Li Ruili, Liu Guangxue, Aili Xire, Zhang Miao, Li Hongjun, Lu Jie
Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Xicheng District, Beijing, 100053, China.
Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, 100053, China.
Eur J Med Res. 2025 Apr 15;30(1):281. doi: 10.1186/s40001-025-02555-x.
HIV can alter the brain structure and function in the early stage of infection. This study investigated the differences in cortical thickness patterns between healthy controls (HCs) and people living with HIV (PLWH) with asymptomatic neurocognitive impairment (ANI) or cognitive integrity (CI).
Twenty-one ANI, 25 CI, and 24 HCs were recruited and underwent high-resolution T1-weighted magnetic resonance images. Cortical thickness was analyzed using the Computational Anatomy Toolbox, and the correlation analysis was conducted between cortical thickness and clinical and neuropsychological variables.
Both CI and ANI exhibited decreased cortical thickness, primarily in the left frontal cortices and bilateral limbic system. ANI demonstrated a more pronounced and widespread pattern of cortical thinning. Lower CD4 counts and higher peak plasma viral load were associated with decreased cortical thickness of the right pericallosal sulcus and middle-posterior part of cingulate gyrus and sulcus in ANI. Conversely, compared to HCs, both ANI and CI showed cortical thickening in the left insula cortex, and ANI tended to have a thicker cortex. Moreover, the increased thickness of left insula cortex in both CI and ANI were positively correlated with attention and working memory.
The cortical thickness thinning was observed in the frontal and limbic systems in both ANI and CI. Meanwhile, the thickening of the insular cortex may represent mild neuroinflammation or a transient compensatory mechanism. This study provides new insights into the neural mechanisms underlying HIV-related cognitive impairment and highlights the importance of cortical thickness alteration patterns when assessing cognitive function of PLWH.
HIV可在感染早期改变大脑结构和功能。本研究调查了健康对照者（HCs）与无症状神经认知障碍（ANI）或认知完整（CI）的HIV感染者（PLWH）之间皮质厚度模式的差异。
招募了21名ANI患者、25名CI患者和24名HCs，并对其进行了高分辨率T1加权磁共振成像。使用计算解剖学工具箱分析皮质厚度，并对皮质厚度与临床和神经心理学变量进行相关性分析。
CI组和ANI组均表现出皮质厚度降低，主要集中在左侧额叶皮质和双侧边缘系统。ANI组皮质变薄的模式更为明显和广泛。较低的CD4细胞计数和较高的血浆病毒载量峰值与ANI组右侧胼胝体沟和扣带回及沟的中后部皮质厚度降低有关。相反，与HCs相比，ANI组和CI组在左侧岛叶皮质均表现出皮质增厚，且ANI组的皮质往往更厚。此外，CI组和ANI组左侧岛叶皮质厚度增加均与注意力和工作记忆呈正相关。
在ANI组和CI组的额叶和边缘系统中均观察到皮质厚度变薄。同时，岛叶皮质增厚可能代表轻度神经炎症或一种短暂的代偿机制。本研究为HIV相关认知障碍的神经机制提供了新的见解，并强调了在评估PLWH认知功能时皮质厚度改变模式的重要性。
