Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.
Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.
J Neuroimaging. 2021 Jul;31(4):796-808. doi: 10.1111/jon.12861. Epub 2021 Apr 26.
To investigate the reorganization of the central nervous system provided by resting state-functional MRI (rs-fMRI), graph-theoretical analysis, and a newly developed functional brain network disruption index in patients with human immunodeficiency virus (HIV) infection.
Forty HIV-positive patients without neurological impairment and 20 age- and sex-matched healthy controls underwent rs-fMRI at 3T; blood sampling was obtained the same day to evaluate biochemical variables (absolute, relative, and nadir CD4 T-lymphocytes value and plasmatic HIV-RNA). From fMRI data, disruption indices, as well as global and local graph theoretical measures, were estimated and examined for group differences (HIV vs. controls) as well as for associations with biochemical variables (HIV only). Finally, all data (global and local graph-theoretical measures, disruption indices, and biochemical variables) were tested for putative differences across three patient groups based on the duration of combined antiretroviral therapy (cART).
Brain function of HIV patients appeared to be deeply reorganized as compared to normal controls. The disruption index showed significant negative association with relative CD4 values, and a positive significant association between plasmatic HIV-RNA and local graph-theoretical metrics in the left lingual gyrus and the right lobule IV and V of right cerebellar hemisphere was also observed. Finally, a differential distribution of HIV clinical biomarkers and several brain metrics was observed across cART duration groups.
Our study demonstrates that rs-fMRI combined with advanced graph theoretical analysis and disruption indices is able to detect early and subtle functional changes of brain networks in HIV patients.
本研究旨在通过静息态功能磁共振成像(rs-fMRI)、图论分析和新开发的功能脑网络破坏指数，探讨人类免疫缺陷病毒(HIV)感染患者的中枢神经系统重组。
40 名无神经功能障碍的 HIV 阳性患者和 20 名年龄和性别匹配的健康对照者在 3T 下进行 rs-fMRI 检查;同日采集血样，评估生化指标(绝对、相对和最低 CD4 T 淋巴细胞值和血浆 HIV-RNA)。从 fMRI 数据中，估计了破坏指数以及全局和局部图论测量值，并对组间差异(HIV 与对照组)以及与生化变量(仅 HIV)的相关性进行了检验。最后，根据联合抗逆转录病毒治疗(cART)的持续时间，对所有数据(全局和局部图论测量值、破坏指数和生化变量)进行了三个患者组之间差异的检验。
与正常对照组相比，HIV 患者的大脑功能似乎发生了深度重组。破坏指数与相对 CD4 值呈显著负相关，血浆 HIV-RNA 与左舌回和右侧小脑后叶 IV 和 V 叶的局部图论指标之间也存在显著正相关。最后，在 cART 持续时间组中，观察到 HIV 临床生物标志物和几种脑指标的差异分布。
本研究表明，rs-fMRI 结合先进的图论分析和破坏指数能够检测到 HIV 患者脑网络的早期和微妙的功能变化。
