Cocaine dependence does not contribute substantially to white matter abnormalities in HIV infection.

Abstract

This study investigated the association of HIV infection and cocaine dependence with cerebral white matter integrity using diffusion tensor imaging (DTI). One hundred thirty-five participants stratified by HIV and cocaine status (26 HIV+/COC+, 37 HIV+/COC-, 37 HIV-/COC+, and 35 HIV-/COC-) completed a comprehensive substance abuse assessment, neuropsychological testing, and MRI with DTI. Among HIV+ participants, all were receiving HIV care and 46% had an AIDS diagnosis. All COC+ participants were current users and met criteria for cocaine use disorder. We used tract-based spatial statistics (TBSS) to assess the relation of HIV and cocaine to fractional anisotropy (FA) and mean diffusivity (MD). In whole-brain analyses, HIV+ participants had significantly reduced FA and increased MD compared to HIV- participants. The relation of HIV and FA was widespread throughout the brain, whereas the HIV-related MD effects were restricted to the corpus callosum and thalamus. There were no significant cocaine or HIV-by-cocaine effects. These DTI metrics correlated significantly with duration of HIV disease, nadir CD4+ cell count, and AIDS diagnosis, as well as some measures of neuropsychological functioning. These results suggest that HIV is related to white matter integrity throughout the brain, and that HIV-related effects are more pronounced with increasing duration of infection and greater immune compromise. We found no evidence for independent effects of cocaine dependence on white matter integrity, and cocaine dependence did not appear to exacerbate the effects of HIV.

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Citation

Published Version (Please cite this version)

10.1007/s13365-017-0512-5

Publication Info

Cordero, Daniella M, Sheri L Towe, Nan-Kuei Chen, Kevin R Robertson, David J Madden, Scott A Huettel and Christina S Meade (2017). Cocaine dependence does not contribute substantially to white matter abnormalities in HIV infection. Journal of neurovirology, 23(3). pp. 441–450. 10.1007/s13365-017-0512-5 Retrieved from https://hdl.handle.net/10161/22532.

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Scholars@Duke

Madden

David Joseph Madden

Professor in Psychiatry and Behavioral Sciences

My research focuses primarily on the cognitive neuroscience of aging: the investigation of age-related changes in perception, attention, and memory, using both behavioral measures and neuroimaging techniques, including positron emission tomography (PET), functional magnetic resonance imaging (fMRI), and diffusion tensor imaging (DTI).

The behavioral measures have focused on reaction time, with the goal of distinguishing age-related changes in specific cognitive abilities from more general effects arising from a slowing in elementary perceptual processes. The cognitive abilities of interest include selective attention as measured in visual search tasks, semantic and episodic memory retrieval, and executive control processes.

The behavioral measures are necessary to define the cognitive abilities of interest, and the neuroimaging techniques help define the functional neuroanatomy of those abilities. The PET and fMRI measures provide information regarding neural activity during cognitive performance. DTI is a recently developed technique that images the structural integrity of white matter. The white matter tracts of the brain provide critical pathways linking the gray matter regions, and thus this work will complement the studies using PET and fMRI that focus on gray matter activation.

A current focus of the research program is the functional connectivity among regions, not only during cognitive task performance but also during rest. These latter measures, referred to as intrinsic functional connectivity, are beginning to show promise as an index of overall brain functional efficiency, which can be assessed without the implementation of a specific cognitive task. From DTI, information can be obtained regarding how anatomical connectivity constrains intrinsic functional connectivity. It will be important to determine the relative influence of white matter pathway integrity, intrinsic functional connectivity, and task-related functional connectivity, as mediators of age-related differences in behavioral measures of cognitive performance.

Ultimately, the research program can help link age-related changes in cognitive performance to changes in the structure and function of specific neural systems. The results also have implications for clinical translation, in terms of the identification of neural biomarkers for the diagnosis of neural pathology and targeting rehabilitation procedures.

Huettel

Scott Huettel

Professor in the Department of Psychology and Neuroscience

Research in my laboratory investigates the brain mechanisms underlying economic and social decision making; collectively, this research falls into the field of “decision neuroscience” or "neuroeconomics". My laboratory uses fMRI to probe brain function, behavioral assays to characterize individual differences, and other physiological methods (e.g., eye tracking, pharmacological manipulation, genetics) to link brain and behavior. Concurrent with research on basic processes, my laboratory has also investigated the application of new analysis methods for fMRI data, including functional connectivity analyses, pattern classification analyses, and combinatoric multivariate approaches. We have also been applying computational methods to problems in behavioral economics and consumer decision making.  

I have also been very active in outreach, mentorship, and educational activities; as examples, I am lead author on the textbook Functional Magnetic Resonance Imaging (Sinauer Associates; 3rd edition in 2014), I teach Fundamentals of Decision Science, Decision Neuroscience and Neuroethics, and many of my postdoctoral and graduate trainees now lead research laboratories of their own.

Meade

Christina S. Meade

Visiting Associate Prof of Psychology & Neuroscience

Dr. Meade’s domestic research program focuses on predictors of HIV risk behavior in adults with substance use and psychiatric disorders, and the relationship between neuropsychiatric conditions and continued risk behavior in HIV-positive adults. She is particularly interested in how drug addiction and HIV infection impact executive functions, such as decision making, that lead individuals to engage in risky behaviors. Many of her current projects incorporate MRI to isolate the effects of addiction and HIV on both brain function and structure. Dr. Meade is also interested in the development of evidence-based treatments to improve cognitive functioning and reduce risk behaviors among drug users.

Given that most people infected or affected by HIV/AIDS live in Sub-Saharan Africa, Dr. Meade’s international research program is based in South Africa. The Western Cape has experienced a dramatic increase in methamphetamine use since the early 2000s, and there is concern that it may further fuel the HIV epidemic in this country. Current projects focus on characterizing drug addiction and HIV risk behaviors in this understudied group, both in in community and treatment settings, and ultimately increasing uptake of HIV services to improve health outcomes and reduce the continued spread of HIV.


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