دورية أكاديمية
أعرض في EDS

Underlying Neural Mechanisms of Cognitive Improvement in Fronto-striatal Response Inhibition in People Living with HIV Switching Off Efavirenz: A Randomized Controlled BOLD fMRI Trial.

التفاصيل البيبلوغرافية
العنوان: Underlying Neural Mechanisms of Cognitive Improvement in Fronto-striatal Response Inhibition in People Living with HIV Switching Off Efavirenz: A Randomized Controlled BOLD fMRI Trial.
المؤلفون: Oomen PGA; Department of Internal Medicine and Infectious Diseases, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands., Hakkers CS; Department of Internal Medicine and Infectious Diseases, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands., Arends JE; Department of Internal Medicine and Infectious Diseases, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands., van der Berk GEL; Department of Internal Medicine and Infectious Diseases, Onze Lieve Vrouwe Gasthuis, Oosterpark 9, 1091 AC, Amsterdam, The Netherlands., Pas P; Department of Psychiatry, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands., Hoepelman AIM; Department of Internal Medicine and Infectious Diseases, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands., van Welzen BJ; Department of Internal Medicine and Infectious Diseases, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands. B.J.vanWelzen@umcutrecht.nl., du Plessis S; Department of Psychiatry, Stellenbosch University, Francie van Zijl Drive, Tygerberg, Cape Town, 7505, South Africa.; SAMRC Genomics and Brain Disorders Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Parow, Cape Town, 7505, South Africa.
المصدر: Infectious diseases and therapy [Infect Dis Ther] 2024 May; Vol. 13 (5), pp. 1067-1082. Date of Electronic Publication: 2024 Apr 20.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Adis Country of Publication: New Zealand NLM ID: 101634499 Publication Model: Print-Electronic Cited Medium: Print ISSN: 2193-8229 (Print) Linking ISSN: 21936382 NLM ISO Abbreviation: Infect Dis Ther Subsets: PubMed not MEDLINE
أسماء مطبوعة: Publication: 2014- : [Auckland] Adis
Original Publication: [London] : Springer Healthcare
مستخلص: Introduction: It is unclear whether neurotoxicity due to the antiretroviral drug efavirenz (EFV) results in neurocognitive impairment in people living with HIV (PLWH). Previously, we found that discontinuing EFV was associated with improved processing speed and attention on neuropsychological assessment. In this imaging study, we investigate potential neural mechanisms underlying this cognitive improvement using a BOLD fMRI task assessing cortical and subcortical functioning.
Methods: Asymptomatic adult PLWH stable on emtricitabine/tenofovirdisoproxil/efavirenz were randomly (1:2) assigned to continue their regimen (n = 12) or to switch to emtricitabine/tenofovirdisoproxil/rilpivirine (n = 28). At baseline and after 12 weeks, both groups performed the Stop-Signal Anticipation Task, which tests reactive and proactive inhibition (indicative of subcortical and cortical functioning, respectively), involving executive functioning, working memory, and attention. Behavior and BOLD fMRI activation levels related to processing speed and attention Z-scores were assessed in 17 pre-defined brain regions.
Results: Both groups had comparable patient and clinical characteristics. Reactive inhibition behavioral responses improved for both groups on week 12, with other responses unchanged. Between-group activation did not differ significantly. For reactive inhibition, positive Pearson coefficients were observed for the change in BOLD fMRI activation levels and change in processing speed and attention Z-scores in all 17 regions in participants switched to emtricitabine/tenofovir disoproxil/rilpivirine, whereas in the control group, negative correlation coefficients were observed in 10/17 and 13/17 regions, respectively. No differential pattern was observed for proactive inhibition.
Conclusion: Potential neural mechanisms underlying cognitive improvement after discontinuing EFV in PLWH were found in subcortical functioning, with our findings suggesting that EFV's effect on attention and processing speed is, at least partially, mediated by reactive inhibition.
Trial Registration: Clinicaltrials.gov identifier [NCT02308332].
(© 2024. The Author(s).)
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فهرسة مساهمة: Keywords: BOLD functional MRI; Efavirenz; HIV; HIV-associated neurocognitive disorders (HAND); Neurocognition; Response inhibition
سلسلة جزيئية: ClinicalTrials.gov NCT02308332
تواريخ الأحداث: Date Created: 20240420 Latest Revision: 20240519
رمز التحديث: 20240519
مُعرف محوري في PubMed: PMC11098980
DOI: 10.1007/s40121-024-00966-7
PMID: 38642238
قاعدة البيانات: MEDLINE
الوصف
تدمد:2193-8229
DOI:10.1007/s40121-024-00966-7