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Effects of HIV and Early Life Stress on Amygdala Morphometry and Neurocognitive Function

Published online by Cambridge University Press:  24 May 2012

Uraina S. Clark*
Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, Rhode Island Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, Rhode Island
Ronald A. Cohen
Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, Rhode Island Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island
Lawrence H. Sweet
Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, Rhode Island Neuroimaging Center, Butler Hospital, Providence, Rhode Island
Assawin Gongvatana
Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, Rhode Island Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island
Kathryn N. Devlin
Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island
George N. Hana
Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island
Michelle L. Westbrook
Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island Center for AIDS Research, The Miriam Hospital, Providence, Rhode Island
Richard C. Mulligan
Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, Rhode Island Neuroimaging Center, Butler Hospital, Providence, Rhode Island
Beth A. Jerskey
Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, Rhode Island Neuroimaging Center, Butler Hospital, Providence, Rhode Island
Tara L. White
Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, Rhode Island
Bradford Navia
Tufts University School of Medicine, Boston, Massachusetts
Karen T. Tashima
Center for AIDS Research, The Miriam Hospital, Providence, Rhode Island Department of Medicine, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
Correspondence and reprint requests to: Uraina S. Clark, Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Box G-S121-4, Brown University, Providence, RI 02912. E-mail:


Both HIV infection and high levels of early life stress (ELS) have been related to abnormalities in frontal-subcortical structures, yet the combined effects of HIV and ELS on brain structure and function have not been previously investigated. In this study we assessed 49 non-demented HIV-seropositive (HIV+) and 47 age-matched HIV-seronegative healthy control (HC) adults. Levels of ELS exposure were quantified and used to define four HIV-ELS groups: HC Low-ELS (N = 20); HC High-ELS (N = 27); HIV+ Low-ELS (N = 24); HIV+ High-ELS (N = 25). An automated segmentation tool measured volumes of brain structures known to show HIV-related or ELS-related effects; a brief neurocognitive battery was administered. A significant HIV-ELS interaction was observed for amygdala volumes, which was driven by enlargements in HIV+ High-ELS participants. The HIV+ High-ELS group also demonstrated significant reductions in psychomotor/processing speed compared with HC Low-ELS. Regression analyses in the HIV+ group revealed that amygdala enlargements were associated with higher ELS, lower nadir CD4 counts, and reduced psychomotor/processing speed. Our results suggest that HIV infection and high ELS interact to increase amygdala volume, which is associated with neurocognitive dysfunction in HIV+ patients. These findings highlight the lasting neuropathological influence of ELS and suggest that high ELS may be a significant risk factor for neurocognitive impairment in HIV-infected individuals. (JINS, 2012, 19, 1–12)

Research Articles
Copyright © The International Neuropsychological Society 2012

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