Functional Imaging Reserve in NeuroHIV

Functional Imaging Reserve in NeuroHIV

The purpose of this research study is to look at the brain's efficiency and ability to make up for deficits in the front of the brain to see if people living with HIV (PLWH) are still able to perform well on various cognitive tasks even though there are other underlying processes at work, like inflammation, that affect the brain in a negative way. Results of this study may provide insight into the pathophysiology of disease and may reveal arenas for future possible interventions in PLWH who have impaired neuropsychological performance.

This proposal systematically characterizes brain efficiency and recruitment in virologically suppressed persons living with HIV (PLWH) and demographically similar HIV uninfected (HIV-) controls. This proposal collects advanced functional neuroimaging that provide critical information about cerebral blood flow (CBF) and brain connectivity (functional connectivity strength; FCS); quantitative measures of immune dysfunction in the blood and cerebrospinal fluid (CSF) (immune activation and immune exhaustion); and neuropsychological performance testing. This overall goal of this proposal is to delineate the interplay between dysfunction in frontal networks and recruitment of compensatory networks that underlie the neuropsychiatric symptoms seen in PLWH.

Inclusion Criteria:

• 20 to 80 years old
• documented HIV infection for at least 1 year or confirmed HIV - status
• PLWH must be on stable cART regimen for at least 12 months with undetectable plasma HIV RNA (less than 50 copies per mL)
• at least 9 years of education
• able to provide informed consent
• if female, a negative pregnancy test and not breast feeding
• able to undergo an MRI scan

Exclusion Criteria:

• significant neurological disorders (e.g. stroke, head injury with loss of consciousness for more than 5 minutes, developmental learning disability)
• active uncontrolled Axis I psychiatric disorder according to the DSM 5
• current or history of substance use disorder (including, but not limited to amphetamines, cocaine, alcohol, opiates, and barbiturates)
• prescribed blood thinners
• allergic to lidocaine or similar anesthetic
• history of any bleeding disorder
• contraindication to MRI scanning (e.g. claustrophobia, pacemaker, etc.)
• pregnant or breastfeeding