Pilot Award Recipient: Manya Magnus, PhD, MPH

HIV-associated Neurocognitive Disorders and Cognitive Control Among HIV-infected Older Adults: a Pilot Study Using fMRI Among a High Risk, Community-Based Sample in DC

March 01, 2012

The prevalence of HIV among individuals in the United States 50 years and older has grown substantially with increased antiretroviral availability and improved care. With this changing demographic, a significant public health concern has emerged: older adults have heightened vulnerability to cognitive dysfunction (HIV-associated neurocognitive disorders, HAND) when compared to younger adults. Despite the elevated prevalence of HAND, its neural bases are largely uncharacterized - it is unclear how HIV affects neuronal function, and how changes at the neuronal level give rise to behavioral deficits. Neuroimaging techniques such as magnetic resonance imaging are non-invasive ways to examine pathological changes caused by HIV. Despite their attractiveness as a diagnostic or measurement approach, few studies apply stateof-the-art brain imaging to examine cognitive processing deficits associated with HIV. A root cause of this missed opportunity is the challenge in forming multidisciplinary teams connecting experts with access to community based patient pools to cognitive neuroscientists with expertise in probing the neural bases of complex behaviors. This proposal represents collaboration between epidemiologists in the GWU Milken Institute School of Public Health, with expertise in recruitment of at risk populations, with cognitive neuroscientists in the department of Neuroscience at GUMC, experienced in the use of advanced MRI techniques. This team is in a unique position to recruit participants from the DC community and conduct and analyze cutting edge functional MRI (fMRI) experiments. This study not only will characterize the relationship between HAND and behavioral deficits among HIV-infected persons 50 years of age and older and their uninfected counterparts, it will provide proof of concept towards the multidisciplinary collaboration between GWU SPHHS and GUMC investigators within the DC DCFAR.