Neural dynamics of attention in HIV: A cognitive aging phenotype?

Sandeepa Sur, Leah H. Rubin
2020 EBioMedicine  
Extensive efforts to minimize central nervous system (CNS) complications in virally suppressed people with HIV (PWH) have had limited success. The clinical presentation of CNS comorbidities such as HIV-associated neurocognitive disorders (HAND) is non-uniform and changes with age. This variability can impede the identification of the pathophysiological mechanisms underlying HAND. Focusing on specific cognitive systems, such as the attentional systems, may facilitate our understanding of the
more » ... anisms leading to dysfunction and provide more narrowly defined treatment targets. In this issue of EBioMedicine, Arif and colleagues [1] aimed to identify the neural factors contributing to attention deficits in 79 PWH (28 with HAND) compared to 94 HIV-uninfected individuals. The clinical significance of a focus on attention is high, as deficits in this cognitive domain are central to cognitive aging in PWH [2] and can affect the ability to perform daily tasks such as poor HIV medication adherence [3] . The team employed a novel approach in the use of state-of-the art magnetoencephalography, (MEG) a functional neuroimaging method that measures magnetic field produced by electrical activity in the brain, to measure temporal and spatial cortical dynamics as measured by brain oscillations. The high temporal resolution of MEG is well-suited for attention tasks, which are a result of dynamic cortical interactions. Spatially, the resolution is almost as good as functional magnetic resonance imaging (fMRI; in millimeters) for cortical surfaces but is less adequate than fMRI for assessing "deep brain" or subcortical structures. The results provide compelling evidence that alterations in MEG-recorded oscillations in a number of brain regions reflect significant alterations in key aspects of attention and speed in PWH and the degree of alterations depends on age and HAND status. A critical question that remains unanswered is whether HIV infection accelerates aging through mechanisms similar to aging process (accelerated aging), or HIV increases the risk for comorbidities,
doi:10.1016/j.ebiom.2020.103114 pmid:33181460 pmcid:PMC7658472 fatcat:f4uryrqgy5hofderv255vhqqhi