10 - Clinical Neuroanatomy by Imaging of Apathy in People Living with HIV: Differential Alterations in Depressive Disorder and Attentional Networks

Poster Board Number: 10
There are separate poster presentation times for odd and even posters.
Odd poster #s – first hour
Even poster #s – second hour

Co-authors:

Elba Beatriz TORNESE - University of Buenos Aires; Milagros MUÑIZ - University of Buenos Aires; Rubén Daniel ALGIERI - University of Buenos Aires; Soledad FERRANTE - University of Buenos Aires

Abstract Body :
Introduction: Depressive symptoms have high prevalence and importance in chronic diseases and can be a limitation and complication due to their negative impact. People living with HIV (PLHIV) present clinical specificities in their depression with an important prevalence of apathy and resistance to treatment, which generates underdiagnosis, inconclusive treatment and the association with neurocognitive alterations. The objective was to determine the neuroanatomical structures involved in PLHIV with depression and/or apathy, their differential relationship with attentional networks and clinical-care utility.Material and method: The study group consisted of 52 PLVIH, all of them receiving antirretrovirals, with diagnosis of depressive disorder (F32.9, DSM IV) and signs of apathy. All participants received a neuropsychological and neuropsychiatric evaluation and functional neuroimaging (SPECT 99Tc-ECD) with semi-quantitative analysis. Statistical parameters were applied and ethical-legal norms were accomplished.Results: The semi-quantitative analysis applied to neuroimages by SPECT determined absolute hypoperfusion, according to severity in: left cingulate cortex (-20.25%), prefrontal left upper cortex (-17.45%), left insula (-17.40%), right cingulate cortex (-17.15%), caudate nucleus (-15.80%). The right caudate nucleus showed a higher hypoperfussion (-15.80%) followed by his contralateral (-15.35%) and left insula (-10.65%). In PVVIH with apathy, left insula showed correlation with the perfusion from left caudate nucleus (r2=0.84) and right (r2=0.83). Patients with apathy had a significant alteration of alternating and divided attention compared to the focused and sustained.Conclusion: Apathy in patients living with HIV with depression presents specific neurocognitive alterations and differentials in the attention domain. Neurofunctional alterations were found in the striatum and the insula, correlated with the involvement of the cingulate cortex