Document Type

Capstone Experience

Graduation Date

8-2020

Degree Name

Master of Public Health

Department

Epidemiology

First Committee Member

Lorena Baccaglini, PhD, DDS, MS

Second Committee Member

Jianghu Dong, PhD

Third Committee Member

Tony W. Wilson, PhD

Fourth Committee Member

Pamela E. May, PhD

Abstract

Objective: The goal of this study was to do an exploratory analysis to determine if gray matter brain volumes and cortical thickness measures obtained from structural magnetic resonance imaging (sMRI) can discriminate people with HIV-associated neurocognitive disorders (HAND), neurocognitively unimpaired people with HIV (NU PWH), and HIV-negative controls (HIV- controls) using linear discriminant analyses.

Methods: A total of 231 participants, including 110 PWH and 121 HIV- controls, completed a neuropsychological (NP) battery and an sMRI protocol. The bilateral gray matter volumes and cortical thickness brain regions were analyzed using 18 linear discriminant models to assess the discriminability of gray matter volumes and cortical thickness measures separately. The sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR-), and area under the curve (AUC) were computed for each model using the classification results based on the sMRI measures compared to the NP battery.

Results: Of the 110 PWH, 48 were classified as HAND and 62 were classified as NU PWH using the NP battery. The best performing model was the full sample whole brain gray matter volume model with education included, and had a sensitivity of 75.0% (95% CI: 60.4%-86.4%), a specificity of 92.9% (95% CI: 88.2%-96.2%), and an AUC=0.84 (95% CI: 0.76-0.92).

Conclusion: While sMRI measures could aid to inform HAND diagnoses, more rigorous analysis needs to be done before interpreting these results clinically.

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