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HIV 感染合并帕金森病老年人的脑信号振荡改变。

Alterations of Brain Signal Oscillations in Older Individuals with HIV Infection and Parkinson's Disease.

机构信息

Neuroscience Program, Biosciences Division, Center for Health Sciences, SRI International, Menlo Park, CA, USA.

Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, 94305, USA.

出版信息

J Neuroimmune Pharmacol. 2021 Jun;16(2):289-305. doi: 10.1007/s11481-020-09914-x. Epub 2020 Apr 14.

Abstract

More than 30 years after the human immunodeficiency virus (HIV) epidemic, HIV patients are now aging due to the advances of antiretroviral therapy. With immunosenescence and the susceptibility of dopamine-rich basal ganglia regions to HIV-related injury, older HIV patients may show neurofunctional deficits similar to patients with Parkinson's disease (PD). We examined the amplitudes of low frequency fluctuations (ALFF) across different frequency bands of the BOLD signal in 30 older HIV-infected individuals, 33 older healthy controls, and 36 PD patients. Participants underwent resting-state fMRI, neuropsychological testing, and a clinical motor exam. HIV patients mainly showed abnormalities in cortical ALFF with reduced prefrontal amplitudes and enhanced sensorimotor and inferior temporal amplitudes. Frontal hypoactivation was overlapping for HIV and PD groups and different from controls. PD patients further exhibited reduced pallidum amplitudes compared to the other groups. In the HIV group, lower pallidum amplitudes were associated with lower CD4 nadir and CD4 T cell counts. Abnormalities in ALFF dynamics were largely associated with cognitive and motor functioning in HIV and PD groups. The disruption of neurofunctional frequency dynamics in subcortical-cortical circuits could contribute to the development of cognitive and motor dysfunction and serve as a biomarker for monitoring disease progression with immunosenescence. Graphical Abstract.

摘要

人类免疫缺陷病毒 (HIV) 流行 30 多年后,由于抗逆转录病毒疗法的进步,HIV 患者现在正在衰老。随着免疫衰老和富含多巴胺的基底节区域对 HIV 相关损伤的易感性,老年 HIV 患者可能表现出与帕金森病 (PD) 患者相似的神经功能缺陷。我们检查了 30 名老年 HIV 感染个体、33 名老年健康对照者和 36 名 PD 患者的不同频率带的 BOLD 信号的低频波动 (ALFF) 振幅。参与者接受了静息状态 fMRI、神经心理学测试和临床运动检查。HIV 患者主要表现为皮质 ALFF 异常,前额叶振幅降低,感觉运动和下颞叶振幅增强。与对照组相比,HIV 和 PD 组的额叶激活不足。与其他组相比,PD 患者的苍白球振幅进一步降低。在 HIV 组中,较低的苍白球振幅与较低的 CD4 最低点和 CD4 T 细胞计数相关。ALFF 动力学的异常主要与 HIV 和 PD 组的认知和运动功能相关。皮质下-皮质回路中神经功能频率动态的破坏可能导致认知和运动功能障碍的发展,并可作为监测免疫衰老导致疾病进展的生物标志物。

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