There is evidence of HIV affecting cognitive functioning across age groups, with adult studies showing related deficits in frontostriatal and hippocampal regional activity. Additionally, delayed initiation of antiretroviral treatment (ART) has been associated with poorer cognitive outcomes in HIV-infected youth. Little is known, however, of the neural correlates underlying such cognitive deficits in youth populations. We investigated maintenance working memory-related brain activity in South African HIV-infected youth and controls, and the effect of ART initiation age on underlying structures. Sixty-four perinatally infected youth (ages 9-12) and 20 controls (ages 9-13) underwent functional magnetic resonance imaging (fMRI) while completing 1-back and 0-back blocks of the N-back task. At an uncorrected p value threshold of 0.001, the HIV-infected group showed decreased activation in the left superior temporal gyrus, pre- and postcentral gyri, insula, and putamen as well as bilateral hippocampus, and mid cingulum. The HIV patients with delayed ART initiation showed less activation during processing conditions in the mid cingulum; left inferior parietal gyrus; and right inferior frontal, bilateral thalamic, and superior temporal regions. When these regions were tested for structural differences, the mid cingulum and right inferior frontal gyrus, insula, and thalamus were found to have less cortical thickness, surface area, or volume in the group with delayed ART initiation. Regional differences between HIV-infected youth and controls noted in the N-back task are consistent with impairments in structures involved in maintenance working memory. These data support earlier ART initiation in perinatally infected individuals.

中文翻译：

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维持工作记忆的神经相关性，以及相关的结构质量，与垂直传播的HIV中较早的抗逆转录病毒治疗的启动有关。

有证据表明，艾滋病毒影响了各个年龄段的认知功能，成人研究表明，额骨和海马区域活动相关的缺陷。此外，在HIV感染的青年中，抗逆转录病毒治疗（ART）的延迟启动与较差的认知结果有关。然而，对于青年人群中这种认知缺陷的神经相关性知之甚少。我们调查了南非艾滋病毒感染的青年和对照组中与维护工作记忆相关的大脑活动，以及抗病毒治疗起始年龄对基础结构的影响。64名围产期感染的青年（9-12岁）和20名对照（9-13岁）接受了功能性磁共振成像（fMRI），同时完成了N背任务的1背和0背阻滞。在未校正的p值阈值为0.001的情况下，HIV感染组的左颞上回，中央前和中央后回，岛岛和壳核以及双侧海马和扣带中部的激活减少。延迟ART起始的HIV患者在扣带中部的加工过程中显示出较少的激活。左下顶回; 右下额叶，双侧丘脑和颞上叶区域。当测试这些区域的结构差异时，发现延缓ART起始的组中，中扣带和右下额回，岛突和丘脑皮层厚度，表面积或体积较小。N-back任务中指出的艾滋病毒感染青年与控制之间的区域差异与维护工作记忆所涉及的结构受损一致。