School of Biological Science and Medical Engineering, Beihang University, Beijing, China.
Department of Radiology, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Hum Brain Mapp. 2021 Jul;42(10):3131-3140. doi: 10.1002/hbm.25423. Epub 2021 Mar 23.
Currently, it is still unknown whether human immune deficiency virus (HIV)-related structural alterations in the brain are dependent on age. With people living with HIV at different ages, we aim to investigate age-specific structural alterations in HIV patients. Eighty-three male HIV patients and eighty-three age-matched male controls were enrolled, and high-resolution T1 weighted images were collected and analyzed with four morphological metrics. Then, statistical analyses were respectively conducted to ascertain HIV effects, age effects, and medication effects in brain structure of HIV patients, and the relationship with neuropsychological evaluations were further explored. Finally, discriminative performances of these structural abnormalities were quantitatively testified with three machine learning models. Compared with healthy controls, HIV patients displayed lower gray matter volumes (GMV), lower gyrification index, deeper sulcus depth, and larger cortical thickness (CTH). Age-specific differences were found in GMV and CTH: young-aged HIV patients displayed more obvious morphological alterations than middle-aged HIV patients when comparing corresponding age-matched healthy controls. Furthermore, age-specific long-term medication effect of combination antiretroviral therapy were also presented. Additionally, several subcortical structural changes were negatively associated with language, attention and motor functions. Finally, three machine learning models demonstrated young-aged HIV patients were easier to be recognized than middle-aged HIV patients. Our study indicated young-aged HIV patients were more vulnerable to HIV infection in brain structure than middle-aged patients, and future studies should not ignore the age effect in studying the HIV-related abnormalities.
目前，尚不清楚人类免疫缺陷病毒（HIV）相关的大脑结构改变是否依赖于年龄。由于感染 HIV 的人群年龄不同，我们旨在研究 HIV 患者的年龄特异性结构改变。本研究纳入了 83 名男性 HIV 患者和 83 名年龄匹配的男性对照者，采集并分析了高分辨率 T1 加权图像的 4 种形态学指标。然后，分别对 HIV 患者大脑结构中的 HIV 效应、年龄效应和药物效应进行统计分析，并进一步探讨了与神经心理学评估的关系。最后，通过 3 种机器学习模型定量检验了这些结构异常的判别性能。与健康对照组相比，HIV 患者的灰质体积（GMV）较低，脑回指数较低，脑沟深度较深，皮质厚度（CTH）较大。GMV 和 CTH 存在年龄特异性差异：与相应年龄匹配的健康对照组相比，年轻的 HIV 患者的形态改变比中年患者更明显。此外，还发现了长期联合抗逆转录病毒治疗的年龄特异性药物效应。此外，一些皮质下结构变化与语言、注意力和运动功能呈负相关。最后，三个机器学习模型表明，年轻的 HIV 患者比中年患者更容易被识别。我们的研究表明，年轻的 HIV 患者比中年患者更容易受到 HIV 感染，在研究 HIV 相关异常时，不应忽视年龄效应。
