• John R Keltner, Christine Fennema-Notestine, Florin Vaida, Dongzhe Wang, Donald R Franklin, Robert H Dworkin, Chelsea Sanders, J Allen McCutchan, Sarah L Archibald, David J Miller, George Kesidis, Clint Cushman, Sung Min Kim, Ian Abramson, Michael J Taylor, Rebecca J Theilmann, Michelle D Julaton, Randy J Notestine, Stephanie Corkran, Mariana Cherner, Nichole A Duarte, Terry Alexander, Jessica Robinson-Papp, Benjamin B Gelman, David M Simpson, Ann C Collier, Christina M Marra, Susan Morgello, Greg Brown, Igor Grant, J Hampton Atkinson, Terry L Jernigan, Ronald J Ellis, and CHARTER Group.
• Department of Psychiatry, University of California San Diego, 220 Dickinson St., San Diego, CA, 92103, USA, jkeltner@ucsd.edu.
• J. Neurovirol. 2014 Jun 1;20(3):209-18.

AbstractDespite modern antiretroviral therapy, HIV-associated sensory neuropathy affects over 50 % of HIV patients. The clinical expression of HIV neuropathy is highly variable: many individuals report few symptoms, but about half report distal neuropathic pain (DNP), making it one of the most prevalent, disabling, and treatment-resistant complications of HIV disease. The presence and intensity of pain is not fully explained by the degree of peripheral nerve damage, making it unclear why some patients do, and others do not, report pain. To better understand central nervous system contributions to HIV DNP, we performed a cross-sectional analysis of structural magnetic resonance imaging volumes in 241 HIV-infected participants from an observational multi-site cohort study at five US sites (CNS HIV Anti-Retroviral Treatment Effects Research Study, CHARTER). The association between DNP and the structural imaging outcomes was investigated using both linear and nonlinear (Gaussian Kernel support vector) multivariable regression, controlling for key demographic and clinical variables. Severity of DNP symptoms was correlated with smaller total cerebral cortical gray matter volume (r = -0.24; p = 0.004). Understanding the mechanisms for this association between smaller total cortical volumes and DNP may provide insight into HIV DNP chronicity and treatment-resistance.

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