Brain Microstructural Changes Support Cognitive Deficits in Normal Children Born to HIVinfected Mothers

Abstract

Synopsis In the current study, we evaluated the brain integrity [by mapping the fractional anisotropy (FA) and mean diffusivity (MD)] and neurocognitive performance (NP) in normal children (NCI) born to HIV-infected mother compared to normal children (NCH) born to healthy mother and HIV-infected children (HI). Reduced FA in multiple brain sites of HI and NCI children suggests loss of tissue integrity while altered MD indicates presence of cerebral edema. Presence of tissue changes and abnormal cognition in absence of HIV-infection in NCI children advice that ART may have detrimental effects on brain. Introduction: Perinatal HIV infection is a growing problem worldwide. The early inception of antiretrovirals therapy (ART) helps to improve clinical, immunological, and developmental outcomes[1-3]. Because of the reported neurotoxic effect of ART few studies evaluated the brain changes and neurocognitive performance in normal children (NCI) born to HIV-infected mother underwent ART[4,5]. They observed significant brain changes and neurocognitive deficits in NCI compared to the children born (NCH) to healthy mother. So far, there is no comprehensive study investigating the white matter and gray matter changes in association with the neurocognitive performance (NP) in NCI subjects. In the current study, we assessed the brain’s microstructural tissue integrity using diffusion-tensor-imaging (DTI), and NP in NCI children compared to NCH and HIV-infected children (HI).