# Mechanism and Predictors of Neurocognitive Impairment in HIV Infection

> **NIH NIH K23** · UNIVERSITY OF MARYLAND BALTIMORE · 2022 · $189,320

## Abstract

As many as 50% of HIV infected patients develop HIV-associated neurocognitive disorder (HAND), despite
treatment with antiretroviral therapy (ART). The number of affected patients may rise, given the increasing,
and nearly normal, life expectancy of HIV patients. Fluctuating and sometimes declining neuropsychological
performance in treated HIV patients are clinically significant because they may lead to decreased
adherence to medication, higher mortality, poorer quality of life and mental health issues.
 The etiologies of these progressive neuropsychological changes are unclear, but may reflect
dysfunction in a range of neural subsystems, including cortico-cortical, cortico-cerebellar or corticostriatal
circuits that serve to integrate cognitive, motor and affective processing mechanisms. To study
neuropsychological effects of HIV infection and its co-morbidities, we propose to differentiate HIV effects
from five critical confounding factors: age, hepatitis C co-infection, ART type, systemic inflammation, and
vascular risk. We will determine: (1) if multiple, compared to single, clinical and neuroimaging features can
predict subsequent neuropsychological performance and (2) if longitudinal changes in brain structure and
function provide evidence about the nature of the underlying neural mechanisms of observed performance
changes. Using a Research Domain Criteria (RDoC) framework, we will focus on integrating performance
measures from the cognitive and sensorimotor domains with underlying changes in brain structure and
function. We are fortunate to have access to longitudinal data from the MACS, now known as the
MACS/WIHS Combined Cohort Study, a large, well characterized sample of males and females that will
allow us to identify changes in brain structure and function during HIV treatment. The research is significant
because neuropsychological performance deficits remain prevalent in spite of widespread ART use and
have significant public health implications. This project will allow identification of HIV patients who may
benefit from medical care changes related to vascular risk or ART type.
 The Principal Investigator, Erin O’Connor MD, is an Assistant Professor of Radiology at UMSOM,
whose long term career goal is to become an independent investigator in translational neuroradiology,
focusing on imaging predictors of neuropsychological effects in neuroinflammatory, neurodegenerative and
neurovascular disorders. To work towards this goal, we propose a research project designed to identify the
neural mechanisms underlying HIV-related cognitive and motor disability. For this project, Dr. O’Connor will
be mentored by a highly experienced neuroimaging team, including Dr. Chang, an HIV expert, Dr. Becker,
an expert in HIV neuropsychology and aging, and Dr. Zeffiro, an expert in translational neuroimaging and
statistics. The skills and analyses derived from this training grant will serve as the basis for a subsequent
R01 proposal designed to validate ...

## Key facts

- **NIH application ID:** 10355516
- **Project number:** 5K23MH118070-03
- **Recipient organization:** UNIVERSITY OF MARYLAND BALTIMORE
- **Principal Investigator:** Erin E O'Connor
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $189,320
- **Award type:** 5
- **Project period:** 2020-03-01 → 2024-02-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10355516

## Citation

> US National Institutes of Health, RePORTER application 10355516, Mechanism and Predictors of Neurocognitive Impairment in HIV Infection (5K23MH118070-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10355516. Licensed CC0.

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