Ma Juming, Zhou Zhongkai, Han Shuai, Hou Chuanke, Jiang Xingyuan, Xu Fan, Luo Haixia, Liu Jiaojiao, Wang Wei, Zhao Haiyan, Zhao Lingling, Li Hongjun
Department of Radiology, Qilu Hospital of Shandong University, Jinan, China.
Department of Radiology, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Brain Behav. 2025 Jun;15(6):e70559. doi: 10.1002/brb3.70559.
HIV-associated neurocognitive disorders (HAND), especially asymptomatic neurocognitive impairment (ANI), the initial stage of HAND, persist among a substantial proportion of individuals living with HIV despite the introduction of combination antiretroviral therapy (cART). Resting-state functional magnetic resonance imaging (rs-fMRI) focusing on ANI among HIV-related patients is rarely reported.
60 right-handed Chinese male patients with HIV-associated ANI underwent baseline and follow-up neurocognitive examination, and rs-fMRI scans over an average interval of 1.68 years. Brain function alterations were evaluated through amplitude of low-frequency fluctuation (ALFF/fALFF), regional homogeneity (ReHo), and functional connectivity (FC) analyses.
In this study, significant reductions in ALFF were observed in the MOG, cuneus, superior frontal gyrus, and supplementary motor area in the follow-up group compared to baseline. This was accompanied by increased ALFF in the right insula. ReHo analysis revealed decreased values in the left median cingulate, right calcarine fissure, MOG, and left precentral gyrus, alongside increased ReHo in the supramarginal gyrus, postcentral gyrus, parahippocampal gyrus, and calcarine fissure. FC analysis demonstrated decreased connectivity between the precentral gyrus and calcarine cortex and between the MOG and calcarine cortex. Correlation analysis indicated that these imaging changes were correlated with declines in specific neurocognitive domains, including memory, speed of information processing, and executive function.
Our research demonstrates a gradual deterioration in brain function in HIV-positive individuals with ANI despite receiving cART. This decline correlates with worsening neurocognitive abilities, specifically visual processing and executive function.
尽管引入了联合抗逆转录病毒疗法（cART），但在相当一部分艾滋病毒感染者中，与艾滋病毒相关的神经认知障碍（HAND），尤其是HAND的初始阶段无症状神经认知障碍（ANI）仍然存在。针对艾滋病毒相关患者中ANI的静息态功能磁共振成像（rs-fMRI）报道很少。
60名右利手的中国男性艾滋病毒相关ANI患者接受了基线和随访神经认知检查，以及平均间隔1.68年的rs-fMRI扫描。通过低频振幅波动（ALFF/fALFF）、局部一致性（ReHo）和功能连接（FC）分析来评估脑功能改变。
在本研究中，与基线相比，随访组在楔叶、楔前叶、额上回和辅助运动区观察到ALFF显著降低。同时右侧岛叶的ALFF增加。ReHo分析显示左中央扣带、右侧距状裂、楔叶和左中央前回的值降低，同时缘上回、中央后回、海马旁回和距状裂的ReHo增加。FC分析表明中央前回与距状皮质之间以及楔叶与距状皮质之间的连接性降低。相关性分析表明，这些影像学变化与特定神经认知领域的下降相关，包括记忆、信息处理速度和执行功能。
我们的研究表明，尽管接受了cART，但艾滋病毒阳性且患有ANI的个体脑功能仍在逐渐恶化。这种下降与神经认知能力的恶化相关，特别是视觉处理和执行功能。
