Gray matter volumes discriminate cognitively impaired and unimpaired people with HIV
Background: Current diagnostic criteria of HIV-associated neurocognitive disorders (HAND) rely on neuropsychological assessments. The aim of this study was to evaluate if gray matter volumes (GMV) can distinguish people with HAND, neurocognitively unimpaired people with HIV (unimpaired PWH), and uni...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-01-01
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| Series: | NeuroImage: Clinical |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213158221002199 |
| _version_ | 1818367842884517888 |
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| author | Mikki Schantell Brittany K. Taylor Brandon J. Lew Jennifer L. O'Neill Pamela E. May Susan Swindells Tony W. Wilson |
| author_facet | Mikki Schantell Brittany K. Taylor Brandon J. Lew Jennifer L. O'Neill Pamela E. May Susan Swindells Tony W. Wilson |
| author_sort | Mikki Schantell |
| collection | DOAJ |
| description | Background: Current diagnostic criteria of HIV-associated neurocognitive disorders (HAND) rely on neuropsychological assessments. The aim of this study was to evaluate if gray matter volumes (GMV) can distinguish people with HAND, neurocognitively unimpaired people with HIV (unimpaired PWH), and uninfected controls using linear discriminant analyses. Methods: A total of 231 participants, including 110 PWH and 121 uninfected controls, completed a neuropsychological assessment and an MRI protocol. Among PWH, HAND (n = 48) and unimpaired PWH (n = 62) designations were determined using the widely accepted Frascati criteria. We then assessed the extent to which GMV, corrected for intracranial volume, could accurately distinguish the three groups using linear discriminant analysis. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, area under the curve (AUC), and accuracy were computed for each model using the classification results based on GMV compared to the neuropsychological assessment. Results: The best performing model was comprised of bilaterally combined GMV and was stratified by sex. Among males, sensitivity was 85.2% (95% CI: 66.3%–95.8%), specificity was 97.0% (95% CI: 91.6%-99.4%), and the AUC was 0.91 (95% CI: 0.83–0.99). Among females, sensitivity was 100.0% (95% CI: 83.9%–100.0%), specificity was 98.8% (95% CI: 93.4%-100.0%), and the AUC was 0.99 (95% CI: 0.98–1.00). Conclusions: GMV accurately discriminated HAND from unimpaired PWH and controls. Measures of GMV may be highly sensitive to HAND, and revisions to the Frascati criteria should consider including GMV in conjunction with a neuropsychological assessment to diagnose HAND. |
| first_indexed | 2024-12-13T22:58:29Z |
| format | Article |
| id | doaj.art-a81dc75139cc448bac5de605b89e29c9 |
| institution | Directory Open Access Journal |
| issn | 2213-1582 |
| language | English |
| last_indexed | 2024-12-13T22:58:29Z |
| publishDate | 2021-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | NeuroImage: Clinical |
| spelling | doaj.art-a81dc75139cc448bac5de605b89e29c92022-12-21T23:28:27ZengElsevierNeuroImage: Clinical2213-15822021-01-0131102775Gray matter volumes discriminate cognitively impaired and unimpaired people with HIVMikki Schantell0Brittany K. Taylor1Brandon J. Lew2Jennifer L. O'Neill3Pamela E. May4Susan Swindells5Tony W. Wilson6Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA; College of Medicine, University of Nebraska Medical Center (UNMC), Omaha, NE, USAInstitute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USAInstitute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA; College of Medicine, University of Nebraska Medical Center (UNMC), Omaha, NE, USADepartment of Internal Medicine, Division of Infectious Diseases, UNMC, Omaha, NE, USADepartment of Neurological Sciences, UNMC, Omaha, NE, USADepartment of Internal Medicine, Division of Infectious Diseases, UNMC, Omaha, NE, USAInstitute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA; College of Medicine, University of Nebraska Medical Center (UNMC), Omaha, NE, USA; Corresponding author at: Institute for Human Neuroscience, 378 Bucher Cir, Boys Town, NE 68010, United States.Background: Current diagnostic criteria of HIV-associated neurocognitive disorders (HAND) rely on neuropsychological assessments. The aim of this study was to evaluate if gray matter volumes (GMV) can distinguish people with HAND, neurocognitively unimpaired people with HIV (unimpaired PWH), and uninfected controls using linear discriminant analyses. Methods: A total of 231 participants, including 110 PWH and 121 uninfected controls, completed a neuropsychological assessment and an MRI protocol. Among PWH, HAND (n = 48) and unimpaired PWH (n = 62) designations were determined using the widely accepted Frascati criteria. We then assessed the extent to which GMV, corrected for intracranial volume, could accurately distinguish the three groups using linear discriminant analysis. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, area under the curve (AUC), and accuracy were computed for each model using the classification results based on GMV compared to the neuropsychological assessment. Results: The best performing model was comprised of bilaterally combined GMV and was stratified by sex. Among males, sensitivity was 85.2% (95% CI: 66.3%–95.8%), specificity was 97.0% (95% CI: 91.6%-99.4%), and the AUC was 0.91 (95% CI: 0.83–0.99). Among females, sensitivity was 100.0% (95% CI: 83.9%–100.0%), specificity was 98.8% (95% CI: 93.4%-100.0%), and the AUC was 0.99 (95% CI: 0.98–1.00). Conclusions: GMV accurately discriminated HAND from unimpaired PWH and controls. Measures of GMV may be highly sensitive to HAND, and revisions to the Frascati criteria should consider including GMV in conjunction with a neuropsychological assessment to diagnose HAND.http://www.sciencedirect.com/science/article/pii/S2213158221002199neuroHIVHANDClassificationSex differencesStructural MRI |
| spellingShingle | Mikki Schantell Brittany K. Taylor Brandon J. Lew Jennifer L. O'Neill Pamela E. May Susan Swindells Tony W. Wilson Gray matter volumes discriminate cognitively impaired and unimpaired people with HIV NeuroImage: Clinical neuroHIV HAND Classification Sex differences Structural MRI |
| title | Gray matter volumes discriminate cognitively impaired and unimpaired people with HIV |
| title_full | Gray matter volumes discriminate cognitively impaired and unimpaired people with HIV |
| title_fullStr | Gray matter volumes discriminate cognitively impaired and unimpaired people with HIV |
| title_full_unstemmed | Gray matter volumes discriminate cognitively impaired and unimpaired people with HIV |
| title_short | Gray matter volumes discriminate cognitively impaired and unimpaired people with HIV |
| title_sort | gray matter volumes discriminate cognitively impaired and unimpaired people with hiv |
| topic | neuroHIV HAND Classification Sex differences Structural MRI |
| url | http://www.sciencedirect.com/science/article/pii/S2213158221002199 |
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