Increased brain-predicted aging in treated HIV disease

• Published in: Neurology Vol. 88; no. 14; pp. 1349 - 1357
• Main Authors: Cole, James H, Underwood, Jonathan, Caan, Matthan W.A, De Francesco, Davide, van Zoest, Rosan A, Leech, Robert, Wit, Ferdinand W.N.M, Portegies, Peter, Geurtsen, Gert J, Schmand, Ben A, Schim van der Loeff, Maarten F, Franceschi, Claudio, Sabin, Caroline A, Majoie, Charles B.L.M, Winston, Alan, Reiss, Peter, Sharp, David J
• Format: Journal Article
• Language: English
• Published: United States American Academy of Neurology 04-04-2017; Lippincott Williams & Wilkins
• Subjects: Aging; Brain - diagnostic imaging; Brain - pathology; Brain - virology; Cognition Disorders - etiology; Female; HIV - genetics; HIV Infections - blood; HIV Infections - complications; HIV Infections - diagnostic imaging; Humans; Imaging, Three-Dimensional; Male; Middle Aged; Neuroimaging; Neuropsychological Tests; Predictive Value of Tests; RNA - isolation & purification
• ISSN: 0028-3878; 1526-632X
• DOI: 10.1212/WNL.0000000000003790

OBJECTIVE:To establish whether HIV disease is associated with abnormal levels of age-related brain atrophy, by estimating apparent brain age using neuroimaging and exploring whether these estimates related to HIV status, age, cognitive performance, and HIV-related clinical parameters.
METHODS:A large sample of virologically suppressed HIV-positive adults (n = 162, age 45–82 years) and highly comparable HIV-negative controls (n = 105) were recruited as part of the Comorbidity in Relation to AIDS (COBRA) collaboration. Using T1-weighted MRI scans, a machine-learning model of healthy brain aging was defined in an independent cohort (n = 2,001, aged 18–90 years). Neuroimaging data from HIV-positive and HIV-negative individuals were then used to estimate brain-predicted age; then brain-predicted age difference (brain-PAD = brain-predicted brain age − chronological age) scores were calculated. Neuropsychological and clinical assessments were also carried out.
RESULTS:HIV-positive individuals had greater brain-PAD score (mean ± SD 2.15 ± 7.79 years) compared to HIV-negative individuals (−0.87 ± 8.40 years; b = 3.48, p < 0.01). Increased brain-PAD score was associated with decreased performance in multiple cognitive domains (information processing speed, executive function, memory) and general cognitive performance across all participants. Brain-PAD score was not associated with age, duration of HIV infection, or other HIV-related measures.
CONCLUSION:Increased apparent brain aging, predicted using neuroimaging, was observed in HIV-positive adults, despite effective viral suppression. Furthermore, the magnitude of increased apparent brain aging related to cognitive deficits. However, predicted brain age difference did not correlate with chronological age or duration of HIV infection, suggesting that HIV disease may accentuate rather than accelerate brain aging.This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND), which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.