Cortical atrophy and white matter hyperintensities in HIV infection

Abstract

Background: In normal elderly individuals (age greater than 65 years) presence of brain white matter hyperintensities is associated with cortical atrophy, particularly of the frontal lobes. As HIV-seropositive individuals experience increase longevity due to highly active antiretroviral therapy it is likely they will also develop typical aging related changes in brain structure such as white matter hyperintensities. The aim of this study was to determine the relationship between white matter hyperintensities and brain cortical gray matter volumes in human immunodeficiency virus, type 1 (HIV) seropositive individuals. Methods: Voxel-based-morphometry was used to compare cortical gray matter volumes between 62 HIV seropositive participants in the Hawaii Aging with HIV cohort study, 30 with moderate brain white matter hyperintensities and 32 with minimal or no white matter hyperintensities. The Hawaii Aging with HIV Cohort study included two groups of HIV seropositive individuals, an older group comprised of individuals with age greater than 50 years old, and a younger group comprised of individuals with age from 20-39 years old. Results: Presence of moderate brain white matter hyperintensities was associated with decreased cortical gray matter volumes in the frontal lobes bilaterally (p < 0.05) in HIV seropositive individuals. Conclusions: The findings of this study suggest that presence of moderate brain white matter hyperintensities is associated with frontal lobe cortical atrophy in HIV seropositive individuals. These results are supportive of the hypothesis iv that the frontal lobes have greater susceptibility to the effects of small vessel ischemic vascular disease than other brain regions.