Regional brain gray and white matter changes in perinatally HIV-Infected adolescents

Manoj K. Sarma, Rajakumar Nagarajan, Margaret A. Keller, Rajesh Kumar, Karin Nielsen-Saines, David E. Michalik, Jaime Deville, Joseph A. Church, M. Albert Thomas

Research output: Contribution to journalArticlepeer-review

53 Scopus citations


Despite the success of antiretroviral therapy (ART), perinatally infected HIV remains a major health problem worldwide. Although advance neuroimaging studies have investigated structural brain changes in HIV-infected adults, regional gray matter (GM) and white matter (WM) volume changes have not been reported in perinatally HIV-infected adolescents and young adults. In this cross-sectional study, we investigated regional GM and WM changes in 16 HIV-infected youths receiving ART age 17.0 ± 2.9 years compared with age-matched 14 healthy controls (age 16.3 ± 2.3 years) using magnetic resonance imaging (MRI)-based high-resolution T1-weighted images with voxel based morphometry (VBM) analyses. White matter atrophy appeared in perinatally HIV-infected youths in brain areas including the bilateral posterior corpus callosum (CC), bilateral external capsule, bilateral ventral temporal WM, mid cerebral peduncles, and basal pons over controls. Gray matter volume increase was observed in HIV-infected youths for several regions including the left superior frontal gyrus, inferior occipital gyrus, gyrus rectus, right mid cingulum, parahippocampal gyrus, bilateral inferior temporal gyrus, and middle temporal gyrus compared with controls. Global WM and GM volumes did not differ significantly between groups. These results indicate WM injury in perinatally HIV-infected youths, but the interpretation of the GM results, which appeared as increased regional volumes, is not clear. Further longitudinal studies are needed to clarify if our results represent active ongoing brain infection or toxicity from HIV treatment resulting in neuronal cell swelling and regional increased GM volume. Our findings suggest that assessment of regional GM and WM volume changes, based on VBM procedures, may be an additional measure to assess brain integrity in HIV-infected youths and to evaluate success of current ART therapy for efficacy in the brain.Highlights First time investigation of gray-white matter changes in HIV-infected youthsBrain white matter atrophy observed in the HIV-infected youthsSignificantly increased gray matter volume emerged in several regions.Pilot findings indicate white matter injury in perinatally HIV-infected youths. Abbreviations*ART*antiretroviral therapy*MRI*magnetic resonance imaging*VBM*voxel based morphometry*GM*gray matter*WM*white matter* SPM*statistical parametric mapping*CSF*cerebrospinal fluid*WMV*white matter volume*GMV*gray matter volume.

Original languageEnglish (US)
Pages (from-to)29-34
Number of pages6
JournalNeuroImage: Clinical
StatePublished - 2014
Externally publishedYes


  • Antiretroviral therapy
  • Gray matter
  • HIV
  • Statistical parametric mapping
  • Voxel based morphometry
  • White matter

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Neurology
  • Clinical Neurology
  • Cognitive Neuroscience


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