Abstract
Expression of executive dysfunctions is marked by substantial heterogeneity in people living with HIV infection (PLWH) and attributed to neuropathological degradation of frontostriatal circuitry with age and disease. We compared the neurophysiology of executive function in older PLWH and Parkinson’s disease (PD), both affecting frontostriatal systems. Thirty-one older PLWH, 35 individuals with PD, and 28 older healthy controls underwent executive task-activated fMRI, neuropsychological testing, and a clinical motor exam. fMRI task conditions distinguished cognitive control operations, invoking a lateral frontoparietal network, and motor control operations, activating a cerebellar-precentral-medial prefrontal network. HIV-specific findings denoted a prominent sensorimotor hypoactivation during cognitive control and striatal hypoactivation during motor control related to CD4+ T cell count and HIV disease duration. Activation deficits overlapped for PLWH and PD, relative to controls, in dorsolateral frontal, medial frontal, and middle cingulate cortices for cognitive control, and in limbic, frontal, parietal, and cerebellar regions for motor control. Thus, despite well-controlled HIV infection, frontostriatal and sensorimotor activation deficits occurred during executive control in older PLWH. Overlapping activation deficits in posterior cingulate and hippocampal regions point toward similarities in mesocorticolimbic system aberrations among older PLWH and PD. The extent of pathophysiology in PLWH was associated with variations in immune system health, neural signature consistent with subclinical parkinsonism, and mild neurocognitive impairment. The failure to adequately engage these pathways could be an early sign for cognitive and motor functional decline in the aging population of PLWH.
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Data availability
The data and materials are available on reasonable request from the authors.
Abbreviations
- HIV:
-
human immune-deficiency virus
- PLWH:
-
people living with HIV
- PD:
-
Parkinson’s disease
- CTL:
-
normal controls
- HAND:
-
HIV associated neurocognitive disorder
- MNCI:
-
mild neurocognitive impairment
- ART:
-
antiretroviral therapy
- LEDD:
-
levodopa dependent daily dose
- MDS-UPDRS:
-
Movement Disorder Society - Unified Parkinson’s Disease Rating Scale
- BOLD:
-
blood oxygenation level dependent
- fMRI:
-
functional magnetic resonance imaging
- RTs:
-
reaction times
- inc:
-
incongruent
- con:
-
congruent
- RS:
-
response switching
- RR:
-
response repetition
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Acknowledgements
We thank Ryan Goodcase, Joshua Karpf, Priya Asok, Talora Martin, Varsha Prabhakar, and Stephanie Sassoon for assistance with recruitment, screening, clinical interviewing, and testing of study participants.
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This work was supported by the National Institute on Alcohol Abuse and Alcoholism (AA023165, AA017347, AA010723), National Institute on Neurological Disorders and Stroke (NS075097), National Institute on Aging (AG047366), and the Michael J Fox Foundation for Parkinson’s Research.
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Müller-Oehring, E.M., Hong, JY., Poston, K.L. et al. Neurofunctional characteristics of executive control in older people with HIV infection: a comparison with Parkinson’s disease. Brain Imaging and Behavior 16, 1776–1793 (2022). https://doi.org/10.1007/s11682-022-00645-6
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DOI: https://doi.org/10.1007/s11682-022-00645-6