Altered metabolism in right basal ganglia associated with asymptomatic neurocognitive impairment in HIV-infected individuals

Yi Zhan; Dan-Chao Cai; Ying Liu; Fengxiang Song; Fei Shan; Pengrui Song; Guochao Chen; Yijun Zhang; He Wang; Yuxin Shi

doi:10.1016/j.heliyon.2023.e23342

Altered metabolism in right basal ganglia associated with asymptomatic neurocognitive impairment in HIV-infected individuals

Heliyon. 2023 Dec 6;10(1):e23342. doi: 10.1016/j.heliyon.2023.e23342. eCollection 2024 Jan 15.

Authors

Yi Zhan¹, Dan-Chao Cai¹, Ying Liu², Fengxiang Song¹, Fei Shan¹, Pengrui Song¹, Guochao Chen¹, Yijun Zhang¹, He Wang^{2

3}, Yuxin Shi¹

Affiliations

¹ Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
² Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.
³ Human Phenome Institute, Fudan University, Shanghai, China.

Abstract

Background: Only few studies have focused on the metabolite differences between asymptomatic neurocognitive impairment (ANI) and cognitively normal people living with HIV (PLWH). The current study aims to examine whether brain metabolisms in basal ganglia (BG) by magnetic resonance spectroscopy (MRS) were potential to discriminate ANI from cognitively normal PLWH.

Methods: According to neuropsychological (NP) test, 80 PLWH (37.4 ± 10.2 years) were divided into ANI group (HIV-ANI, n = 31) and NP normal group (HIV-normal, n = 49). Brain metabolisms by MRS from right BG were compared between groups, including N-acetylaspartate and N-acetyl aspartylglutamate (tNAA), creatine and phosphocreatine (tCr), and choline-containing compounds (tCho). A total value of three metabolites were introduced. All brain metabolisms were evaluated as its percentage of total. Furthermore, correlations between MRS and NP and clinical measures were evaluated. A logistic regression model was applied, and the AUC values for the model and the continuous factors were compared using receiver operating curve (ROC) analysis.

Results: Compared to HIV-normal group, tNAA/total was lower and tCr/total was higher in the HIV-ANI group (P < 0.05). Both tNAA/total and tCr/total values were correlated with NP score (P < 0.05), especially in verbal fluency, speed of information processing, learning, and recall (P < 0.05). The logistic model included BG-tCr/total, current CD4 and infection years of PLWH. The AUC value for the BG-tCr/total was 0.696 and was not significantly lower than that for logistic model (P < 0.01).

Conclusion: The altered brain metabolites in the right BG were found in the ANI group compared to PLWH with normal cognition, and further associated with NP deficits. The current findings indicated that brain metabolites assessed by MRS has the potential to discriminate ANI from cognitively normal PLWH.

Keywords: Asymptomatic neurocognitive impairment; HIV-Associated neurocognitive disorder; Human immunodeficiency virus; Neuropsychological test; Single-voxel proton MR spectroscopy.

Grants and funding

R01 NS108809/NS/NINDS NIH HHS/United States