Korean J Radiol.  2018 Jun;19(3):431-442. 10.3348/kjr.2018.19.3.431.

Altered White Matter Integrity in Human Immunodeficiency Virus-Associated Neurocognitive Disorder: A Tract-Based Spatial Statistics Study

  • 1Department of Radiology, Soonchunhyang University Cheonan Hospital, Cheonan 31151, Korea.
  • 2Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea. nyshin@catholic.ac.kr
  • 3Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul 03722, Korea.
  • 4Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul 03722, Korea.


Human immunodeficiency virus (HIV) infection has been known to damage the microstructural integrity of white matter (WM). However, only a few studies have assessed the brain regions in HIV-associated neurocognitive disorders (HAND) with diffusion tensor imaging (DTI). Therefore, we sought to compare the DTI data between HIV patients with and without HAND using tract-based spatial statistics (TBSS).
Twenty-two HIV-infected patients (10 with HAND and 12 without HAND) and 11 healthy controls (HC) were enrolled in this study. A whole-brain analysis of fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity was performed with TBSS and a subsequent 20 tract-specific region-of-interest (ROI)-based analysis to localize and compare altered WM integrity in all group contrasts.
Compared with HC, patients with HAND showed decreased FA in the right frontoparietal WM including the upper corticospinal tract (CST) and increased MD and RD in the bilateral frontoparietal WM, corpus callosum, bilateral CSTs and bilateral cerebellar peduncles. The DTI values did not significantly differ between HIV patients with and without HAND or between HIV patients without HAND and HC. In the ROI-based analysis, decreased FA was observed in the right superior longitudinal fasciculus and was significantly correlated with decreased information processing speed, memory, executive function, and fine motor function in HIV patients.
These results suggest that altered integrity of the frontoparietal WM contributes to cognitive dysfunction in HIV patients.


Human immunodeficiency virus; HIV; HIV-associated neurocognitive disorders (HAND); Diffusion tensor imaging; TBSS
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