Glymphatic dysfunction in HIV: a resting-state functional magnetic resonance imaging biomarker linking cognitive impairment and immune suppression
Bibliographic record
Abstract
OBJECTIVE: To investigate glymphatic dysfunction in people with HIV (PWH) and its associations with immunological status and cognitive function, utilizing the coupling strength of global blood-oxygen-level-dependent and cerebrospinal fluid (gBOLD-CSF). DESIGN: Retrospective study of 75 PWH and 52 non-HIV controls undergoing neuropsychological tests and resting-state functional magnetic resonance imaging (rs-fMRI). METHODS: GBOLD-CSF coupling, Montreal Cognitive Assessment (MoCA) and seven cognitive domain scores were calculated. Group difference in gBOLD-CSF coupling strength was analyzed using a general linear model, adjusting for age, sex, and education. Partial correlation analyses were performed to examine the correlations of cognitive performance and immunological status with gBOLD-CSF coupling. Multivariate regression analysis was utilized to further evaluate the associations of gBOLD-CSF coupling with cognition. RESULTS: PWH exhibited significantly weaker gBOLD-CSF coupling than non-HIV controls ( P = 0.018) and revealed impairments in attention/working memory, speed of information processing, and abstract/executive function (all P < 0.05). Reduced gBOLD-CSF coupling was associated with deficits in MoCA scores ( r = -0.332, P = 0.004), verbal fluency ( r = 0.245, P = 0.038), attention/working memory ( r = 0.240, P = 0.042), speed of information processing ( r = 0.245, P = 0.038), and abstract/executive function ( r = 0.241, P = 0.042) in PWH. Multivariate regression analysis showed gBOLD-CSF coupling was the only independent predictor for speed of information processing ( β = 0.410, P = 0.031) and MoCA scores ( β = -0.399, P = 0.037). Weaker gBOLD-CSF coupling was correlated with lower nadir and current CD4 + cell count ( r = -0.379, P = 0.019; r = -0.321, P = 0.049, respectively). CONCLUSION: Reduced gBOLD-CSF coupling in PWH suggests glymphatic dysfunction and was associated with cognitive impairment and HIV-related immune suppression. It may serve as a noninvasive biomarker for monitoring cognitive disturbances and disease progression in HIV.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".