Thinning of the cerebral cortex visualized in HIV/AIDS reflects CD4 ⁺ T lymphocyte decline

Abstract

HIV͞AIDS infection is the fourth leading cause of death worldwide, and one in every 100 adults aged 15-49 years is HIV-infected. Forty percent of AIDS patients suffer from neurological symptoms, but the selective profile of damage caused by HIV in the brain is not well understood. Here, we report 3D maps revealing how AIDS affects the human cerebral cortex, identifying the most vulnerable regions and where deficits link with cognitive decline and immunesystem suppression. With high-resolution brain MRI scans, we created composite maps of cortical gray-matter thickness in 26 AIDS patients and 14 healthy controls to establish the selective pattern of brain deficits in AIDS. In AIDS, primary sensory, motor, and premotor cortices were 15% thinner. Thinner frontopolar and language cortex correlated with immune system deterioration measured through blood levels of CD4 ؉ T lymphocytes. Prefrontal and parietal tissue loss correlated with cognitive͞motor deficits. T cell depletion and cognitive impairment are, therefore, associated with specific 3D brain-deficit patterns visualized with MRI. These quantitative MRI-based maps reveal that HIV selectively damages the cortex. They provide an approach to gauge the impact of AIDS on the living brain and show that the brain is still vulnerable to infection even when patients are receiving antiretroviral therapy.brain ͉ MRI ͉ disease ͉ T cell ͉ immunity

Abnormal MEG Oscillatory Activity during Visual Processing in the Prefrontal Cortices and Frontal Eye-Fields of the Aging HIV Brain

“…Thus, ERS activity detected in the right DLPFC and FEF of controls potentially reflects neural activity serving low-level attentional control (i.e., right DLPFC) of processes that maintain or control eye-position in the visual field. Finally, Thompson et al showed that the degree of cognitive impairment in non-demented HIV-infected patients was strongly correlated with the thickness of the DLPFC [30].…”

Antiretroviral Adherence and the Nature of HIV-Associated Verbal Memory Impairment

“…9,10 With the advent of highly-active antiretroviral therapy (HAART) in the mid-to-late ’90s, 11 the neurocognitive sequelae of HIV have lessened in severity 12–14 and become somewhat more variable in expression, 15 although mild neurocognitive deficits persist. 13,16–19 Although the current cognitive impairment-profile of HIV is relatively mild for many individuals, it is nonetheless predictive of significant decline in daily functioning.…”

Relationship between psychiatric status and frontal–subcortical systems in HIV-infected individuals

“…However, individuals continue to experience significant CNS disturbances. Recent evidence provided by Thompson et al (2005) demonstrated the impressive extent to which HIV exerts deleterious effects on the CNS, even during successful HAART treatment. The authors reported several brain regions to be reduced as much as 15% in volume.…”