Diffusion tensor MR imaging of white matter integrity in HIV-positive patients with planning deficit.

Introduction: The aim of this study was to evaluate whether normal controls and human immunodeficiency virus (HIV) patients with and without planning deficits differ on white matter integrity.

Methods: A total of 34 HIV-positive patients with planning deficits were compared with 13 HIV-positive patients without planning deficits and 19 gender-, age-, and education-matched control subjects. Diffusion tensor imaging (DTI) was performed along 30 noncolinear directions in a 1.5-T scanner. For tract-based spatial statistics analysis, a white matter skeleton was created, and a permutation-based inference with 5000 permutations with a threshold of p < 0.05 was used to identify abnormalities in fractional anisotropy (FA). The median, radial, and axial diffusivities were also projected onto the mean FA skeleton.

Results: Compared with controls, HIV-positive patients with planning deficits had decreased FA in bilateral anterior thalamic radiations, bilateral inferior fronto-occiptal fasciculi, genu and splenium of the corpus callosum, bilateral superior longitudinal fascicule, and bilateral uncinate fasciculi. Compared to HIV-positive patients without planning deficits, patients with planning deficits had decreased FA in bilateral anterior thalamic radiations, bilateral inferior fronto-occiptal fasciculi, genu of the corpus callosum, bilateral superior longitudinal fascicule, and right uncinate fascicule.

Conclusion: DTI can detect extensive white matter abnormalities in the normal-appearing white matter of HIV-positive patients with planning deficits compared with controls and HIV-positive patients without planning deficits.