Department of Neurological Sciences, University of Nebraska Medical Center (UNMC), Omaha, NE, United States; Center for Magnetoencephalography, UNMC, Omaha, NE, United States; Cognitive Neuroscience of Development & Aging (CoNDA) Center, UNMC, Omaha, NE, United States.
Department of Internal Medicine, Division of Infectious Diseases, UNMC, Omaha, NE, United States.
EBioMedicine. 2020 Nov;61:103065. doi: 10.1016/j.ebiom.2020.103065. Epub 2020 Oct 21.
Despite living a normal lifespan, at least 35% of persons with HIV (PWH) in resource-rich countries develop HIV-associated neurocognitive disorder (HAND). This high prevalence of cognitive decline may reflect accelerated ageing in PWH, but the evidence supporting an altered ageing phenotype in PWH has been mixed.
We examined the impact of ageing on the orienting of visual attention in PWH using dynamic functional mapping with magnetoencephalography (MEG) in 173 participants age 22-72 years-old (94 uninfected controls, 51 cognitively-unimpaired PWH, and 28 with HAND). All MEG data were imaged using a state-of-the-art beamforming approach and neural oscillatory responses during attentional orienting were examined for ageing, HIV, and cognitive status effects.
All participants responded slower during trials that required attentional reorienting. Our functional mapping results revealed HIV-by-age interactions in left prefrontal theta activity, alpha oscillations in the left parietal, right cuneus, and right frontal eye-fields, and left dorsolateral prefrontal beta activity (p<.005). Critically, within PWH, we observed a cognitive status-by-age interaction, which revealed that ageing impacted the oscillatory gamma activity serving attentional reorienting differently in cognitively-normal PWH relative to those with HAND in the left temporoparietal, inferior frontal gyrus, and right prefrontal cortices (p<.005).
This study provides key evidence supporting altered ageing trajectories across vital attention circuitry in PWH, and further suggests that those with HAND exhibit unique age-related changes in the oscillatory dynamics serving attention function. Additionally, our neural findings suggest that age-related changes in PWH may serve a compensatory function.
National Institutes of Health, USA.
尽管寿命正常，但资源丰富国家至少有 35%的艾滋病毒感染者（PWH）会发展为与艾滋病毒相关的神经认知障碍（HAND）。这种认知能力下降的高患病率可能反映了 PWH 的加速衰老，但支持 PWH 衰老表型改变的证据一直存在争议。
我们使用基于脑磁图（MEG）的动态功能成像技术，检查了衰老对 173 名年龄在 22-72 岁的 PWH （94 名未感染者对照、51 名认知未受损的 PWH 和 28 名有 HAND 的 PWH）的视觉注意力定向的影响。所有 MEG 数据均采用最先进的波束形成方法进行成像，并检查了注意定向过程中的神经振荡反应，以观察衰老、HIV 和认知状态的影响。
所有参与者在需要注意力重新定向的试验中反应速度都较慢。我们的功能映射结果显示，在左前额叶θ活动、左顶叶、右楔前叶和右额眼区的α振荡以及左背外侧前额叶β活动中，出现了 HIV 与年龄的相互作用（p<.005）。重要的是，在 PWH 中，我们观察到认知状态与年龄的相互作用，这表明在认知正常的 PWH 中，衰老对注意重新定向的γ活动有不同的影响，而在 HAND 患者中则不同，这种影响出现在左颞顶叶、下额回和右前额叶皮质（p<.005）。
这项研究提供了关键证据，支持了 PWH 重要注意力回路中衰老轨迹的改变，并进一步表明，HAND 患者的注意力功能的振荡动力学具有独特的与年龄相关的变化。此外，我们的神经发现表明，PWH 的年龄相关变化可能起到了代偿功能。
美国国立卫生研究院。
