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3 The Relationship Between Apolipoprotein-E4 Genotype, Memory, and the Medial Temporal Lobe and How These Relationships Vary by Race in Middle-Aged Persons with HIV
- Laura M Campbell, Maulika Kohli, Erin E Sundermann, Christine Fennema-Notestine, Averi Barrett, Cinnamon Bloss, Mark W Bondi, David B Clifford, Ronald J Ellis, Donald Franklin, Benjamin Gelman, Igor Grant, Robert K Heaton, Scott Letendre, Payal B Patel, David J Moore, Susan Morgello, Raeanne C Moore
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 683-684
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- Article
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Objective:
Many people with HIV (PWH) are at risk for age-related neurodegenerative disorders such as Alzheimer’s disease (AD). Studies on the association between cognition, neuroimaging outcomes, and the Apolipoprotein E4 (APOE4) genotype, which is associated with greater risk of AD, have yielded mixed results in PWH; however, many of these studies have examined a wide age range of PWH and have not examined APOE by race interactions that are observed in HIV-negative older adults. Thus, we examined how APOE status relates to cognition and medial temporal lobe (MTL) structures (implicated in AD pathogenesis) in mid- to older-aged PWH. In exploratory analyses, we also examined race (African American (AA)/Black and non-Hispanic (NH) White) by APOE status interactions on cognition and MTL structures.
Participants and Methods:The analysis included 88 PWH between the ages of 45 and 68 (mean age=51±5.9 years; 86% male; 51% AA/Black, 38% NH-White, 9% Hispanic/Latinx, 2% other) from the CNS HIV Antiretroviral Therapy Effects Research multi-site study. Participants underwent APOE genotyping, neuropsychological testing, and structural MRI; APOE groups were defined as APOE4+ (at least one APOE4 allele) and APOE4- (no APOE4 alleles). Eighty-nine percent of participants were on antiretroviral therapy, 74% had undetectable plasma HIV RNA (<50 copies/ml), and 25% were APOE4+ (32% AA/Black/15% NH-White). Neuropsychological testing assessed seven domains, and demographically-corrected T-scores were calculated. FreeSurfer 7.1.1 was used to measure MTL structures (hippocampal volume, entorhinal cortex thickness, and parahippocampal thickness) and the effect of scanner was regressed out prior to analyses. Multivariable linear regressions tested the association between APOE status and cognitive and imaging outcomes. Models examining cognition covaried for comorbid conditions and HIV disease characteristics related to global cognition (i.e., AIDS status, lifetime methamphetamine use disorder). Models examining the MTL covaried for age, sex, and
relevant imaging covariates (i.e., intracranial volume or mean cortical thickness).
Results:APOE4+ carriers had worse learning (ß=-0.27, p=.01) and delayed recall (ß=-0.25, p=.02) compared to the APOE4- group, but APOE status was not significantly associated with any other domain (ps>0.24). APOE4+ status was also associated with thinner entorhinal cortex (ß=-0.24, p=.02). APOE status was not significantly associated with hippocampal volume (ß=-0.08, p=0.32) or parahippocampal thickness (ß=-0.18, p=.08). Lastly, race interacted with APOE status such that the negative association between APOE4+ status and cognition was stronger in NH-White PWH as compared to AA/Black PWH in learning, delayed recall, and verbal fluency (ps<0.05). There were no APOE by race interactions for any MTL structures (ps>0.10).
Conclusions:Findings suggest that APOE4 carrier status is associated with worse episodic memory and thinner entorhinal cortex in mid- to older-aged PWH. While APOE4+ groups were small, we found that APOE4 carrier status had a larger association with cognition in NH-White PWH as compared to AA/Black PWH, consistent with studies demonstrating an attenuated effect of APOE4 in older AA/Black HIV-negative older adults. These findings further highlight the importance of recruiting diverse samples and suggest exploring other genetic markers (e.g., ABCA7) that may be more predictive of AD in some races to better understand AD risk in diverse groups of PWH.
Daily Cannabis Use is Associated With Lower CNS Inflammation in People With HIV
- C. Wei-Ming Watson, Laura M. Campbell, Ni Sun-Suslow, Suzi Hong, Anya Umlauf, Ronald J. Ellis, Jennifer E. Iudicello, Scott Letendre, Thomas D. Marcotte, Robert K. Heaton, Erin E. Morgan, Igor Grant
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- Journal:
- Journal of the International Neuropsychological Society / Volume 27 / Issue 6 / July 2021
- Published online by Cambridge University Press:
- 15 July 2021, pp. 661-672
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Objective:
Recent cannabis exposure has been associated with lower rates of neurocognitive impairment in people with HIV (PWH). Cannabis’s anti-inflammatory properties may underlie this relationship by reducing chronic neuroinflammation in PWH. This study examined relations between cannabis use and inflammatory biomarkers in cerebrospinal fluid (CSF) and plasma, and cognitive correlates of these biomarkers within a community-based sample of PWH.
Methods:263 individuals were categorized into four groups: HIV− non-cannabis users (n = 65), HIV+ non-cannabis users (n = 105), HIV+ moderate cannabis users (n = 62), and HIV+ daily cannabis users (n = 31). Differences in pro-inflammatory biomarkers (IL-6, MCP-1/CCL2, IP-10/CXCL10, sCD14, sTNFR-II, TNF-α) by study group were determined by Kruskal–Wallis tests. Multivariable linear regressions examined relationships between biomarkers and seven cognitive domains, adjusting for age, sex/gender, race, education, and current CD4 count.
Results:HIV+ daily cannabis users showed lower MCP-1 and IP-10 levels in CSF compared to HIV+ non-cannabis users (p = .015; p = .039) and were similar to HIV− non-cannabis users. Plasma biomarkers showed no differences by cannabis use. Among PWH, lower CSF MCP-1 and lower CSF IP-10 were associated with better learning performance (all ps < .05).
Conclusions:Current daily cannabis use was associated with lower levels of pro-inflammatory chemokines implicated in HIV pathogenesis and these chemokines were linked to the cognitive domain of learning which is commonly impaired in PWH. Cannabinoid-related reductions of MCP-1 and IP-10, if confirmed, suggest a role for medicinal cannabis in the mitigation of persistent inflammation and cognitive impacts of HIV.
9 - ‘Part of my Heritage’: Ladies’ Pipe Bands, Associational Culture and ‘Homeland’ Identities in the Scottish Diaspora
- Edited by Angela McCarthy, University of Otago
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- Book:
- Global Migrations
- Published by:
- Edinburgh University Press
- Published online:
- 23 September 2017
- Print publication:
- 17 May 2016, pp 159-176
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Summary
INTRODUCTION
THROUGHOUT THE IMPERIAL AND non-imperial destinations to which Scots gravitated, they expressed their ethnic identities in various ways, including the founding of Caledonian societies, the building of memorials and statues, and the organisation of festivals such as Highland Games and pipe band competitions. Angela McCarthy explains that although scholars are alert to these components, they have generally focused either on one particular aspect, such as ethnic societies, or fleetingly mentioned such elements without sustained analysis. For many ladies’ pipe band members, and indeed other members of Scottish groups, their association was linked – to varying degrees – to a sense of Scottish ethnicity. This chapter will extend this scholarship by surveying Scottish ethnic identities through two approaches: public group expressions of Scottishness, as revealed by ladies’ pipe bands and their various connections to other forms of Scottish associational culture; and personal expressions of individual band members. It therefore engages with established research on associational culture, but also emphasises personal articulations of Scottishness. This central objective is important, for, while
Scottish associational culture was critical for some, it alone cannot shape our understanding of ethnic identities, Scottish or otherwise. Indeed, given that most Scottish migrants did not join a Scottish association, it was their personal sense of Scottishness which overshadowed their ethnic affiliations.
As sociologist David McCrone puts it, ‘Perhaps too much attention is paid to the identity labels that people are “forced” to wear, and not enough on how they select and actively present themselves to others.’
This chapter draws on a larger study which examined ten ladies’ pipe bands across Scotland and its diaspora (Australia, Canada, England and New Zealand) between 1918 and 2012. It uses as evidence interviews conducted both in person, and where necessary, by email. The ages of the interview subjects vary, with most of these women beginning their piping hobbies as teenagers (mostly around twelve to eighteen years old) in the late 1940s and throughout the 1950s and 1960s. Their current ages therefore range between fifty-six and ninety-two, reflecting a sampling of musicians in age and association to a Scottish descent group. All these interviewees were recruited through social networking. In Australia, no former members could be located, and in England, no interest could be summoned.