasciculus), and size-matched tracts not typically associated with HIV-related differences (spinothalamic, right medial lemniscus, and left occipitopontine). We first conducted a full sample comparison of WM differences between groups, and then randomly reduced the sample to the point where we still found differences in WM. Results:Nonlocal PCA denoising allowed us to detect differences after a sample reduction of 35% in the forceps minor, 17% in the right uncinate fasciculus, and 6% in the corpus callosum.Conclusions: PCA denoising had a beneficial effect on detecting significant differences in PWH after sample size reduction. The smaller forceps minor tract and right uncinate fasciculus showed greater sensitivity to PCA denoising than the larger corpus callosum.These results show the importance of identifying the most effective PCA denoising strategy when investigating WM in PWH.

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Diffusion tensor magnetic resonance imaging of white matter integrity in patients with HIV-associated neurocognitive disorders

Cited by 6 publications

References 37 publications

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

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

Application of Diffusion Tensor Imaging (DTI) in the Diagnosis of HIV-Associated Neurocognitive Disorder (HAND): A Meta-Analysis and a System Review

Principal component analysis denoising improves sensitivity of MR diffusion to detect white matter injury in neuroHIV

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