Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, Rhode Island 02912, USA.
J Int Neuropsychol Soc. 2012 Jul;18(4):657-68. doi: 10.1017/S1355617712000434. Epub 2012 May 24.
Both HIV infection and high levels of early life stress (ELS) have been related to abnormalities in frontal-subcortical structures, yet the combined effects of HIV and ELS on brain structure and function have not been previously investigated. In this study we assessed 49 non-demented HIV-seropositive (HIV+) and 47 age-matched HIV-seronegative healthy control (HC) adults. Levels of ELS exposure were quantified and used to define four HIV-ELS groups: HC Low-ELS (N = 20); HC High-ELS (N = 27); HIV+ Low-ELS (N = 24); HIV+ High-ELS (N = 25). An automated segmentation tool measured volumes of brain structures known to show HIV-related or ELS-related effects; a brief neurocognitive battery was administered. A significant HIV-ELS interaction was observed for amygdala volumes, which was driven by enlargements in HIV+ High-ELS participants. The HIV+ High-ELS group also demonstrated significant reductions in psychomotor/processing speed compared with HC Low-ELS. Regression analyses in the HIV+ group revealed that amygdala enlargements were associated with higher ELS, lower nadir CD4 counts, and reduced psychomotor/processing speed. Our results suggest that HIV infection and high ELS interact to increase amygdala volume, which is associated with neurocognitive dysfunction in HIV+ patients. These findings highlight the lasting neuropathological influence of ELS and suggest that high ELS may be a significant risk factor for neurocognitive impairment in HIV-infected individuals.
HIV 感染和早期生活应激（ELS）水平升高均与额皮质下结构异常有关，但 HIV 和 ELS 对大脑结构和功能的综合影响尚未被研究过。在这项研究中，我们评估了 49 名非痴呆的 HIV 阳性（HIV+）和 47 名年龄匹配的 HIV 阴性健康对照（HC）成年人。ELS 暴露水平被量化，并用于定义四个 HIV-ELS 组：HC 低 ELS（N = 20）；HC 高 ELS（N = 27）；HIV+低 ELS（N = 24）；HIV+高 ELS（N = 25）。一种自动分割工具测量了已知与 HIV 相关或 ELS 相关的大脑结构的体积；进行了简短的神经认知测试。观察到杏仁核体积存在显著的 HIV-ELS 相互作用，这是由 HIV+高 ELS 参与者的增大驱动的。与 HC 低 ELS 相比，HIV+高 ELS 组的精神运动/处理速度也显著降低。在 HIV+组的回归分析中，发现杏仁核增大与较高的 ELS、较低的 CD4 计数和精神运动/处理速度降低有关。我们的结果表明，HIV 感染和高 ELS 相互作用会增加杏仁核体积，这与 HIV+患者的神经认知功能障碍有关。这些发现强调了 ELS 的持久神经病理学影响，并表明高 ELS 可能是 HIV 感染个体神经认知障碍的重要危险因素。
