White matter microstructure among perinatally HIV-infected youth: a diffusion tensor imaging study

  • Manoj K. Sarma
  • Margaret A. Keller
  • Paul M. Macey
  • David E. Michalik
  • Judy Hayes
  • Karin Nielsen-Saines
  • Jaime Deville
  • Joseph A. Church
  • Irwin Walot
  • M. Albert ThomasEmail author


We evaluated white matter microstructure integrity in perinatally HIV-infected (PHIV) youths receiving cART compared to age- and gender-matched healthy youths through DTI metrics using voxel-based morphometry (VBM). We investigated 14 perinatally HIV-infected patients (age 17.9 ± 2.5 years) on cART and 17 healthy youths (HC) (age 18.0 ± 3.0 years) using a 3T MRI scanner. Four DTI-derived metrics were fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD). Statistical analysis was done with voxel-based analysis of covariance (ANCOVA), with age and gender as covariates. Region-of-interest secondary analyses in statistically significant regions were also performed. Regional increases in FA in the PHIV youths were found in left middle frontal gyrus, right precuneus, right lingual gyrus, and left supramarginal gyrus. Increased MD was found in the right precentral gyrus while decreased MD was found in the white matter of the right superior parietal lobule and right inferior temporal gyrus/fusiform gyrus. Regions of increased/decreased RD overlapped with regions of increased/decreased MD. Both increased and decreased AD were found in three to four regions respectively. The regional FA, MD, RD, and AD values were consistent with the voxel-based analysis findings. The findings are mostly consistent with previous literature, but increased FA has not been previously reported for perinatally HIV-infected youths. Potentially early and prolonged therapy in our population may have contributed to this new finding. Both toxicity of antiretroviral therapy and indolent infection must be considered as causative factors in the DTI metric changes that we have observed.


Brain Human immunodeficiency virus (HIV) Combination anti-retroviral therapy (cART) Diffusion tensor imaging (DTI) Fractional anisotropy (FA) Mean diffusivity (MD) Radial diffusivity (RD) Axial diffusivity (AD) Voxel-based morphometry (VBM) 



We also acknowledge the scientific support of Dr. Rajakumar Nagarajan.

Funding information

This research was supported by research grants from the National Institute of Neurological Disorders and Stroke (NINDS) 1R21NS08064901A1, 1R21NS09095601A1, and 1R21NS06062001A1.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Journal of NeuroVirology, Inc. 2019

Authors and Affiliations

  • Manoj K. Sarma
    • 1
  • Margaret A. Keller
    • 2
    • 3
  • Paul M. Macey
    • 4
    • 5
  • David E. Michalik
    • 6
  • Judy Hayes
    • 2
  • Karin Nielsen-Saines
    • 7
  • Jaime Deville
    • 7
  • Joseph A. Church
    • 8
  • Irwin Walot
    • 9
  • M. Albert Thomas
    • 1
    Email author return OK on get
  1. 1.Radiological Sciences, David Geffen School of MedicineUCLALos AngelesUSA
  2. 2.Pediatrics, Los Angeles County Harbor-UCLA Medical CenterTorranceUSA
  3. 3.Los Angeles Biomedical Research Institute at Harbor-UCLA Medical CenterTorranceUSA
  4. 4.Brain Research InstituteUCLA School of MedicineLos AngelesUSA
  5. 5.UCLA School of NursingLos AngelesUSA
  6. 6.Infectious Diseases-PediatricsMiller Children’s Hospital of Long BeachLong BeachUSA
  7. 7.Pediatrics, David Geffen School of MedicineUCLALos AngelesUSA
  8. 8.Pediatrics, Keck School of Medicine, Children’s Hospital Los AngelesUniversity of Southern CaliforniaLos AngelesUSA
  9. 9.Radiology, Los Angeles County Harbor-UCLA Medical CenterTorranceUSA

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