Assessment of Brain Volume and Cortical Thickness in People with HIV and Major Depressive Disorder

Objective: This study aims to examine neuroanatomical differences associated with depressive symptoms in people with HIV (PWH) by comparing three groups: depressed PWH (PWH Dep+), non-depressed PWH (PWH Dep−), and HIV-negative controls. The primary goal is to explore specific alterations in brain volume and cortical thickness linked to depressive symp-tomatology in PWH. Methods: A total of 61 male participants (28 PWH, 33 controls) underwent psychiatric evaluation and high-resolution structural MRI scanning. Voxel-based morphometry (VBM) and cortical thickness analyses were conducted, with age and education considered as covariates. Participants were classified into PWH Dep+ and PWH Dep− based on depression scales. Results: The PWH Dep+ group exhibited increased gray matter volume in the left anterior cin-gulate cortex and decreased cortical thickness in the left frontal pole compared to controls. In contrast, PWH Dep− participants showed increased cortical thickness in the bilateral postcentral gyrus and posterior cingulate gyrus. Additionally, volume reductions in the middle occipital and middle temporal gyri distinguished PWH Dep+ from PWH Dep−. Conclusions: Depression in PWH is associated with structural brain changes, particularly in frontal and occipital regions. Although causality cannot be inferred due to the cross-sectional design, these results may enhance our understanding of the neuropathological mechanisms un-derlying depression in PWH. The findings should be interpreted with caution, given the relatively small sample size and the exclusion of female participants.