Minosse Silvia, Picchi Eliseo, Giuliano Francesca Di, Lanzafame Simona, Manenti Guglielmo, Pistolese Chiara Adriana, Sarmati Loredana, Teti Elisabetta, Andreoni Massimo, Floris Roberto, Guerrisi Maria, Garaci Francesco, Toschi Nicola
Annu Int Conf IEEE Eng Med Biol Soc. 2020 Jul;2020:1726-1729. doi: 10.1109/EMBC44109.2020.9176449.
In 2019, approximately 38 million people were living with human immunodeficiency virus (HIV). Combined antiretroviral therapy (cART) has determined a change in the course of HIV infection, transforming it into a chronic condition which results in cumulative exposure to antiretroviral drugs, inflammatory effects and aging. Relatedly, at least one quarter of HIV-infected patients suffer from cognitive, motor and behavioral disorder, globally known as HIV-associated neurocognitive disorders (HAND). In this context, objective, neuroimaging-based biomarkers are therefore highly desirable in order to detect, quantify and monitor HAND in all disease stages. In this study, we employed functional MRI in conjunction with graph-theoretical analysis as well as a newly developed functional brain network disruption index to assess a putative functional reorganization in HIV positive patients. We found that brain function of HIV patients is deeply reorganized as compared to normal controls. Interestingly, the regions in which we found reorganized hubs are integrated into neuronal networks involved in working memory, motor and executive functions often altered in patients with HAND. Overall, our study demonstrates that rs-fMRI combined with advanced graph theoretical analysis and disruption indices is able to detect early, subtle functional changes of brain networks in HIV patients before structural changes become evident.
2019年，约有3800万人感染了人类免疫缺陷病毒（HIV）。联合抗逆转录病毒疗法（cART）改变了HIV感染的进程，将其转变为一种慢性病，导致患者长期暴露于抗逆转录病毒药物之下，并产生炎症反应和衰老。与此相关的是，全球至少四分之一的HIV感染患者患有认知、运动和行为障碍，即众所周知的HIV相关神经认知障碍（HAND）。因此，在这种情况下，非常需要基于神经影像学的客观生物标志物，以便在所有疾病阶段检测、量化和监测HAND。在本研究中，我们采用功能磁共振成像（fMRI）结合图论分析以及新开发的功能性脑网络破坏指数，来评估HIV阳性患者假定的功能重组。我们发现，与正常对照组相比，HIV患者的脑功能发生了深度重组。有趣的是，我们发现发生重组的枢纽区域被整合到了与工作记忆、运动和执行功能相关的神经网络中，而这些功能在HAND患者中常常发生改变。总体而言，我们的研究表明，静息态功能磁共振成像（rs-fMRI）结合先进的图论分析和破坏指数，能够在HIV患者的结构变化变得明显之前，检测到其脑网络早期、细微的功能变化。
