Cortical Neuroplasticity and fNIRS Seed-Based Connectivity in Adolescent HIV: A Pilot Randomized Clinical Trial

HIV neuroinvasion results in neuronal dysregulation and compromised neurocognition. Neuroplasticity measures, such as HIV cognitive rehabilitation, have shown potential for partially reversing cognitive deficits after HIV invasion. Previous functional NIRS (fNIRS) studies have demonstrated that customized attention brain training (ABT) has the potential to alter brain activity in adolescent HIV. Nonetheless, the effects of ABT on brain functional connectivity in adolescent HIV remain unclear. This study investigated behavioral and functional connectivity changes in adolescent HIV amongst participants (n = 26) receiving 12 weeks of ABT compared to treatment-as-usual (TAU) controls. Twenty-six adolescents living with HIV were recruited and randomly assigned to either the ABT group (n = 13) or the TAU group (n = 13). Participants completed NEPSY-II and fNIRS measures before and after the training. Functional connectivity (FC) measures were evaluated using seed-based correlation analysis, located in the central executive network (CEN) and across the hemispheres. No significant behavioral differences were noted on the NEPSY-II and BRIEF scores; however, functional connectivity measures indicated that the ABT group exhibited significantly increased FCs in the left hemisphere (p < 0.05) following brain training. Additionally, thresholding analysis indicated that the dorsolateral prefrontal cortex may serve as a potential marker for brain training in adolescent neuro-HIV.