{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T17:54:55Z","timestamp":1785779695380,"version":"3.56.0"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T00:00:00Z","timestamp":1779494400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100017950","name":"Shanghai Municipal Health Commission","doi-asserted-by":"publisher","award":["20234Y0263"],"award-info":[{"award-number":["20234Y0263"]}],"id":[{"id":"10.13039\/100017950","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Explorer Program of the Science and Technology Commission of Shanghai Municipality","award":["23TS1400600"],"award-info":[{"award-number":["23TS1400600"]}]},{"name":"Scientific Research Projects of Taiyuan Municipal Health Commission","award":["Y2023004"],"award-info":[{"award-number":["Y2023004"]}]},{"name":"Scientific Research Projects of Taiyuan Municipal Health Commission","award":["Z2024003"],"award-info":[{"award-number":["Z2024003"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This aim of this work was to investigate glymphatic function in people with human immunodeficiency virus type 1 (HIV-1) using diffusion tensor image analysis along the perivascular space (DTI-ALPS) and to explore its associations with cognition and clinical status, as well as its diagnostic utility in identifying asymptomatic neurocognitive impairment (ANI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Forty people with HIV (PWH) with ANI (PWH-ANI), 44 PWH with normal cognition (PWH-NC), and 29 age-, sex-, and education-matched persons without HIV underwent MRI and neuropsychological assessments. DTI-ALPS indices were calculated and their group differences were evaluated using general linear models. Partial correlation and multivariate regression analyses were conducted to assess associations between DTI-ALPS indices and cognitive or clinical variables. Mediation analyses were used to examine whether DTI-ALPS mediated the effect of HIV on cognition. Receiver operating characteristic (ROC) curve analysis was performed to assess the diagnostic performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>DTI-ALPS indices were significantly lower in PWH-ANI than persons without HIV and PWH-NC (all P &amp;lt; .01), with no differences between persons without HIV and PWH-NC. Among PWH, lower DTI-ALPS was associated with higher cognitive T scores (ie, poorer performance) in attention\/working memory, speed of information processing, and abstract\/executive function (all false discovery rate\u2013adjusted P &amp;lt; .05). DTI-ALPS for the bilateral hemisphere (DTI-ALPS_B) emerged as the only independent predictor and partially mediated the relationship between HIV status and these cognitive domains. ROC analysis showed that the combined model of DTI-ALPS_B and Montreal Cognitive Assessment (MoCA) outperformed MoCA alone (AUC, 0.782 and 0.619, respectively; P = .001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Reduced DTI-ALPS is evident in PWH-ANI and was associated with and mediated cognitive impairment. DTI-ALPS may serve as a noninvasive biomarker facilitating early detection of PWH-ANI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiag265","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T11:43:29Z","timestamp":1779277409000},"page":"112-121","source":"Crossref","is-referenced-by-count":0,"title":["Altered Diffusion Tensor Image Analysis Along the Perivascular Space in People With Human Immunodeficiency Virus: Association With Cognition and Diagnostic Utility for Asymptomatic Neurocognitive Impairment"],"prefix":"10.1093","volume":"234","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5032-5036","authenticated-orcid":false,"given":"Ke","family":"Xue","sequence":"first","affiliation":[{"name":"Qingdao Institute, School of Life Medicine, Department of Radiology, Shanghai Public Health Clinical Center, Fudan University , Qingdao 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,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4591-4431","authenticated-orcid":false,"given":"Jay C","family":"Buckey","sequence":"additional","affiliation":[{"name":"Geisel School of Medicine at Dartmouth Space Medicine Innovations Laboratory, , Lebanon, New Hampshire ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jili","family":"Wu","sequence":"additional","affiliation":[{"name":"Fourth People\u2019s Hospital of Taiyuan Department of Radiology, , Taiyuan ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengxiang","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Radiology, Shanghai Public Health Clinical Center, Fudan University , Shanghai ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of 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