Ke Xue, YuXin Shi, Fengxiang Song, Danchao Cai, Jie Shen, Zecheng Yang, Fei Shan, Zhiyong Zhang, Yi Zhan
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引用次数: 0
Abstract
Objective: To investigate glymphatic dysfunction in people living with HIV (PLWH) and its associations with immunological status and cognitive function, utilizing the coupling strength of global blood-oxygen-level-dependent and cerebrospinal fluid (gBOLD-CSF).
Design: Retrospective study of 75 PLWH and 52 non-HIV controls undergoing neuropsychological tests and resting-state functional magnetic resonance imaging (rs-fMRI).
Methods: GBOLD-CSF coupling, Montreal Cognitive Assessment (MoCA) and seven cognitive domain scores were calculated. Group difference in gBOLD-CSF coupling strength was analyzed using a general linear model, adjusting for age, sex, and education. Partial correlation analyses were performed to examine the correlations of cognitive performance and immunological status with gBOLD-CSF coupling. Multivariate regression analysis was utilized to further evaluate the associations of gBOLD-CSF coupling with cognition.
Results: PLWH exhibited significantly weaker gBOLD-CSF coupling than non-HIV controls (p = 0.018) and revealed impairments in attention/working memory, speed of information processing, and abstract/executive function (all p < 0.05). Reduced gBOLD-CSF coupling was associated with deficits in MoCA scores (r = -0.332, p = 0.004), verbal fluency (r = 0.245, p = 0.038), attention/working memory (r = 0.240, p = 0.042), speed of information processing (r = 0.245, p = 0.038), and abstract/executive function (r = 0.241, p = 0.042) in PLWH. Multivariate regression analysis showed gBOLD-CSF coupling was the only independent predictor for speed of information processing (β=0.410, p = 0.031) and MoCA scores (β=-0.399, p = 0.037). Weaker gBOLD-CSF coupling was correlated with lower nadir and current CD4 counts(r = -0.379, p = 0.019; r = -0.321, p = 0.049, respectively).
Conclusion: Reduced gBOLD-CSF coupling in PLWH suggests glymphatic dysfunction and was associated with cognitive impairment and HIV-related immune suppression. It may serve as a non-invasive biomarker for monitoring cognitive disturbances and disease progression in HIV.
期刊介绍：
Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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