Dissociable Contributions of Precuneus and Cerebellum to Subjective and Objective Neuropathy in HIV

Zahr, Natalie M.; Pohl, Kilian M.; Pfefferbaum, Adolf; Sullivan, Edith V.

doi:10.1007/s11481-019-09837-2

Cited by 10 publications

(7 citation statements)

References 89 publications

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“…The precuneus is thought to be uniquely affected in HIV, previous studies have shown severity of depression, which potentially affects sleep, is related to precuneus volume. 34 Our findings are consistent with previous literature that found that there is increased connectivity between the precuneus and DMN is correlated with rest. 32 This relationship is strengthened in the HIV+ group, potentially reflecting the need for increased FC between the precuneus and posterior DMN to maintain sleep quality after HIV infection.…”

Section: Discussionsupporting

confidence: 93%

Functional MRI Correlates of Sleep Quality in HIV

Venkataraman

Zhuang

Marsella

et al. 2021

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Objective: To examine resting-state functional MRI (rs-fMRI) networks related to sleep in the context of HIV infection. Methods: rs-fMRI data were collected in 40 HIV-infected (HIV+) individuals at baseline (treatment-naive), 12 week (post-treatment) and one year timepoints. A group of 50 agematched HIV-negative (HIV-) individuals were also imaged at baseline and one year timepoints. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was administered at all timepoints. Using group independent component analysis (ICA), maps of functional networks were generated from fMRI data; from these, sleep-related networks were selected. A generalized linear model (GLM) was used to analyze if these networks were significantly associated with the PSQI score, and if this relationship was influenced by HIV status/ treatment or timepoint. Results: HIV+ individuals had significantly lower PSQI score after treatment (p=0.022). Networks extracted from group ICA analysis included the anterior and posterior default mode network (DMN), central executive network (CEN), bilateral frontoparietal networks (FPNs), and the anterior cingulate cortex salience network (ACC SN). We found the posterior DMN, right FPN, and ACC SN GLMs showed significantly higher goodness-of-fit after incorporating PSQI data (p = 0.0204, 0.044, 0.044, respectively). Furthermore, the correlation between ACC SN and posterior DMN connectivity was significantly decreased in the HIV+ cohort. Conclusion:Functional networks such as the DMN, FPN, CEN, and ACC SN are altered in poor sleep, as measured by the PSQI score. Furthermore, the relationship between these networks and PSQI is different in the HIV+ and HIV-populations.

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Section: Discussionsupporting

confidence: 93%

Functional MRI Correlates of Sleep Quality in HIV

Venkataraman

Zhuang

Marsella

et al. 2021

NSS

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“…Brain regions that correlated with perception of vibration included frontal precentral, frontal medial, and temporal superior cortices; the cingulate mid-posterior cortex, implicated in pain perception, and previously reported as relevant to both diabetic and HIV-related neuropathies (Sugimine et al, 2016, Hsieh et al, 2015, Keltner et al, 2017); the thalamus, relevant to perception of pain (Geha and Apkarian, 2005, Peyron et al, 2000), and sometimes directly implicated in neuropathy (Selvarajah et al, 2011); and the pons, which has been reported in case studies of rare neuropathies (cf., Weinmann, 1967, Rossi et al., 1986). Consistent with posterior cingulate involvement, our recent study in HIV found relations between subjective symptoms of neuropathy and smaller parietal precuneus volume (Zahr et al, 2019); both regions support introspection and self-awareness (Kjaer et al, 2002, Jacob and Kostev, 2016).…”

Section: Discussionsupporting

confidence: 70%

“…Compromise in activities of daily living has previously been noted in patients living with diabetic (Le Floch et al, 2014) and chemotherapy-induced (Kanda et al, 2017) neuropathies. Our study of peripheral neuropathy in HIV found a correlation between symptoms of neuropathy and performance on ataxia with eyes closed (Zahr et al, 2019), (but see, Berner et al, 2017). These findings suggest that subjective symptoms of neuropathy in AUD contribute to impaired physical functioning, including deficits in balance and postural stability, as observed in diabetic neuropathy (cf., Riandini et al, 2018).…”

Section: Discussionmentioning

confidence: 78%

“…In the current study, individuals with AUD were more likely than controls to report symptoms of neuropathy; these correlated with a greater frequency of impairment in an “objective” measure of neuropathy, perception of vibration. This relationship in AUD was not identified in HIV, where subjective symptoms and “objective” signs of neuropathy were dissociable (Zahr et al, 2019). This finding, along with impairment in only perception of vibration in AUD, whereas individuals infected with HIV showed deficits in deep tendon ankle reflexes, position sense, and 2-point discrimination, suggests differing pathogenic mechanisms for neuropathy in the 2 disorders.…”

Section: Discussionmentioning

confidence: 99%

“…Recent evidence supports Central Nervous System (CNS) involvement in peripheral neuropathy (e.g., Tesfaye et al, 2016, Zahr et al, 2019, Keltner et al, 2017, Pfefferbaum et al, 2009). Diabetes with neuropathy relative to diabetes without neuropathy is associated with compromise in volume of cingulate cortex (Boland et al, 2014), implicated in the affective processing of pain (Coppieters et al, 2017, Buckalew et al., 2008, Absinta et al, 2012).…”

Section: Introductionmentioning

confidence: 97%

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Central Nervous System Correlates of “Objective” Neuropathy in Alcohol Use Disorder

Zahr

Pohl

Pfefferbaum

et al. 2019

Alcoholism Clin & Exp Res

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Background.-Among the neurological consequences of alcoholism is peripheral neuropathy. Relative to HIV or diabetes-related neuropathies, neuropathy associated with Alcohol Use Disorders (AUD) is understudied. In both the diabetes and HIV literature, emerging evidence supports a CNS component to peripheral neuropathy. Methods.-In seeking a central substrate for AUD-related neuropathy, the current study was conducted in 154 individuals with AUD (43 women, ages 21-74) and 99 healthy controls (41 women, ages 21-77) and explored subjective symptoms (self-report) and objective signs (perception of vibration, deep tendon ankle reflex, position sense, 2-point discrimination) of neuropathy separately. In addition to regional brain volumes, risk factors for AUD-related neuropathy, including age, sex, total lifetime ethanol consumed, nutritional indices (i.e., thiamine, folate), and measures of liver integrity (i.e., γ-glutamyl-transferase) were evaluated. Results.-The AUD group described more subjective symptoms of neuropathy and were more frequently impaired on bilateral perception of vibration. From 5 correlates, the number of AUD-related seizures was most significantly associated with subjective symptoms of neuropathy. There were 15 correlates of impaired perception of vibration among the AUD participants: of these, age and volume of frontal precentral cortex were the most robust predictors. Conclusions.-This study supports CNS involvement in objective signs of neuropathy in AUD.

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