Longitudinal Neuroanatomical Changes in the Temporal Lobe in Patients with HIV-Associated Neurocognitive Disorders at the Lagos University Teaching Hospital: A Cortical Mapping Study

HIV-associated neurocognitive disorders represent a spectrum of cognitive, motor, and behavioural disturbances affecting up to 50 percent of people living with HIV, even in the era of antiretroviral therapy. The temporal lobe, including the hippocampus and parahippocampal gyrus, is particularly vulnerable to HIV-associated neurodegeneration. Longitudinal neuroanatomical data on temporal lobe structural changes in antiretroviral therapy-treated Nigerian patients are absent, limiting understanding of how effective treatment modifies the course of brain atrophy in this population. This study aims to characterise longitudinal temporal lobe cortical thickness and volume changes in HIV-positive patients with and without neurocognitive disorders attending the Lagos University Teaching Hospital, South West Nigeria. One hundred HIV-positive patients, 50 with and 50 without neurocognitive disorder diagnoses, and 50 HIV-negative controls will undergo structural MRI at baseline and at 12-month follow-up. Cortical parcellation using FreeSurfer will provide longitudinal thickness trajectories for temporal gyri, entorhinal cortex, and hippocampal subfields. Plasma HIV RNA and CD4 count trajectories will be correlated with neuroanatomical change rates. Findings will provide original longitudinal neuroanatomical evidence for temporal lobe vulnerability in HIV-associated neurocognitive disorders in an antiretroviral therapy-treated Nigerian cohort, informing neuroprotective treatment monitoring strategies.

Keywords: HIV-associated neurocognitive disorders, temporal lobe, cortical mapping, neuroimaging, Lagos