AIMS Cognitive impairment may be greater in HIV-positive (HIV+) women than in HIV+ men. Whether sex-specific differences exist in brain microstructure of HIV+ individuals is unknown and was evaluated. METHOD 39 HIV+ (21 men, 18 women) and 45 seronegative (SN, 20 men, 25 women) participants were assessed with brain diffusion tensor imaging and cognitive assessments (7 neuropsychological domains). Fractional anisotropy (FA) and mean diffusivity (MD) were measured with an automated atlas in selected brain regions. Group comparisons were assessed with linear mixed effects models, with sub-regions and hemisphere (left/right) as repeated factors for each region. RESULTS HIV+ women, but not HIV+ men, were slower than sex-matched SN controls on sensorimotor function (Dominant-hand: interaction-p = 0.007; Non-dominant hand: interaction-p = 0.039). Similarly, only HIV+ women had lower FA in the globus pallidus (GP, interaction-p = 0.011). Additionally, regardless of sex, the HIV+ group had poorer Fluency, Speed, and Attention than SN-controls (p = 0.006-0.008), as well as lower FA and higher MD in multiple brain regions (p = <0.001-0.044). Across all participants, performance on Attention was predicted by uncinate-FA (p < 0.001, r = 0.5) and corpus callosum (CC)-FA (p = 0.038, r = 0.23), while the Speed of Information Processing was predicted by CC-FA (p = 0.009, r = 0.3). Furthermore, faster sensorimotor function correlated with higher CC-FA and uncinate-FA in men but not in women (Sex*DTI-interaction-p = 0.03-0.06). CONCLUSIONS The relatively poorer sensorimotor function and abnormally lower GP_FA, suggesting lesser neuronal integrity, in HIV+ women demonstrate sex-specific effects from HIV-infection on these measures. These findings may be related to the greater immune activation and neuroinflammation in HIV+ women compared to HIV+ men. Graphical Abstract.

中文翻译：

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与 HIV+ 男性相比，HIV+ 女性有更大的感觉运动缺陷和异常低的苍白球各向异性分数。

AIMS 与 HIV+ 男性相比，HIV 阳性 (HIV+) 女性的认知障碍可能更大。HIV阳性个体的大脑微观结构中是否存在性别特异性差异尚不清楚，并进行了评估。方法 39 名 HIV+（21 名男性，18 名女性）和 45 名血清阴性（SN，20 名男性，25 名女性）参与者接受了脑扩散张量成像和认知评估（7 个神经心理学领域）的评估。分数各向异性 (FA) 和平均扩散率 (MD) 在选定的大脑区域中使用自动图谱进行测量。使用线性混合效应模型评估组比较，其中子区域和半球（左/右）作为每个区域的重复因素。结果 HIV+ 女性，但不是 HIV+ 男性，在感觉运动功能上比性别匹配的 SN 对照慢（惯用手：交互 p = 0.007；非惯用手：交互 p = 0.039）。同样，只有 HIV 阳性的女性苍白球中的 FA 较低（GP，相互作用 p = 0.011）。此外，无论性别如何，HIV+ 组的流畅性、速度和注意力都比 SN 对照组差（p = 0.006-0.008），并且在多个大脑区域中 FA 较低，MD 较高（p = <0.001-0.044）。在所有参与者中，注意力表现由 uncinate-FA（p < 0.001，r = 0.5）和胼胝体（CC）-FA（p = 0.038，r = 0.23）预测，而信息处理速度由 CC 预测-FA（p = 0.009，r = 0.3）。此外，更快的感觉运动功能与男性更高的 CC-FA 和钩状 FA 相关，但与女性无关（Sex*DTI-interaction-p = 0.03-0.06）。结论 相对较差的感觉运动功能和异常低的 GP_FA，表明神经元完整性较差，在 HIV+ 女性中，HIV 感染对这些措施具有性别特异性影响。这些发现可能与 HIV+ 女性相比 HIV+ 男性更强的免疫激活和神经炎症有关。图形概要。