Diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI) have been previously used to explore white matter related to human immunodeficiency virus (HIV) infection. While DTI and DKI suffer from low specificity, the Combined Hindered and Restricted Model of Diffusion (CHARMED) provides additional microstructural specificity. We used these three models to evaluate microstructural differences between 35 HIV-positive patients without neurological impairment and 20 healthy controls who underwent diffusion-weighted imaging using three b-values. While significant group effects were found in all diffusion metrics, CHARMED and DKI analyses uncovered wider involvement (80% vs. 20%) of all white matter tracts in HIV infection compared with DTI. In restricted fraction (FR) analysis, we found significant differences in the left corticospinal tract, middle cerebellar peduncle, right inferior cerebellar peduncle, right corticospinal tract, splenium of the corpus callosum, left superior cerebellar peduncle, left superior cerebellar peduncle, pontine crossing tract, left posterior limb of the internal capsule, and left/right medial lemniscus. These are involved in language, motor, equilibrium, behavior, and proprioception, supporting the functional integration that is frequently impaired in HIV-positivity. Additionally, we employed a machine learning algorithm (XGBoost) to discriminate HIV-positive patients from healthy controls using DTI and CHARMED metrics on an ROIwise basis, and unique contributions to this discrimination were examined using Shapley Explanation values. The CHARMED and DKI estimates produced the best performance. Our results suggest that biophysical multishell imaging, combining additional sensitivity and built-in specificity, provides further information about the brain microstructural changes in multimodal areas involved in attentive, emotional and memory networks often impaired in HIV patients.While DTI suffers from low specificity, DKI and the Combined Hindered and Restricted Model of Diffusion (CHARMED) provide additional specificity. We used both the CHARMED, DKI and the DTI models to evaluate microstructural differences between 35 HIV-positive patients without neurological impairment and 20 healthy controls who underwent diffusion-weighted imaging using three b-values. Both whole brain statistics and explainable machine learning techniques suggest that the CHARMED model, combining additional sensitivity and built-in specificity, provides further information about the brain microstructural changes in multimodal areas involved in attentive, emotional and memory networks often impaired in HIV patients.image

Minosse, S., Picchi, E., Conti, A., di Giuliano, F., di Cio', F., Sarmati, L., et al. (2023). Multishell diffusion MRI reveals whole-brain white matter changes in HIV. HUMAN BRAIN MAPPING, 44(15), 5113-5124 [10.1002/hbm.26448].

Multishell diffusion MRI reveals whole-brain white matter changes in HIV

Minosse S.;Picchi E.;Conti A.;di Giuliano F.;di Cio' F.;Sarmati L.;Teti E.;Andreoni M.;Floris R.;Guerrisi M.;Garaci F.;Toschi N.
2023-01-01

Abstract

Diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI) have been previously used to explore white matter related to human immunodeficiency virus (HIV) infection. While DTI and DKI suffer from low specificity, the Combined Hindered and Restricted Model of Diffusion (CHARMED) provides additional microstructural specificity. We used these three models to evaluate microstructural differences between 35 HIV-positive patients without neurological impairment and 20 healthy controls who underwent diffusion-weighted imaging using three b-values. While significant group effects were found in all diffusion metrics, CHARMED and DKI analyses uncovered wider involvement (80% vs. 20%) of all white matter tracts in HIV infection compared with DTI. In restricted fraction (FR) analysis, we found significant differences in the left corticospinal tract, middle cerebellar peduncle, right inferior cerebellar peduncle, right corticospinal tract, splenium of the corpus callosum, left superior cerebellar peduncle, left superior cerebellar peduncle, pontine crossing tract, left posterior limb of the internal capsule, and left/right medial lemniscus. These are involved in language, motor, equilibrium, behavior, and proprioception, supporting the functional integration that is frequently impaired in HIV-positivity. Additionally, we employed a machine learning algorithm (XGBoost) to discriminate HIV-positive patients from healthy controls using DTI and CHARMED metrics on an ROIwise basis, and unique contributions to this discrimination were examined using Shapley Explanation values. The CHARMED and DKI estimates produced the best performance. Our results suggest that biophysical multishell imaging, combining additional sensitivity and built-in specificity, provides further information about the brain microstructural changes in multimodal areas involved in attentive, emotional and memory networks often impaired in HIV patients.While DTI suffers from low specificity, DKI and the Combined Hindered and Restricted Model of Diffusion (CHARMED) provide additional specificity. We used both the CHARMED, DKI and the DTI models to evaluate microstructural differences between 35 HIV-positive patients without neurological impairment and 20 healthy controls who underwent diffusion-weighted imaging using three b-values. Both whole brain statistics and explainable machine learning techniques suggest that the CHARMED model, combining additional sensitivity and built-in specificity, provides further information about the brain microstructural changes in multimodal areas involved in attentive, emotional and memory networks often impaired in HIV patients.image
2023
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/36
Settore MED/37 - Neuroradiologia
Settore MED/17
Settore PHYS-06/A - Fisica per le scienze della vita, l'ambiente e i beni culturali
Settore MEDS-22/B - Neuroradiologia
Settore MEDS-22/A - Diagnostica per immagini e radioterapia
Settore MEDS-10/B - Malattie infettive
English
white matter in HIV; multishell diffusion; machine learning; explainability; SHAP
This work is supported by: #NEXTGENERATIONEU (NGEU) and funded by the Ministry of University and Research (MUR), National Recovery and Resilience Plan (NRRP), project MNESYS (PE0000006) (to NT)– A Multiscale integrated approach to the study of the nervous system in health and disease (DN. 1553 11.10.2022); by the MUR-PNRR M4C2I1.3 PE6 project PE00000019 Heal Italia (to NT); by the NATIONAL CENTRE FOR HPC, BIG DATA AND QUANTUM COMPUTING, within the spoke “Multiscale Modeling and Engineering Applications” (top NT); The European Innovation Council (Project CROSSBRAIN, Grant Agreement n. 101070908, Project BRAINSTORM, Grant Agreement 101099355); And by the Horizon 2020 research and innovation Programme (Project EXPERIENCE: Grant Agreement 101017727).
Minosse, S., Picchi, E., Conti, A., di Giuliano, F., di Cio', F., Sarmati, L., et al. (2023). Multishell diffusion MRI reveals whole-brain white matter changes in HIV. HUMAN BRAIN MAPPING, 44(15), 5113-5124 [10.1002/hbm.26448].
Minosse, S; Picchi, E; Conti, A; di Giuliano, F; di Cio', F; Sarmati, L; Teti, E; de Santis, S; Andreoni, M; Floris, R; Guerrisi, M; Garaci, F; Toschi...espandi
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/403488
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