机器学习定量评估 HIV 感染者的脑白质加速老化。
Machine Learning Quantifies Accelerated White-Matter Aging in Persons With HIV.
机构信息
Department of Neurology, Washington University School of Medicine, St Louis, Missouri, USA.
Department of Family and Preventive Medicine, University of California, San Diego, California, USA.
出版信息
J Infect Dis. 2022 Aug 12;226(1):49-58. doi: 10.1093/infdis/jiac156.
BACKGROUND
Persons with HIV (PWH) undergo white matter changes, which can be quantified using the brain-age gap (BAG), the difference between chronological age and neuroimaging-based brain-predicted age. Accumulation of microstructural damage may be accelerated in PWH, especially with detectable viral load (VL).
METHODS
In total, 290 PWH (85% with undetectable VL) and 165 HIV-negative controls participated in neuroimaging and cognitive testing. BAG was measured using a Gaussian process regression model trained to predict age from diffusion magnetic resonance imaging in publicly available normative controls. To test for accelerated aging, BAG was modeled as an age × VL interaction. The relationship between BAG and global neuropsychological performance was examined. Other potential predictors of pathological aging were investigated in an exploratory analysis.
RESULTS
Age and detectable VL had a significant interactive effect: PWH with detectable VL accumulated +1.5 years BAG/decade versus HIV-negative controls (P = .018). PWH with undetectable VL accumulated +0.86 years BAG/decade, although this did not reach statistical significance (P = .052). BAG was associated with poorer global cognition only in PWH with detectable VL (P < .001). Exploratory analysis identified Framingham cardiovascular risk as an additional predictor of pathological aging (P = .027).
CONCLUSIONS
Aging with detectable HIV and cardiovascular disease may lead to white matter pathology and contribute to cognitive impairment.
背景
艾滋病毒（HIV）感染者会发生白质变化，可以通过脑龄差距（BAG）来量化，即实际年龄与基于神经影像学的大脑预测年龄之间的差异。HIV 感染者的微观结构损伤可能会加速积累，尤其是在可检测到病毒载量（VL）的情况下。
方法
共有 290 名 HIV 感染者（85%的病毒载量不可检测）和 165 名 HIV 阴性对照者参与了神经影像学和认知测试。BAG 是使用高斯过程回归模型测量的，该模型经过训练，可以根据来自公开的正常对照者的弥散磁共振成像数据来预测年龄。为了检测加速老化，将 BAG 建模为年龄与 VL 的交互作用。还检查了 BAG 与全球神经心理学表现之间的关系。在探索性分析中，还研究了其他潜在的病理性老化预测因子。
结果
年龄和可检测到的 VL 有显著的交互作用：携带可检测 VL 的 HIV 感染者每十年 BAG 增加 1.5 年，而 HIV 阴性对照者则增加 1.0 年（P=0.018）。未检测到 VL 的 HIV 感染者 BAG 每十年增加 0.86 年，但这并未达到统计学意义（P=0.052）。仅在携带可检测 VL 的 HIV 感染者中，BAG 与较差的整体认知能力相关（P<0.001）。探索性分析发现，弗雷明汉心血管风险是病理性老化的另一个预测因子（P=0.027）。
结论
可检测的 HIV 和心血管疾病导致的衰老可能会导致白质病变，并导致认知障碍。
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