Cocaine use is associated with cerebral white matter hyperintensities in HIV disease
Abstract Background White matter hyperintensities (WMH), a marker of cerebral small vessel disease and predictor of cognitive decline, are observed at higher rates in persons with HIV (PWH). The use of cocaine, a potent central nervous system stimulant, is disproportionately common in PWH and may co...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-09-01
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| Series: | Annals of Clinical and Translational Neurology |
| Online Access: | https://doi.org/10.1002/acn3.51854 |
| _version_ | 1797685045925773312 |
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| author | Christina S. Meade Ryan P. Bell Sheri L. Towe Christopher D. Lascola Kareem Al‐Khalil Matthew J. Gibson |
| author_facet | Christina S. Meade Ryan P. Bell Sheri L. Towe Christopher D. Lascola Kareem Al‐Khalil Matthew J. Gibson |
| author_sort | Christina S. Meade |
| collection | DOAJ |
| description | Abstract Background White matter hyperintensities (WMH), a marker of cerebral small vessel disease and predictor of cognitive decline, are observed at higher rates in persons with HIV (PWH). The use of cocaine, a potent central nervous system stimulant, is disproportionately common in PWH and may contribute to WMH. Methods The sample included of 110 PWH on antiretroviral therapy. Fluid‐attenuated inversion recovery (FLAIR) and T1‐weighted anatomical MRI scans were collected, along with neuropsychological testing. FLAIR images were processed using the Lesion Segmentation Toolbox. A hierarchical regression model was run to investigate predictors of WMH burden [block 1: demographics; block 2: cerebrovascular disease (CVD) risk; block 3: lesion burden]. Results The sample was 20% female and 79% African American with a mean age of 45.37. All participants had persistent HIV viral suppression, and the median CD4+ T‐cell count was 750. Nearly a third (29%) currently used cocaine regularly, with an average of 23.75 (SD = 20.95) days in the past 90. In the hierarchical linear regression model, cocaine use was a significant predictor of WMH burden (β = .28). WMH burden was significantly correlated with poorer cognitive function (r = −0.27). Finally, higher WMH burden was significantly associated with increased serum concentrations of interferon‐γ‐inducible protein 10 (IP‐10) but lower concentrations of myeloperoxidase (MPO); however, these markers did not differ by COC status. Conclusions WMH burden is associated with poorer cognitive performance in PWH. Cocaine use and CVD risk independently contribute to WMH, and addressing these conditions as part of HIV care may mitigate brain injury underlying neurocognitive impairment. |
| first_indexed | 2024-03-12T00:39:42Z |
| format | Article |
| id | doaj.art-e888f13f7c7b4e1cb11bb26d4f623694 |
| institution | Directory Open Access Journal |
| issn | 2328-9503 |
| language | English |
| last_indexed | 2024-03-12T00:39:42Z |
| publishDate | 2023-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Clinical and Translational Neurology |
| spelling | doaj.art-e888f13f7c7b4e1cb11bb26d4f6236942023-09-15T09:08:30ZengWileyAnnals of Clinical and Translational Neurology2328-95032023-09-011091633164610.1002/acn3.51854Cocaine use is associated with cerebral white matter hyperintensities in HIV diseaseChristina S. Meade0Ryan P. Bell1Sheri L. Towe2Christopher D. Lascola3Kareem Al‐Khalil4Matthew J. Gibson5Department of Psychiatry and Behavioral Sciences Duke University School of Medicine Durham North Carolina 27710 USADepartment of Psychiatry and Behavioral Sciences Duke University School of Medicine Durham North Carolina 27710 USADepartment of Psychiatry and Behavioral Sciences Duke University School of Medicine Durham North Carolina 27710 USABrain Imaging and Analysis Center Duke University Medical Center Durham North Carolina 27710 USADepartment of Psychiatry and Behavioral Sciences Duke University School of Medicine Durham North Carolina 27710 USADepartment of Psychiatry and Behavioral Sciences Duke University School of Medicine Durham North Carolina 27710 USAAbstract Background White matter hyperintensities (WMH), a marker of cerebral small vessel disease and predictor of cognitive decline, are observed at higher rates in persons with HIV (PWH). The use of cocaine, a potent central nervous system stimulant, is disproportionately common in PWH and may contribute to WMH. Methods The sample included of 110 PWH on antiretroviral therapy. Fluid‐attenuated inversion recovery (FLAIR) and T1‐weighted anatomical MRI scans were collected, along with neuropsychological testing. FLAIR images were processed using the Lesion Segmentation Toolbox. A hierarchical regression model was run to investigate predictors of WMH burden [block 1: demographics; block 2: cerebrovascular disease (CVD) risk; block 3: lesion burden]. Results The sample was 20% female and 79% African American with a mean age of 45.37. All participants had persistent HIV viral suppression, and the median CD4+ T‐cell count was 750. Nearly a third (29%) currently used cocaine regularly, with an average of 23.75 (SD = 20.95) days in the past 90. In the hierarchical linear regression model, cocaine use was a significant predictor of WMH burden (β = .28). WMH burden was significantly correlated with poorer cognitive function (r = −0.27). Finally, higher WMH burden was significantly associated with increased serum concentrations of interferon‐γ‐inducible protein 10 (IP‐10) but lower concentrations of myeloperoxidase (MPO); however, these markers did not differ by COC status. Conclusions WMH burden is associated with poorer cognitive performance in PWH. Cocaine use and CVD risk independently contribute to WMH, and addressing these conditions as part of HIV care may mitigate brain injury underlying neurocognitive impairment.https://doi.org/10.1002/acn3.51854 |
| spellingShingle | Christina S. Meade Ryan P. Bell Sheri L. Towe Christopher D. Lascola Kareem Al‐Khalil Matthew J. Gibson Cocaine use is associated with cerebral white matter hyperintensities in HIV disease Annals of Clinical and Translational Neurology |
| title | Cocaine use is associated with cerebral white matter hyperintensities in HIV disease |
| title_full | Cocaine use is associated with cerebral white matter hyperintensities in HIV disease |
| title_fullStr | Cocaine use is associated with cerebral white matter hyperintensities in HIV disease |
| title_full_unstemmed | Cocaine use is associated with cerebral white matter hyperintensities in HIV disease |
| title_short | Cocaine use is associated with cerebral white matter hyperintensities in HIV disease |
| title_sort | cocaine use is associated with cerebral white matter hyperintensities in hiv disease |
| url | https://doi.org/10.1002/acn3.51854 |
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