A diffusion tensor imaging and neurocognitive study of HIV-positive children who are HAART-naïve "slow progressors"

Jacqueline Hoare, Jean Paul Fouche, Bruce Spottiswoode, Kirsty Donald, Nicole Philipps, Heidre Bezuidenhout, Christine Mulligan, Victoria Webster, Charity Oduro, Leigh Schrieff, Robert Paul, Heather Zar, Kevin Thomas, Dan Stein

Research output: Contribution to journalArticlepeer-review

74 Scopus citations

Abstract

There are few neuropsychological or neuroimaging studies of HIV-positive children with "slow progression". "Slow progressors" are typically defined as children or adolescents who were vertically infected with HIV, but who received no or minimal antiretroviral therapy. We compared 12 asymptomatic HIV-positive children (8 to 12 years) with matched controls on a neuropsychological battery as well as diffusion tensor imaging in a masked region of interest analysis focusing on the corpus callosum, internal capsule and superior longitudinal fasciculus. The "slow progressor" group performed significantly worse than controls on the Wechsler Abbreviated Scale of Intelligence Verbal and Performance IQ scales, and on standardised tests of visuospatial processing, visual memory and executive functioning. "Slow progressors" had lower fractional anisotropy (FA), higher mean diffusivity (MD) and radial diffusivity (RD) in the corpus callosum (p0<0.05), and increased MD in the superior longitudinal fasciculus, compared to controls. A correlation was found between poor performance on a test of executive function and a test of attention with corpus callosum FA, and a test of executive function with lowered FA in the superior longitudinal fasiculus. These data suggest that demyelination as reflected by the increase in RD may be a prominent disease process in paediatric HIV infection.

Original languageEnglish
Pages (from-to)205-212
Number of pages8
JournalJournal of NeuroVirology
Volume18
Issue number3
DOIs
StatePublished - Jun 2012
Externally publishedYes

Keywords

  • Cognitive impairment
  • Diffusion tensor
  • HIV/AIDS
  • Imaging
  • Paediatric

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