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Clinical and neuroimaging correlates of cognition in HIV

Research output: Contribution to journalArticle

Olubanke Davies, Becky I Haynes, Sarah J Casey, Sofia Gerbase, Gareth J Barker, Mervi Pitkanen, Ranjababu Kulasegaram, Michael D Kopelman

Original languageEnglish
Pages (from-to)754-764
Number of pages11
JournalJournal of NeuroVirology
Volume25
Issue number6
Early online date18 Jun 2019
DOIs
Publication statusPublished - 1 Dec 2019

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  • Davies_et_al-2019-Journal_of_NeuroVirology

    Davies_et_al_2019_Journal_of_NeuroVirology.pdf, 623 KB, application/pdf

    25/06/2019

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    Title: Clinical and neuroimaging correlates of cognition in HIV
    Author: Olubanke Davies, Becky I. Haynes, Sarah J. Casey et al
    Publication: Journal of NeuroVirology
    Publisher: Springer Nature
    Date: Jan 1, 2019

    Copyright © 2019, The Author(s)

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    This is an open access article distributed under the terms of the Creative Commons CC BY license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract

This study investigated whether HIV-positive participants, stable on combined antiretroviral therapy (cART), showed cognitive impairments relative to HIV-negative controls; and whether clinical and neuroimaging factors correlated with cognitive function in the HIV-positive participants. One hundred and twenty-six white men who have sex with men, of whom 78 were HIV-positive and stable on cART and 48 were HIV negative, were recruited to this cross-sectional study. The median age of HIV-positive participants in this study was 47. They underwent clinical and neuropsychological evaluation and magnetic resonance imaging of the brain, including diffusion tensor imaging (DTI). Cognitive scores for both groups were compared, and regression models were run to explore the influence of clinical, psychiatric, lifestyle, and neuroimaging variables on cognition. The prevalence of neurocognitive impairment, using the multivariate normative comparison criteria, was 28% in HIV-positive participants and 5% in HIV-negative participants. After covarying for age, years of education, and non-English speaking background, there were significant differences between the HIV group and the controls across four cognitive domains. The HIV group showed significantly higher mean diffusivity (MD) and lower fractional anisotropy (FA) than the control group on DTI. Although anxiety levels were clinically low, anxiety and DTI measures were the only variables to show significant correlations with cognitive function. In the HIV group, poorer cognitive performance was associated with higher MD and lower FA on DTI and higher (albeit clinically mild) levels of anxiety. Our findings suggest that white matter changes and subtle anxiety levels contribute independently to cognitive impairment in HIV.

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