This study applies a hypothesis-driven approach to examine the effects of chronic marijuana use on HIV-associated inflammation and its subsequent impacts on central nervous system function, with the goal of identifying the mechanisms through which cannabinoids modulate neurological disorders and other comorbidities in persons with HIV.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
220
The investigators will use multimodal, multi-parametric sequences to investigate neuroinflammatory and neurodegenerative processes in vivo. Participants will be assessed three times over 2 years.
Blood samples will be collected for immune and cytokine profiling. Participants will be assessed three times over 2 years.
Participants will have neuropsychological testing three times over 2 years.
Biotech Place
Winston-Salem, North Carolina, United States
RECRUITINGChange in neurocognitive function as measured by neuropsychological battery
The neuropsychological testing battery assesses 7 cognitive domains with 3-4 tests per domain. Raw scores from each test will be converted to demographically adjusted standard scores, called T-scores using up-to-date US normative data. A T-score of 50 is considered the normative mean, and each 10-point deviation is equivalent to 1 standard deviation. The minimum possible T-score is 0 and the maximum is 100, with higher scores meaning better neurocognitive function. The average T-score for all tests in a domain will be the domain T-score, and the average of all domain T-scores will be the global T-score. T-scores will serve as the primary continuous measure because they capture the full range of cognitive function.
Time frame: baseline, 1-year follow-up, and 2-year follow-up
Change in neuronal integrity as measured by N-acetyl aspartate (NAA)
NAA will be measured using Echo-planar spectroscopic imaging. Lower NAA is associated with less neuronal integrity. NAA units of measure is parts per million.
Time frame: baseline, 1-year follow-up, and 2-year follow-up
Change in neuronal-glial interaction as measured by Glutamate + glutamine (GLX)
GLX will be measured using Echo-planar spectroscopic imaging. Lower GLX is indicative of less neuronal-glial interactions. GLX units of measure is parts per million.
Time frame: baseline, 1-year follow-up, and 2-year follow-up
Change in axonal loss and injury as measured by axonal diffusivity (AD)
AD will be measured using diffusion-weighted imaging. Lower axonal diffusivity is associated with more axonal loss and injury. The unit of measure for AD is micrometer\^2/millisecond.
Time frame: baseline, 1-year follow-up, and 2-year follow-up
Change in demyelination or dysmyelination as measured by radial diffusivity (RD)
RD will be measured using diffusion-weighted imaging. Higher radial diffusivity is associated with more demyelination and dysmyelination. The unit of measure for RD is micrometer\^2/millisecond.
Time frame: baseline, 1-year follow-up, and 2-year follow-up
Change in overall white matter integrity as measured by fractional anisotropy (FA)
FA will be measured using diffusion-weighted imaging. Higher FA is associated with higher overall white matter integrity. FA is a scalar value between 0 and 1.
Time frame: baseline, 1-year follow-up, and 2-year follow-up
Change in inflammation-related cellularity as measured by restricted fraction (RF)
RF will be measured using diffusion-weighted imaging. Higher restricted fraction is associated with higher inflammation-related cellularity. The unit of measure for RF is micrometer\^2/millisecond.
Time frame: baseline, 1-year follow-up, and 2-year follow-up
Change in extracellular tissue edema as measured by non-restricted fraction (NF)
NF will be measured using diffusion-weighted imaging. Lower non-restricted fraction is associated with increased extracellular tissue edema. The unit of measure for NF is micrometer\^2/millisecond.
Time frame: baseline, 1-year follow-up, and 2-year follow-up
Change in gray matter as measured by cortical area and thickness and cortical and subcortical volume
Cortical areas and thickness and cortical and subcortical volume will be measured using T1-weighted imaging. Lower gray matter is associated with decreased cognitive function and is a marker of neurodegenerative disease. Cortical area, thickness, and volume units of measure are in millimeter\^2. Subcortical volume units of measure are in millimeter\^3.
Time frame: baseline, 1-year follow-up, and 2-year follow-up
Change in white matter integrity as measured by white matter tract streamline count
White matter tract streamline count will be measured using diffusion-weighted imaging. Lower white matter tract streamline count is associated with lower white matter integrity. The unit of measure for white matter tract streamline count is the total number of streamlines within a white matter tract.
Time frame: baseline, 1-year follow-up, and 2-year follow-up
Change in axonal damage was measured by neurofilament light (NfL) protein
NfL will be measured using blood serum and processed using an ultrasensitive immunoassay. Higher NfL is associated with more axonal damage. NfL protein units of measure are in picogram/milliliter\^-1.
Time frame: baseline, 1-year follow-up, and 2-year follow-up
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