Abstract
Human Immunodeficiency Virus (HIV) and current stimulant abuse have both been shown to damage basal ganglia and hippocampus. While the effects of current stimulant abuse on neurological functioning is well- documented, whether residual damage can be detected in patients with a distant history of past stimulant abuse/ dependence remains to be understood. Given that past stimulant abuse is common among HIV-infected individuals; this is a question of considerable clinical significance. The present study employed Diffusion Tensor Imaging (DTI) and structural MRI to examine brain integrity (as measured by FA and MD) and volume in the basal ganglia (BG) and hippocampus among older HIV-infected adults with histories of stimulant abuse. Lower fractional anisotropy and greater diffusivity (representative of microstructural breakdown) in basal ganglia and hippocampal structures were documented among former stimulant abusers compared to stimulant-naive individuals. Length of abstinence was also associated with BG integrity, such that those with shorter abstinence periods demonstrated greater MD of the BG. Our findings suggest that past stimulant abuse is associated with neurological dysfunction, though this improves with increasing abstinence.
Highlights
Older adults are one of the fastest growing subgroups among the Human Immunodeficiency Virus (HIV) infected population
Participants who reported past stimulant abuse demonstrated lower fractional anisotropy (FA) values in the basal ganglia when compared to participants who did not report past abuse, t (18) =2.302, p =
There was a statistical trend towards decreased hippocampal volume among past stimulant users relative to non-users, t (18) = 1.562, p = .10. This is the first application of Diffusion Tensor Imaging (DTI) to compare basal ganglia and hippocampal integrity in older HIV+ adults with and without histories of stimulant abuse
Summary
Older adults are one of the fastest growing subgroups among the HIV infected population. By the year 2015 they are predicted to comprise 50% of all HIV infected individuals in the US population (CDC, 2007) and understanding the factors that contribute to morbidity in this increasingly prevalent subgroup remains paramount. A number of studies have demonstrated that older HIV-infected adults have higher prevalence and severity of cognitive abnormality when compared to both younger HIV+ and HIV-seronegative healthy elderly controls [1,2,3,4,5,6,7]. Very few studies have looked within the older HIV cohort to understand factors that may place some older adults at risk for cognitive and functional decline. Substance abuse is one such factor with particular relevance to this population
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