TY - JOUR
T1 - ApoE ϵ4 is associated with cognition, brain integrity, and atrophy in HIV Over Age 60
AU - Wendelken, Lauren A.
AU - Jahanshad, Neda
AU - Rosen, Howard J.
AU - Busovaca, Edgar
AU - Allen, Isabel
AU - Coppola, Giovanni
AU - Adams, Collin
AU - Rankin, Katherine P.
AU - Milanini, Benedetta
AU - Clifford, Katherine
AU - Wojta, Kevin
AU - Nir, Talia M.
AU - Gutman, Boris A.
AU - Thompson, Paul M.
AU - Valcour, Victor
N1 - Publisher Copyright:
© 2016 Wolters Kluwer Health, Inc.
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Background: There are contradicting reports on the associations between Apolipoprotein E4 (ApoE ϵ4) and brain outcomes in HIV with some evidence that relationships may be greatest in older age groups. Methods: We assessed cognition in 76 clinically stable HIV-infected participants over age 60 and genotyped ApoE. Sixty-one of these subjects underwent structural brain magnetic resonance imaging and diffusion tensor imaging. Results: The median age of the participants was 64 years (range: 60-84) and the median estimated duration of HIV infection was 22 years. Apo ϵ4 carriers (n 19) were similar to noncarriers (n 57) in sex (95% vs. 96% male), and education (16.0 vs. 16.2 years) ApoE ϵ4 carriers demonstrated greater deficits in cognitive performance in the executive domain (P 0.045) and had reduced fractional anisotropy and increased mean diffusivity throughout large white matter tracts within the brain compared with noncarriers. Tensor-based morphometry analyses revealed ventricular expansion and atrophy in the posterior corpus callosum, thalamus, and brainstem among HIV-infected ApoE ϵ4 carriers compared with ϵ4 noncarriers. Conclusions: In this sample of older HIV-infected individuals, having at least 1 ApoE ϵ4 allele was associated with decreased cognitive performance in the executive functioning domain, reduced brain white matter integrity, and brain atrophy. Brain atrophy was most prominent in the posterior corpus callosum, thalamus, and brainstem. This pattern of cognitive deficit, atrophy, and damage to white matter integrity was similar to that described in HIV, suggesting an exacerbation of HIV-related pathology; although emergence of other age-associated neurodegenerative disorders cannot be excluded.
AB - Background: There are contradicting reports on the associations between Apolipoprotein E4 (ApoE ϵ4) and brain outcomes in HIV with some evidence that relationships may be greatest in older age groups. Methods: We assessed cognition in 76 clinically stable HIV-infected participants over age 60 and genotyped ApoE. Sixty-one of these subjects underwent structural brain magnetic resonance imaging and diffusion tensor imaging. Results: The median age of the participants was 64 years (range: 60-84) and the median estimated duration of HIV infection was 22 years. Apo ϵ4 carriers (n 19) were similar to noncarriers (n 57) in sex (95% vs. 96% male), and education (16.0 vs. 16.2 years) ApoE ϵ4 carriers demonstrated greater deficits in cognitive performance in the executive domain (P 0.045) and had reduced fractional anisotropy and increased mean diffusivity throughout large white matter tracts within the brain compared with noncarriers. Tensor-based morphometry analyses revealed ventricular expansion and atrophy in the posterior corpus callosum, thalamus, and brainstem among HIV-infected ApoE ϵ4 carriers compared with ϵ4 noncarriers. Conclusions: In this sample of older HIV-infected individuals, having at least 1 ApoE ϵ4 allele was associated with decreased cognitive performance in the executive functioning domain, reduced brain white matter integrity, and brain atrophy. Brain atrophy was most prominent in the posterior corpus callosum, thalamus, and brainstem. This pattern of cognitive deficit, atrophy, and damage to white matter integrity was similar to that described in HIV, suggesting an exacerbation of HIV-related pathology; although emergence of other age-associated neurodegenerative disorders cannot be excluded.
KW - AIDS dementia Complex
KW - Acquired Immune Deficiency Syndrome
KW - ApoE
KW - aging
KW - cognition disorders
UR - http://www.scopus.com/inward/record.url?scp=84969916798&partnerID=8YFLogxK
U2 - 10.1097/QAI.0000000000001091
DO - 10.1097/QAI.0000000000001091
M3 - Article
C2 - 27228100
AN - SCOPUS:84969916798
SN - 1525-4135
VL - 73
SP - 426
EP - 432
JO - Journal of Acquired Immune Deficiency Syndromes
JF - Journal of Acquired Immune Deficiency Syndromes
IS - 4
ER -