High early life stress and aberrant amygdala activ

Authors: Uraina S Clark Lawrence H Sweet Susan Morgello Noah S Philip Ronald A Cohen

Publish Date: 2016/03/24

Volume: 11, Issue: 3, Pages: 649-665

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Abstract

Relative to HIVnegative adults HIV+ adults report elevated levels of early life stress ELS In nonHIV samples high ELS has been linked to abnormalities in brain structure and function as well as increased risk of neuropsychiatric symptoms Yet little is known about the neural effects of high ELS and their relation to elevated neuropsychiatric symptoms in HIV+ adults Recent studies have revealed combined effects of HIV and high ELS on amygdala morphometry Aberrant amygdala activity is prominently implicated in studies of neuropsychiatric symptomology in nonHIV samples Hence this preliminary study examined 1 the combined effects of HIV and high ELS on amygdala activity and 2 the relation between amygdala activity and neuropsychiatric symptoms in HIV+ adults We included 28 HIV+ adults and 25 demographicallymatched HIVnegative control HC adults ELS exposure was quantified using a retrospective ELS questionnaire which defined four groups HIV+ LowELS N = 15 HIV+ HighELS N = 13 HC LowELS N = 16 and HC HighELS N = 9 Participants completed a battery of neuropsychiatric measures BOLD fMRI assessed amygdala reactivity during explicit observation of fearful/angry faces HighELS participants demonstrated reduced levels of amygdala reactivity relative to LowELS participants HIV+ HighELS participants reported higher levels of neuropsychiatric symptoms than all other groups In the HIV+ group lower amygdala responses were associated with higher neuropsychiatric symptoms particularly depression anxiety and alexithymia Collectively these results suggest that high ELS exposure is a significant risk factor for neuropsychiatric symptoms in HIV+ adults Furthermore our results implicate ELSrelated abnormalities in amygdala activity in the etiology of neuropsychiatric symptoms in HIV+ adultsWe thank all of the individuals who participated in this study In addition we gratefully acknowledge Karen T Tashima MD Timothy P Flanigan MD and the teams at The Miriam Hospital Immunology Center and the Manhattan HIV Brain Bank who provided valuable aid in our recruitment efforts Finally we also thank Rachal Hegde for her assistance in preparing this manuscriptThis work was supported by grants from the National Institutes of Health Grants K23 MH096628 USC R25 MH080663 USC R01 MH074368 RAC R25 MH083635 USC and P30 AI042853 RAC the Brown University MRI Research Facility USC and the US Department of Veterans Affairs Grant IK2 CX00724 NSP The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the NIH or Department of Veterans AffairsAll procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards

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