# The Role of Aortic-Carotid Hemodynamics and Aberrant Flow in HIV Cerebral Injury

> **NIH NIH R21** · NORTHWESTERN UNIVERSITY · 2021 · $240,000

## Abstract

Project Summary
While viral suppression can be achieved with combination antiretroviral therapy (cART),
persons living with HIV (PLWH) remain at considerable risk of brain involvement and cognitive
impairment. Despite evidence of vascular pathology in PLWH, these mechanisms are not well
understood. This investigation will use new 4D Flow MRI capabilities to evaluate specific
vascular mechanisms that may play a role in brain alterations and cognitive decline in
suppressed PLWH (Aim 1). Neurovascular 4D flow MRI will be used to quantify total blood
flow to the brain (TCBF) and to derive flow rates, peak velocities and the Pulsatility Index for
the cerebral arteries (Aim 1). We will use Cardiac 4D Flow MRI to quantify ascending aortic
flow, cardiac output/index and derive the aortic-carotid pulse wave velocity (PWV) ratio. This
approach, which has not yet been used to evaluate virally suppressed PLWH, may provide
new insights into vascular mechanisms. We are particularly interested in whether there are
differences in the aortic-carotid PWV ratio and cerebral Pulsatility Index compared to age-
matched seronegative controls (Aim 1). We will enroll participants for our hemodynamic
analysis from a unique cohort with imaging and cognitive data available for early infection with
well-documented cART initiation dates (PLWH and age-matched seronegative controls). By
leveraging the archived data, this R21 funding can also accomplish a 10 year follow-up study to
determine brain changes and cognitive decline over the first decade of infection in cART
suppressed PLWH (Aim 2). We can determine whether the hypothesized vascular
mechanisms are associated with the severity of cerebral small vessel disease (SVD), cortical
thinning, localized volume loss and decline in specific cognitive functions in cART
suppressed PLWH (Aim 3). If confirmed, these vascular mechanisms may inform new
therapeutic strategies and these hemodynamic parameters may provide new measures of
vascular risk and response to treatment in suppressed PLWH.

## Key facts

- **NIH application ID:** 10266136
- **Project number:** 5R21NS122511-02
- **Recipient organization:** NORTHWESTERN UNIVERSITY
- **Principal Investigator:** ANN B RAGIN
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $240,000
- **Award type:** 5
- **Project period:** 2020-09-30 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10266136

## Citation

> US National Institutes of Health, RePORTER application 10266136, The Role of Aortic-Carotid Hemodynamics and Aberrant Flow in HIV Cerebral Injury (5R21NS122511-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10266136. Licensed CC0.

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