Quantitative Brain Volume Correlates of Neuropsychological and Neuropsychiatric Measures in Adults Living with HIV Receiving Antiretroviral Therapy: A 0.35-T MRI Study

Abstract

Background: Cognitive, functional, psychological and sleep-related difficulties remain clinically relevant in people living with HIV (PLWH) receiving antiretroviral therapy (ART), but their relationship with macroscopic brain volume is incompletely characterised in African cohorts. Objective: To determine relationships between quantitative global and regional MRI brain volumes and neuropsychological and neuropsychiatric measures among adults living with HIV receiving ART. Methods: This cross-sectional analysis included 65 PLWH, of whom 60 had usable volumetric MRI data. Structural MRI was acquired using a 0.35-T GE SIGNA Ovation scanner and processed with an FSL-based pipeline incorporating SUSAN, BET, FAST and FIRST. Twenty-two MRI measures were correlated with five continuous outcomes (PAOFI, CTADL, CES-D, STAI-Trait and PSQI), yielding 110 Spearman correlations; pairwise sample sizes ranged from 56 to 60. Benjamini–Hochberg false-discovery-rate correction was applied across all tests. Results: Six correlations reached nominal p < .05, but none survived correction: adjusted white matter–CTADL (ρ = -.30, p = .018, q = .672), left thalamus–CTADL (ρ = .27, p = .039, q = .811), right globus pallidus–CTADL (ρ = .35, p = .006, q = .425), left hippocampus–CTADL (ρ = .26, p = .043, q = .811), brainstem–CTADL (ρ = .34, p = .008, q = .425), and left nucleus accumbens–STAI-Trait (ρ = .27, p = .044, q = .811). No PAOFI, CES-D or PSQI correlation reached nominal significance. Conclusion: Quantitative brain volumes showed several modest nominal relationships, mainly with everyday functioning, but no association remained statistically significant after multiple-comparison correction. The findings are exploratory and require replication in larger, longitudinal cohorts with formal low-field validation and higher-field comparison.