Journal of the International Neuropsychological Society

Table of Contents - July 2012 - Volume 18, Issue 04  

Research Articles

Effects of HIV and Early Life Stress on Amygdala Morphometry and Neurocognitive Function

Uraina S. Clarka1a2a3 c1, Ronald A. Cohena1a2, Lawrence H. Sweeta1a4, Assawin Gongvatanaa1a2, Kathryn N. Devlina2, George N. Hanaa2, Michelle L. Westbrooka2a5, Richard C. Mulligana1a4, Beth A. Jerskeya1a4, Tara L. Whitea3, Bradford Naviaa6 and Karen T. Tashimaa5a7

a1 Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, Rhode Island

a2 Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island

a3 Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, Rhode Island

a4 Neuroimaging Center, Butler Hospital, Providence, Rhode Island

a5 Center for AIDS Research, The Miriam Hospital, Providence, Rhode Island

a6 Tufts University School of Medicine, Boston, Massachusetts

a7 Department of Medicine, The Warren Alpert Medical School of Brown University, Providence, Rhode Island

Abstract

Both HIV infection and high levels of early life stress (ELS) have been related to abnormalities in frontal-subcortical structures, yet the combined effects of HIV and ELS on brain structure and function have not been previously investigated. In this study we assessed 49 non-demented HIV-seropositive (HIV+) and 47 age-matched HIV-seronegative healthy control (HC) adults. Levels of ELS exposure were quantified and used to define four HIV-ELS groups: HC Low-ELS (N = 20); HC High-ELS (N = 27); HIV+ Low-ELS (N = 24); HIV+ High-ELS (N = 25). An automated segmentation tool measured volumes of brain structures known to show HIV-related or ELS-related effects; a brief neurocognitive battery was administered. A significant HIV-ELS interaction was observed for amygdala volumes, which was driven by enlargements in HIV+ High-ELS participants. The HIV+ High-ELS group also demonstrated significant reductions in psychomotor/processing speed compared with HC Low-ELS. Regression analyses in the HIV+ group revealed that amygdala enlargements were associated with higher ELS, lower nadir CD4 counts, and reduced psychomotor/processing speed. Our results suggest that HIV infection and high ELS interact to increase amygdala volume, which is associated with neurocognitive dysfunction in HIV+ patients. These findings highlight the lasting neuropathological influence of ELS and suggest that high ELS may be a significant risk factor for neurocognitive impairment in HIV-infected individuals. (JINS, 2012, 19, 1–12)

(Received January 04 2012)

(Revised March 06 2012)

(Accepted March 07 2012)

Keywords

Correspondence:

c1 Correspondence and reprint requests to: Uraina S. Clark, Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Box G-S121-4, Brown University, Providence, RI 02912. E-mail: uraina_clark@brown.edu

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