HIV-associated distal neuropathic pain is associated with smaller total cerebral cortical gray matter.

TitleHIV-associated distal neuropathic pain is associated with smaller total cerebral cortical gray matter.
Publication TypeJournal Article
Year of Publication2014
AuthorsKeltner, JR, Fennema-Notestine, C, Vaida, F, Wang, D, Franklin, DR, Dworkin, RH, Sanders, C, J McCutchan, A, Archibald, SL, Miller, DJ, Kesidis, G, Cushman, C, Kim, SMin, Abramson, I, Taylor, MJ, Theilmann, RJ, Julaton, MD, Notestine, RJ, Corkran, S, Cherner, M, Duarte, NA, Alexander, T, Robinson-Papp, J, Gelman, BB, Simpson, DM, Collier, AC, Marra, CM, Morgello, S, Brown, G, Grant, I, J Atkinson, H, Jernigan, TL, Ellis, RJ
Corporate AuthorsCHARTER Group
JournalJ Neurovirol
Volume20
Issue3
Pagination209-18
Date Published2014 Jun
ISSN1538-2443
KeywordsAdult, AIDS Dementia Complex, Anti-Retroviral Agents, Brain Injuries, Cerebral Cortex, Cognition Disorders, Confounding Factors (Epidemiology), Cross-Sectional Studies, Female, Gray Matter, Humans, Magnetic Resonance Imaging, Male, Mental Disorders, Middle Aged, Neuralgia, Prevalence, Risk Factors, Substance-Related Disorders
Abstract

Despite modern antiretroviral therapy, HIV-associated sensory neuropathy affects over 50 % of HIV patients. The clinical expression of HIV neuropathy is highly variable: many individuals report few symptoms, but about half report distal neuropathic pain (DNP), making it one of the most prevalent, disabling, and treatment-resistant complications of HIV disease. The presence and intensity of pain is not fully explained by the degree of peripheral nerve damage, making it unclear why some patients do, and others do not, report pain. To better understand central nervous system contributions to HIV DNP, we performed a cross-sectional analysis of structural magnetic resonance imaging volumes in 241 HIV-infected participants from an observational multi-site cohort study at five US sites (CNS HIV Anti-Retroviral Treatment Effects Research Study, CHARTER). The association between DNP and the structural imaging outcomes was investigated using both linear and nonlinear (Gaussian Kernel support vector) multivariable regression, controlling for key demographic and clinical variables. Severity of DNP symptoms was correlated with smaller total cerebral cortical gray matter volume (r = -0.24; p = 0.004). Understanding the mechanisms for this association between smaller total cortical volumes and DNP may provide insight into HIV DNP chronicity and treatment-resistance.

DOI10.1007/s13365-014-0236-8
Alternate JournalJ. Neurovirol.
PubMed ID24549970
PubMed Central IDPMC4040150
Grant ListHHSN271201000027C / / PHS HHS / United States
HHSN271201000030C / MH / NIMH NIH HHS / United States
HHSN271201000036C / MH / NIMH NIH HHS / United States
K23 NS079311 / NS / NINDS NIH HHS / United States
N01 MH22005 / MH / NIMH NIH HHS / United States
P30 MH062512 / MH / NIMH NIH HHS / United States
P30MH0625 / MH / NIMH NIH HHS / United States
R01 MH079752 / MH / NIMH NIH HHS / United States
R25-MH081482 / MH / NIMH NIH HHS / United States