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Jia C, Long Q, Ernst T, Shang Y, Chang L, Adali T. Independent Component and Graph Theory Analyses Reveal Normalized Brain Networks on Resting-State Functional MRI After Working Memory Training in People With HIV. J Magn Reson Imaging 2023; 57:1552-1564. [PMID: 36165907 PMCID: PMC10040468 DOI: 10.1002/jmri.28439] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 09/04/2022] [Accepted: 09/07/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Cognitive training may partially reverse cognitive deficits in people with HIV (PWH). Previous functional MRI (fMRI) studies demonstrate that working memory training (WMT) alters brain activity during working memory tasks, but its effects on resting brain network organization remain unknown. PURPOSE To test whether WMT affects PWH brain functional connectivity in resting-state fMRI (rsfMRI). STUDY TYPE Prospective. POPULATION A total of 53 PWH (ages 50.7 ± 1.5 years, two women) and 53 HIV-seronegative controls (SN, ages 49.5 ± 1.6 years, six women). FIELD STRENGTH/SEQUENCE Axial single-shot gradient-echo echo-planar imaging at 3.0 T was performed at baseline (TL1), at 1-month (TL2), and at 6-months (TL3), after WMT. ASSESSMENT All participants had rsfMRI and clinical assessments (including neuropsychological tests) at TL1 before randomization to Cogmed WMT (adaptive training, n = 58: 28 PWH, 30 SN; nonadaptive training, n = 48: 25 PWH, 23 SN), 25 sessions over 5-8 weeks. All assessments were repeated at TL2 and at TL3. The functional connectivity estimated by independent component analysis (ICA) or graph theory (GT) metrics (eigenvector centrality, etc.) for different link densities (LDs) were compared between PWH and SN groups at TL1 and TL2. STATISTICAL TESTS Two-way analyses of variance (ANOVA) on GT metrics and two-sample t-tests on FC or GT metrics were performed. Cognitive (eg memory) measures were correlated with eigenvector centrality (eCent) using Pearson's correlations. The significance level was set at P < 0.05 after false discovery rate correction. RESULTS The ventral default mode network (vDMN) eCent differed between PWH and SN groups at TL1 but not at TL2 (P = 0.28). In PWH, vDMN eCent changes significantly correlated with changes in the memory ability in PWH (r = -0.62 at LD = 50%) and vDMN eCent before training significantly correlated with memory performance changes (r = 0.53 at LD = 50%). DATA CONCLUSION ICA and GT analyses showed that adaptive WMT normalized graph properties of the vDMN in PWH. EVIDENCE LEVEL 1 TECHNICAL EFFICACY: 1.
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Affiliation(s)
- Chunying Jia
- Department of Computer Science and Electrical Engineering, University of Maryland Baltimore County, Baltimore, MD 21250, USA
| | - Qunfang Long
- Department of Computer Science and Electrical Engineering, University of Maryland Baltimore County, Baltimore, MD 21250, USA
| | - Thomas Ernst
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Yuanqi Shang
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Linda Chang
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Tülay Adali
- Department of Computer Science and Electrical Engineering, University of Maryland Baltimore County, Baltimore, MD 21250, USA
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Yadav SK, Gupta RK, Hashem S, Bhat AA, Garg RK, Venkatesh V, Gupta PK, Singh AK, Chaturvedi S, Ahmed SN, Azeem MW, Haris M. Changes in resting-state functional brain activity are associated with waning cognitive functions in HIV-infected children. NEUROIMAGE-CLINICAL 2018; 20:1204-1210. [PMID: 30391858 PMCID: PMC6224323 DOI: 10.1016/j.nicl.2018.10.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 10/22/2018] [Accepted: 10/26/2018] [Indexed: 01/13/2023]
Abstract
Delayed brain development in perinatally HIV-infected children may affect the functional brain activity and subsequently cognitive function. The current study evaluated the functional brain activity in HIV-infected children by quantifying the amplitude of low frequency fluctuations (ALFF) and functional connectivity (FC). Additionally, correlation of ALFF and FC with cognitive measures was performed. Twenty-six HIV-infected children and 20 control children underwent neuropsychological (NP) assessment and resting-state functional magnetic resonance imaging (rs-fMRI). ALFF and FC maps were generated and group differences were analyzed using two-sample t-test. Furthermore, ALFF and FC showing significant group differences were correlated with NP scores using Pearson's correlation. Significantly lower ALFF in the left middle temporal gyrus, precentral and post central gyrus was observed in HIV-infected children compared to controls. FC was significantly reduced in the right inferior parietal, vermis, middle temporal and left postcentral regions, and significantly increased in the right precuneus, superior parietal and left middle frontal regions in HIV-infected children as compared to control. HIV-infected children showed significantly lower NP scores in various domains including closure, exclusion, memory, verbal meaning, quantity and hidden figure than controls. These waning cognitive functions were significantly associated with changes in ALFF and FC in HIV-infected children. The findings suggest that abnormal ALFF and FC may responsible for cognitive deficits in HIV-infected children. ALFF and FC in association with cognitive evaluation may provide a clinical biomarker to evaluate functional brain activity and to plan neurocognitive intervention in HIV-infected children undergoing standard treatment.
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Affiliation(s)
- Santosh K Yadav
- Division of Translational Medicine, Research Branch, Sidra Medicine, Doha, Qatar.
| | - Rakesh K Gupta
- Department of Radiology and Imaging, Fortis Memorial Research Institute, Gurgaon, India
| | - Sheema Hashem
- Division of Translational Medicine, Research Branch, Sidra Medicine, Doha, Qatar
| | - Ajaz A Bhat
- Division of Translational Medicine, Research Branch, Sidra Medicine, Doha, Qatar
| | - Ravindra K Garg
- Department of Neurology, King George Medical University, Lucknow, India
| | - Vimala Venkatesh
- Department of Microbiology, King George Medical University, Lucknow, India
| | - Pradeep K Gupta
- Department of Radiology and Imaging, Fortis Memorial Research Institute, Gurgaon, India
| | - Alok K Singh
- Department of Neurology, King George Medical University, Lucknow, India
| | - Saurabh Chaturvedi
- Department of Pediatric Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Sabha Nisar Ahmed
- Division of Translational Medicine, Research Branch, Sidra Medicine, Doha, Qatar
| | - Muhammad W Azeem
- Department of Psychiatry, Sidra Medicine/Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Mohammad Haris
- Division of Translational Medicine, Research Branch, Sidra Medicine, Doha, Qatar; Laboratory Animal Research Center, Qatar University, Doha, Qatar
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Wang H, Li R, Zhou Y, Wang Y, Cui J, Nguchu BA, Qiu B, Wang X, Li H. Altered cerebro-cerebellum resting-state functional connectivity in HIV-infected male patients. J Neurovirol 2018; 24:587-596. [PMID: 29785582 DOI: 10.1007/s13365-018-0649-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 04/21/2018] [Accepted: 05/01/2018] [Indexed: 12/11/2022]
Abstract
In addition to the role of planning and executing movement, the cerebellum greatly contributes to cognitive process. Numerous studies have reported structural and functional abnormalities in the cerebellum for HIV-infected patients, but little is known about the altered functional connectivity of particular cerebellar subregions and the cerebrum. Therefore, this study aimed to explore the resting-state functional connectivity (rsFC) changes of the cerebellum and further analyze the relationship between the rsFC changes and the neuropsychological evaluation. The experiment involved 26 HIV-infected men with asymptomatic neurocognitive impairment (ANI) and 28 healthy controls (HC). We selected bilateral hemispheric lobule VI and lobule IX as seed regions and mapped the whole-brain rsFC for each subregion. Results revealed that right lobule VI showed significant increased rsFC with the anterior cingulate cortex (ACC) in HIV-infected subjects. In addition, the correlation analysis on HIV-infected subjects illustrated the increased rsFC was negatively correlated with the attention/working memory score. Moreover, significantly increased cerebellar rsFCs were also observed in HIV-infected patients related to right inferior frontal gyrus (IFG) and right superior medial gyrus (SMG) while decreased rsFC was just found between right lobule VI and the left hippocampus (HIP). These findings suggested that, abnormalities of cerebro-cerebellar functional connectivity might be associated with cognitive dysfunction in HIV-infected men, particularly working memory impairment. It could also be the underlying mechanism of ANI, providing further evidence for early injury in the neural substrate of HIV-infected patients.
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Affiliation(s)
- Huijuan Wang
- Centers for Biomedical Engineering, University of Science and Technology of China, Hefei, Anhui, 230026, China
| | - Ruili Li
- Department of Radiology, Beijing Youan Hospital, Capital Medical University, No.8, Xi Tou Tiao, Youanmen Wai, Feng Tai District, Beijing, 10069, China
| | - Yawen Zhou
- Centers for Biomedical Engineering, University of Science and Technology of China, Hefei, Anhui, 230026, China
| | - Yanming Wang
- Centers for Biomedical Engineering, University of Science and Technology of China, Hefei, Anhui, 230026, China
| | - Jin Cui
- Centers for Biomedical Engineering, University of Science and Technology of China, Hefei, Anhui, 230026, China
| | - Benedictor Alexander Nguchu
- Centers for Biomedical Engineering, University of Science and Technology of China, Hefei, Anhui, 230026, China
| | - Bensheng Qiu
- Centers for Biomedical Engineering, University of Science and Technology of China, Hefei, Anhui, 230026, China
| | - Xiaoxiao Wang
- Centers for Biomedical Engineering, University of Science and Technology of China, Hefei, Anhui, 230026, China.
| | - Hongjun Li
- Department of Radiology, Beijing Youan Hospital, Capital Medical University, No.8, Xi Tou Tiao, Youanmen Wai, Feng Tai District, Beijing, 10069, China.
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Castillo D, Ernst T, Cunningham E, Chang L. Altered Associations between Pain Symptoms and Brain Morphometry in the Pain Matrix of HIV-Seropositive Individuals. J Neuroimmune Pharmacol 2017; 13:77-89. [PMID: 28866752 DOI: 10.1007/s11481-017-9762-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 08/21/2017] [Indexed: 02/06/2023]
Abstract
Pain remains highly prevalent in HIV-seropositive (HIV+) patients despite their well-suppressed viremia with combined antiretroviral therapy. Investigating brain abnormalities within the pain matrix, and in relation to pain symptoms, in HIV+ participants may provide objective biomarkers and insights regarding their pain symptoms. We used Patient-Reported Outcome Measurement Information System (PROMIS®) pain questionnaire to evaluate pain symptoms (pain intensity, pain interference and pain behavior), and structural MRI to assess brain morphometry using FreeSurfer (cortical area, cortical thickness and subcortical volumes were evaluated in 12 regions within the pain matrix). Compared to seronegative (SN) controls, HIV+ participants had smaller surface areas in prefrontal pars triangularis (right: p = 0.04, left: p = 0.007) and right anterior cingulate cortex (p = 0.03) and smaller subcortical regions (thalamus: p ≤ 0.003 bilaterally; right putamen: p = 0.01), as well as higher pain scores (pain intensity-p = 0.005; pain interference-p = 0.008; pain-behavior-p = 0.04). Furthermore, higher pain scores were associated with larger cortical areas, thinner cortices and larger subcortical volumes in HIV+ participants; but smaller cortical areas, thicker cortices and smaller subcortical volumes in SN controls (interaction-p = 0.009 to p = 0.04). These group differences in the pain-associated brain abnormalities suggest that HIV+ individuals have abnormal pain responses. Since these abnormal pain-associated brain regions belong to the affective component of the pain matrix, affective symptoms may influence pain perception in HIV+ patients and should be treated along with their physical pain symptoms. Lastly, associations of lower pain scores with better physical or mental health scores, regardless of HIV-serostatus (p < 0.001), suggest adequate pain treatment would lead to better quality of life in all participants.
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Affiliation(s)
- Deborrah Castillo
- John A. Burns School of Medicine, Neuroscience and MR Research Program, University of Hawaii at Manoa, 1356 Lusitana Street, 7th Floor, Honolulu, HI, 96813, USA
| | - Thomas Ernst
- John A. Burns School of Medicine, Neuroscience and MR Research Program, University of Hawaii at Manoa, 1356 Lusitana Street, 7th Floor, Honolulu, HI, 96813, USA
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 419 W. Redwood Street, Suite 225, Baltimore, MD, 21201, USA
| | - Eric Cunningham
- John A. Burns School of Medicine, Neuroscience and MR Research Program, University of Hawaii at Manoa, 1356 Lusitana Street, 7th Floor, Honolulu, HI, 96813, USA
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 419 W. Redwood Street, Suite 225, Baltimore, MD, 21201, USA
| | - Linda Chang
- John A. Burns School of Medicine, Neuroscience and MR Research Program, University of Hawaii at Manoa, 1356 Lusitana Street, 7th Floor, Honolulu, HI, 96813, USA.
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 419 W. Redwood Street, Suite 225, Baltimore, MD, 21201, USA.
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Chang L, Løhaugen GC, Andres T, Jiang CS, Douet V, Tanizaki N, Walker C, Castillo D, Lim A, Skranes J, Otoshi C, Miller EN, Ernst TM. Adaptive working memory training improved brain function in human immunodeficiency virus-seropositive patients. Ann Neurol 2016; 81:17-34. [PMID: 27761943 PMCID: PMC5299494 DOI: 10.1002/ana.24805] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 10/14/2016] [Accepted: 10/14/2016] [Indexed: 12/28/2022]
Abstract
Objective We aimed to evaluate the effectiveness of an adaptive working memory (WM) training (WMT) program, the corresponding neural correlates, and LMX1A‐rs4657412 polymorphism on the adaptive WMT, in human immunodeficiency virus (HIV) participants compared to seronegative (SN) controls. Methods A total of 201 of 206 qualified participants completed baseline assessments before randomization to 25 sessions of adaptive WMT or nonadaptive WMT. A total of 74 of 76 (34 HIV, 42 SN) completed adaptive WMT and all 40 completed nonadaptive WMT (20 HIV, 20 SN) and were assessed after 1 month, and 55 adaptive WMT participants were also assessed after 6 months. Nontrained near‐transfer WM tests (Digit‐Span, Spatial‐Span), self‐reported executive functioning, and functional magnetic resonance images during 1‐back and 2‐back tasks were performed at baseline and each follow‐up visit, and LMX1A‐rs4657412 was genotyped in all participants. Results Although HIV participants had slightly lower cognitive performance and start index than SN at baseline, both groups improved on improvement index (>30%; false discovery rate [FDR] corrected p < 0.0008) and nontrained WM tests after adaptive WMT (FDR corrected, p ≤ 0.001), but not after nonadaptive WMT (training by training type corrected, p = 0.01 to p = 0.05) 1 month later. HIV participants (especially LMX1A‐G carriers) also had poorer self‐reported executive functioning than SN, but both groups reported improvements after adaptive WMT (Global: training FDR corrected, p = 0.004), and only HIV participants improved after nonadaptive WMT. HIV participants also had greater frontal activation than SN at baseline, but brain activation decreased in both groups at 1 and 6 months after adaptive WMT (FDR corrected, p < 0.0001), with normalization of brain activation in HIV participants, especially the LMX1A‐AA carriers (LMX1A genotype by HIV status, cluster‐corrected‐p < 0.0001). Interpretation Adaptive WMT, but not nonadaptive WMT, improved WM performance in both SN and HIV participants, and the accompanied decreased or normalized brain activation suggest improved neural efficiency, especially in HIV‐LMX1A‐AA carriers who might have greater dopaminergic reserve. These findings suggest that adaptive WMT may be an effective adjunctive therapy for WM deficits in HIV participants. ANN NEUROL 2017;81:17–34
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Affiliation(s)
- Linda Chang
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI.,The Queen's Medical Center, Honolulu, HI
| | - Gro C Løhaugen
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI.,Department of Child Neurology and Rehabilitation (HABU-A), Sørlandet Sykehus HF, HABU, Arendal, Norway, and Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, MTFS, Trondheim, Norway
| | - Tamara Andres
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI
| | - Caroline S Jiang
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI
| | - Vanessa Douet
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI
| | - Naomi Tanizaki
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI
| | - Christina Walker
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI
| | - Deborrah Castillo
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI
| | - Ahnate Lim
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI
| | - Jon Skranes
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI.,Department of Child Neurology and Rehabilitation (HABU-A), Sørlandet Sykehus HF, HABU, Arendal, Norway, and Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, MTFS, Trondheim, Norway
| | - Chad Otoshi
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI
| | - Eric N Miller
- Department of Psychiatry, University of California, Los Angeles, CA
| | - Thomas M Ernst
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI
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