Yadav Santosh K, Gupta Rakesh K, Garg Ravindra K, Venkatesh Vimala, Gupta Pradeep K, Singh Alok K, Hashem Sheema, Al-Sulaiti Asma, Kaura Deepak, Wang Ena, Marincola Francesco M, Haris Mohammad
Division of Translational Medicine, Research Branch, Sidra Medical and Research Center, Doha, Qatar.
Department of Radiology and Imaging, Fortis Memorial Research Institute, Gurgaon, Delhi, India.
Neuroimage Clin. 2017 Feb 2;14:316-322. doi: 10.1016/j.nicl.2017.01.032. eCollection 2017.
Pediatric HIV patients often suffer with neurodevelopmental delay and subsequently cognitive impairment. While tissue injury in cortical and subcortical regions in the brain of adult HIV patients has been well reported there is sparse knowledge about these changes in perinatally HIV infected pediatric patients. We analyzed cortical thickness, subcortical volume, structural connectivity, and neurocognitive functions in pediatric HIV patients and compared with those of pediatric healthy controls. With informed consent, 34 perinatally infected pediatric HIV patients and 32 age and gender matched pediatric healthy controls underwent neurocognitive assessment and brain magnetic resonance imaging (MRI) on a 3 T clinical scanner. Altered cortical thickness, subcortical volumes, and abnormal neuropsychological test scores were observed in pediatric HIV patients. The structural network connectivity analysis depicted lower connection strengths, lower clustering coefficients, and higher path length in pediatric HIV patients than healthy controls. The network betweenness and network hubs in cortico-limbic regions were distorted in pediatric HIV patients. The findings suggest that altered cortical and subcortical structures and regional brain connectivity in pediatric HIV patients may contribute to deficits in their neurocognitive functions. Further, longitudinal studies are required for better understanding of the effect of HIV pathogenesis on brain structural changes throughout the brain development process under standard ART treatment.
儿科艾滋病病毒（HIV）患者常伴有神经发育迟缓，进而出现认知障碍。虽然成人HIV患者大脑皮质和皮质下区域的组织损伤已有大量报道，但对于围产期感染HIV的儿科患者的这些变化却知之甚少。我们分析了儿科HIV患者的皮质厚度、皮质下体积、结构连通性和神经认知功能，并与儿科健康对照者进行了比较。在获得知情同意后，34名围产期感染的儿科HIV患者和32名年龄及性别匹配的儿科健康对照者在3T临床扫描仪上接受了神经认知评估和脑磁共振成像（MRI）检查。在儿科HIV患者中观察到皮质厚度改变、皮质下体积异常以及神经心理测试分数异常。结构网络连通性分析显示，与健康对照者相比，儿科HIV患者的连接强度较低、聚类系数较低且路径长度较长。儿科HIV患者皮质-边缘区域的网络中介中心性和网络枢纽发生了扭曲。这些发现表明，儿科HIV患者皮质和皮质下结构以及区域脑连通性的改变可能导致其神经认知功能缺陷。此外，需要进行纵向研究，以更好地了解在标准抗逆转录病毒治疗（ART）下，HIV发病机制对整个大脑发育过程中脑结构变化的影响。
