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 Thomas

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)313-323
Number of pages11
JournalJournal of NeuroVirology
Issue number3
StatePublished - Jun 15 2019
Externally publishedYes


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

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Cellular and Molecular Neuroscience
  • Virology


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