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Changes in functional connectivity in people with HIV switching antiretroviral therapy.
J Neurovirol. 2020 Jun 04 [Online ahead of print]JN

Abstract

We assessed changes in functional connectivity by fMRI (functional magnetic resonance imaging) and cognitive measures in otherwise neurologically asymptomatic people with HIV (PWH) switching combination antiretroviral therapy (cART). In a prospective study (baseline and follow-up after at least 4 months), virologically suppressed PWH switched non-nuclease reverse-transcriptase inhibitors (NNRTI; tenofovir-DF/emtricitabine with efavirenz to rilpivirine) and integrase-strand-transfer inhibitors (INSTI; tenofovir-DF/emtricitabine with raltegravir to dolutegravir). PWH were assessed by resting-state fMRI and stop-signal reaction time (SSRT) task fMRI as well as with a cognitive battery (CogState™) at baseline and follow-up. Switching from efavirenz to rilpivirine (n = 10) was associated with increased functional connectivity in the dorsal attention network (DAN) and a reduction in SSRTs (p = 0.025) that positively correlated with the time previously on efavirenz (mean = 4.8 years, p = 0.02). Switching from raltegravir to dolutegravir (n = 12) was associated with increased connectivity in the left DAN and bilateral sensory-motor and associative visual networks. In the NNRTI study, significant improvements in the cognitive domains of executive function, working memory and speed of visual processing were observed, whereas no significant changes in cognitive function were observed in the INSTI study. Changes in fMRI are evident in PWH without perceived neuropsychiatric complaints switching cART. fMRI may be a useful tool in assisting to elucidate the underlying pathogenic mechanisms of cART-related neuropsychiatric effects.

Authors+Show Affiliations

Clinical Imaging Sciences Centre, Brighton and Sussex Medical School, Knightsgate Road, Falmer Campus, Brighton, BN1 9RR, UK. sofia.toniolo@ndcn.ox.ac.uk. Nuffield Department of Clinical Neurosciences, University of Oxford, New Radcliffe House, Walton St., Oxford, OX2 6BW, UK. sofia.toniolo@ndcn.ox.ac.uk.Clinical Imaging Sciences Centre, Brighton and Sussex Medical School, Knightsgate Road, Falmer Campus, Brighton, BN1 9RR, UK.Department of Infectious Disease, Faculty of Medicine, St Mary's Campus, Imperial College London, Praed Street, London, W2 1NY, UK. Division of Infection and Immunity, School of Medicine, Cardiff University, UHW Main Building, Heath Park, Cardiff, CF14 4XN, UK.Department of Infectious Disease, Faculty of Medicine, St Mary's Campus, Imperial College London, Praed Street, London, W2 1NY, UK.Department of Infectious Disease, Faculty of Medicine, St Mary's Campus, Imperial College London, Praed Street, London, W2 1NY, UK.Clinical Imaging Sciences Centre, Brighton and Sussex Medical School, Knightsgate Road, Falmer Campus, Brighton, BN1 9RR, UK.Department of Infectious Disease, Faculty of Medicine, St Mary's Campus, Imperial College London, Praed Street, London, W2 1NY, UK. Department of HIV Medicine, Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, UK.Department of HIV Medicine, Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, UK.Department of Infectious Disease, Faculty of Medicine, St Mary's Campus, Imperial College London, Praed Street, London, W2 1NY, UK.Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, BN1 9PX, UK.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32500477

Citation

Toniolo, Sofia, et al. "Changes in Functional Connectivity in People With HIV Switching Antiretroviral Therapy." Journal of Neurovirology, 2020.
Toniolo S, Cercignani M, Mora-Peris B, et al. Changes in functional connectivity in people with HIV switching antiretroviral therapy. J Neurovirol. 2020.
Toniolo, S., Cercignani, M., Mora-Peris, B., Underwood, J., Alagaratnam, J., Bozzali, M., Boffito, M., Nelson, M., Winston, A., & Vera, J. H. (2020). Changes in functional connectivity in people with HIV switching antiretroviral therapy. Journal of Neurovirology. https://doi.org/10.1007/s13365-020-00853-0
Toniolo S, et al. Changes in Functional Connectivity in People With HIV Switching Antiretroviral Therapy. J Neurovirol. 2020 Jun 4; PubMed PMID: 32500477.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Changes in functional connectivity in people with HIV switching antiretroviral therapy. AU - Toniolo,Sofia, AU - Cercignani,Mara, AU - Mora-Peris,Borja, AU - Underwood,Jonathan, AU - Alagaratnam,Jasmini, AU - Bozzali,Marco, AU - Boffito,Marta, AU - Nelson,Mark, AU - Winston,Alan, AU - Vera,Jaime H, Y1 - 2020/06/04/ PY - 2020/01/13/received PY - 2020/05/12/accepted PY - 2020/04/14/revised PY - 2020/6/6/entrez KW - Attention KW - HIV KW - Memory KW - Neuropsychological assessment KW - fMRI JF - Journal of neurovirology JO - J. Neurovirol. N2 - We assessed changes in functional connectivity by fMRI (functional magnetic resonance imaging) and cognitive measures in otherwise neurologically asymptomatic people with HIV (PWH) switching combination antiretroviral therapy (cART). In a prospective study (baseline and follow-up after at least 4 months), virologically suppressed PWH switched non-nuclease reverse-transcriptase inhibitors (NNRTI; tenofovir-DF/emtricitabine with efavirenz to rilpivirine) and integrase-strand-transfer inhibitors (INSTI; tenofovir-DF/emtricitabine with raltegravir to dolutegravir). PWH were assessed by resting-state fMRI and stop-signal reaction time (SSRT) task fMRI as well as with a cognitive battery (CogState™) at baseline and follow-up. Switching from efavirenz to rilpivirine (n = 10) was associated with increased functional connectivity in the dorsal attention network (DAN) and a reduction in SSRTs (p = 0.025) that positively correlated with the time previously on efavirenz (mean = 4.8 years, p = 0.02). Switching from raltegravir to dolutegravir (n = 12) was associated with increased connectivity in the left DAN and bilateral sensory-motor and associative visual networks. In the NNRTI study, significant improvements in the cognitive domains of executive function, working memory and speed of visual processing were observed, whereas no significant changes in cognitive function were observed in the INSTI study. Changes in fMRI are evident in PWH without perceived neuropsychiatric complaints switching cART. fMRI may be a useful tool in assisting to elucidate the underlying pathogenic mechanisms of cART-related neuropsychiatric effects. SN - 1538-2443 UR - https://www.unboundmedicine.com/medline/citation/32500477/Changes_in_functional_connectivity_in_people_with_HIV_switching_antiretroviral_therapy L2 - https://dx.doi.org/10.1007/s13365-020-00853-0 DB - PRIME DP - Unbound Medicine ER -
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