Abstract
BACKGROUND: Depressive disorders (DD) are more prevalent among people with HIV (PWH) compared to the general population. Research in the general population has confirmed the association between depression and gray matter atrophy as well as reduced cortical thickness. However, there is a lack of neuroimaging studies investigating brain structural changes in PWH with comorbid DD (PWH-DD). METHODS: This cross-sectional study included 69 HIV-positive men who have sex with men, categorized into PWH-DD (n = 29) and PWH control (n = 40) groups based on the diagnosis of DD. Participants underwent clinical, neuropsychiatric, and MRI evaluations. Voxel-based and surface-based morphometry techniques were applied to analyze gray matter volume (GMV) and cortical anatomical characteristics in structural MRI data. The imaging findings were ultimately correlated with the results of clinical assessments. RESULTS: Compared to participants in the PWH control group, those in the PWH-DD group showed higher scores in evaluation of depression, anxiety, sleep disturbances, childhood trauma, and mental health symptoms, indicating a greater burden of psychological and emotional distress. Comparisons of brain structure showed that participants in the PWH-DD group exhibited lower GMV in the left middle frontal gyrus, shallower sulcal depth in the left supramarginal and bilateral superior parietal regions, and lower fractal dimension in multiple frontal and temporal lobe areas compared to those in the PWH control group. Among all participants, correlation analysis demonstrated that GMV of the left middle frontal gyrus was significantly negatively correlated with Self-Rating Depression Scale scores. CONCLUSION: This study emphasizes that HIV-positive men who have sex with men with comorbid DD exhibit poorer mental health status and more severe brain structural alterations. However, further longitudinal studies are needed to explore the exact causal relationship between DD and brain structural injury in PWH.