Investigation of Gray Matter Changes Using Voxel-Based Morphometry in HIV-Negative Patients with General Paresis of the Insane.

Purpose: To investigate whole-brain gray matter volume (GMV) changes in human immunodeficiency (HIV)-negative patients with general paresis of the insane (GPI) using voxel-based morphometry (VBM).

Patients And Methods: A total of 18 HIV-negative individuals with GPI and 24 healthy control volunteers matched for sex, age, and education were enrolled in this study. 3 D T1-weighted imaging (3D T1WI) structural images of GPI patients and healthy controls were preprocessed using VBM. The GMV was then segmented and compared between the two groups. In addition, the correlation between cortical/subcortical GMVs and neuropsychological/laboratory test results was analyzed.

Results: Compared to the normal control group, the GPI group showed a decrease in GMV in multiple regions, including the bilateral frontal cortices (superior frontal gyrus, middle frontal gyrus, orbital gyrus), bilateral temporal/occipital cortices (superior temporal, bilateral inferior temporal, bilateral parahippocampal, bilateral cingulate, left precentral, left fusiform, left posterior superior temporal sulcus, left lateral occipital, right middle temporal, right precuneus, right insular, and right medioventral occipital), and right parietal cortices (right superior parietal, right inferior parietal) (p<0.01, FDR corrected). Additionally, there was an increase in GMV in the bilateral basal ganglia, right hippocampus, and bilateral thalamus (p<0.01, FDR corrected). In the GPI group, GMVs of the right rostral hippocampus (r=-0.524, p=0.026), bilateral dorsal caudate nucleus (r=-0.604, p=0.008; r=-0.685, p=0.002), and the right rostral temporal thalamus (r=-0.560, p=0.016) were negatively correlated with MMSE score.

Conclusion: VBM showed that there are structural changes in brain GMV in HIV-negative GPI patients. The use of VBM has the potential to provide a valuable imaging basis for the diagnosis of GPI.