Abstract
Motor impairment is highly prevalent in HIV-infected patients. Here, we assess associations between peripheral muscular deficits as evaluated by the 5 sit-to-stand test (5STS) and structural integrity of the motor system at a central level. Eighty-six HIV-infected patients receiving combination antiretroviral therapy and with no major cerebral events, underwent an MRI scan and the 5STS. Out of 86 participants, forty presented a score greater than two standard deviations above mean normative scores calculated for the 5STS and were therefore considered as motor-impaired. MRI-structural cerebral parameters were compared to the unimpaired participants. Fractional Anisotropy (FA), Axial Diffusivity (AD) and Radial Diffusivity (RD), reflecting microstructural integrity, were extracted from Diffusion-Tensor MRI. Global and regional cerebral volumes or thicknesses were extracted from 3D-T1 morphological MRI. Whereas the two groups did not differ for any HIV variables, voxel-wise analysis revealed that motor-impaired participants present low FA values in various cortico-motor tracts and low AD in left cortico-spinal tract. However, they did not present reduced volumes or thicknesses of the precentral cortices compared to unimpaired participants. The absence of alterations in cortical regions holding motor-neurons might argue against neurodegenerative process as an explanation of White Matter (WM) disorganization.
Highlights
The use of combination antiretroviral therapy has drastically improved the prognosis and the quality of life of patients infected with human immunodeficiency virus (HIV)
The present study shows that HIV-1 participants presenting motor deficits exhibited a selective decrease in the coherence of central motor tracts in the CST, compared to participants without deficits
In animal studies [41,42,43] as in human studies [44,45,46], quantitative Fractional Anisotropy (FA) measures are believed to reflect axonal density and/or myelin content. No such difference was observed in non-motor tracts, this finding supports the specificity of the relationship between peripheral motor deficit and central motor bundle damage
Summary
The use of combination antiretroviral therapy (cART) has drastically improved the prognosis and the quality of life of patients infected with human immunodeficiency virus (HIV). Neurological impairments and neuromuscular problems remain highly prevalent in this population despite better control of HIV replication. These muscular impairments are associated with daily activity limitations and participation restrictions [1,2]. The most common motor impairments in AIDS patients are slowed movements, gait abnormality, limb incoordination, hyperreflexia, hypertonia, and muscular weakness [3,4] Consistent with these observation, we have shown [5] that half of adults with controlled HIV-infection had poor lower limb muscle performance as assessed through 5-Sit-To-Stand test (5STS) [6]. Given that performance on the 5STS test has been related to falls in older adults [7,8,9], HIV-1 participants infected individuals presenting poor 5STS performance should be considered as being at risk for falls
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
