Facial emotion recognition impairments are associated with brain volume abnormalities in individuals with HIV

Abstract

Impaired facial emotion recognition abilities in HIV+ patients are well documented, but little is known about the neural etiology of these difficulties. We examined the relation of facial emotion recognition abilities to regional brain volumes in 44 HIV-positive (HIV+) and 44 HIV-negative control (HC) adults. Volumes of structures implicated in HIV− associated neuropathology and emotion recognition were measured on MRI using an automated segmentation tool. Relative to HC, HIV+ patients demonstrated emotion recognition impairments for fearful expressions, reduced anterior cingulate cortex (ACC) volumes, and increased amygdala volumes. In the HIV+ group, fear recognition impairments correlated significantly with ACC, but not amygdala volumes. ACC reductions were also associated with lower nadir CD4 levels (i.e., greater HIV-disease severity). These findings extend our understanding of the neurobiological substrates underlying an essential social function, facial emotion recognition, in HIV+ individuals and implicate HIV-related ACC atrophy in the impairment of these abilities.

High early life stress and aberrant amygdala activity: risk factors for elevated neuropsychiatric symptoms in HIV+ adults

“…HIV+ adults have been reported to exhibit reduced facial emotion recognition abilities relative to HC adults (Baldonero et al 2013; Clark et al 2010a; Clark et al 2015; Heilman et al 2013; Lane et al 2012). Hence, we assessed the effects of facial emotion recognition abilities on amygdala responses in our sample.…”

“…Hence, we assessed the effects of facial emotion recognition abilities on amygdala responses in our sample. Facial emotion recognition abilities were assessed utilizing methods employed in prior studies (Circelli et al 2013; Clark et al 2010a; Clark et al 2008, 2010b; Clark et al 2015). Briefly, participants were presented with 70 Ekman and Friesen photographs (Ekman & Friesen, 1976) on a 15″ laptop computer.…”

“…Results from neuroimaging studies point to both functional and structural abnormalities, such as abnormalities in serotonergic transmission (Hammoud et al 2010), cortical and subcortical white matter (Smith et al 2008; Stubbe-Drager et al 2012), and grey matter volumes (Clark et al 2015; Paul et al 2005). In addition, some studies have observed significant associations between volumetric abnormalities in affective brain regions and markers of historical HIV-disease severity (e.g., nadir CD4 levels, the lowest ever T-cell count on record) (Clark et al 2012; Clark et al 2015). Taken together, these studies suggest that neuropsychiatric disorders in HIV+ adults may reflect a direct manifestation of the disease and its impact on neural systems involved in affect regulation.…”

“…For example, abnormal levels of amygdala activation are commonly observed in adults with depression or anxiety (Damsa et al 2009; Groenewold et al 2013; Holzschneider and Mulert 2011), and there is evidence that amygdala responses normalize to some degree upon remission of these conditions (Arnone et al 2012; Sheline et al 2001). Overall, there has been minimal investigation of the amygdala in HIV+ cohorts, with most studies focusing on morphologic abnormalities (Ances et al 2012; Behrman-Lay et al 2015; Clark et al 2012; Clark et al 2015; Ortega et al 2013; Spies et al 2015). Hence, it remains unclear whether abnormalities in amygdala activation occur in HIV+ samples, and whether these abnormalities contribute to greater levels of neuropsychiatric symptoms in this patient population.…”

Brain Structural Changes following HIV Infection: Meta-Analysis

“…3 Nevertheless, peripheral viral suppression has not always prevented progressive cognitive and motor impairment, and the origin of these behavioral effects during treatment is still debated, with several ART-era studies demonstrating structural associations with cognitive deficits during treatment. [4][5][6] Early brain structural studies in HIV-infected participants found decreases in brain parenchyma, 7 white matter, 8 and basal ganglia 7,9 volume. During the ART era, observations of cortical, 10 subcortical, gray matter, 9 and white matter 10 atrophy have continued, with decreases in cortical gray matter and brain parenchymal volume observed even in the first year of HIV infection.…”