Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Oct 23;25(1):1019.
doi: 10.1186/s12888-025-07267-4.

Depressive disorders are associated with brain structural injury in HIV-positive men who have sex with men

Yihui He #  1   2   3 , Wen Wang #  1   4 , Ping Wu #  5   6 , Guangqiang Sun  7   8 , Yundong Ma  7   8 , Miaotian Cai  9 , Letian Liu  1   4 , Yanmin Liu  10 , Lei Wang  2   3 , Yulin Zhang  9 , Cheng Wan  11 , Tong Zhang  12   13 , Yang Zhang  14   15
Affiliations

Depressive disorders are associated with brain structural injury in HIV-positive men who have sex with men

Yihui He et al. BMC Psychiatry. .

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.

Keywords: Depressive disorders; Human immunodeficiency virus; Magnetic resonance imaging; Surface-based morphometry; Voxel-based morphometry.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: The studies involving human participants were reviewed and approved by the Institutional Review Boards of Beijing Youan Hospital, Capital Medical University (JYKL 2023–057). All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 2013 Helsinki Declaration and its later amendments or comparable ethical standards. Written informed consent was obtained from all participants prior to their participation in this study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Participants in the PWH-DD group displayed lower gray matter volume in the left middle frontal gyrus compared to those in the PWH control group. Coordinates (X, Y, Z) refer to the peak MNI coordinates of brain regions with peak intensity (Gaussian Random Field correction, cluster level P < 0.05). Abbreviations: PWH-DD, people with HIV with comorbid depressive disorders, MNI, Montreal Neurological Institute
Fig. 2
Fig. 2
Participants in the PWH-DD group exhibited shallower sulcal depth compared to those in the PWH control group, particularly in the left supramarginal gyrus, left superior parietal gyrus, and right superior parietal gyrus. Statistical significance was set at P < 0.001 (uncorrected). Abbreviations: PWH-DD, people with HIV with comorbid depressive disorders
Fig. 3
Fig. 3
Participants in the PWH-DD group exhibited lower fractal dimensions in the left caudal middle frontal gyrus, right rostral middle frontal gyrus, right frontal pole, and left middle temporal gyrus compared to those in the PWH control group. Statistical significance was set at P < 0.001 (uncorrected). Abbreviations: PWH-DD, people with HIV with comorbid depressive disorders
Fig. 4
Fig. 4
In the analysis of all participants, correlation between structural neuroimaging findings and the clinical assessment results. Abbreviations: GMV, gray matter volume; SD, sulcal depth; FD, fractal dimension; L, left; R, right; SAS, Self-rating Anxiety Scale; SDS, Self-rating Depression Scale; PSQI, Pittsburgh Sleep Quality Index; CTQ, Childhood Trauma Questionnaire; SCL-90, Symptom Checklist 90; AUQ, Alcohol Urge Questionnaire; VAS, Visual Analogue Scale for alcohol craving; MoCA, Montreal Cognitive Assessment. *P < 0.05; **P < 0.01
See this image and copyright information in PMC

References

    1. Ciesla JA, Roberts JE. Meta-analysis of the relationship between HIV infection and risk for depressive disorders. Am J Psychiatry. 2001;158(5):725–30. - PubMed
    1. Medeiros GC, Smith FA, Trivedi MH, Beach SR. Depressive disorders in HIV/AIDS: a clinically focused narrative review. Harv Rev Psychiatry. 2020;28(3):146–58. - PubMed
    1. Huang H, Zhang X, Tu L, Zhang L, Chen H. Effectiveness of nurse-led self-care interventions on quality of life, social support, depression and anxiety among people living with HIV: a systematic review and meta-analysis of randomized controlled trials. Int J Nurs Stud. 2025;161: 104916. - PubMed
    1. Rao D, Feldman BJ, Fredericksen RJ, Crane PK, Simoni JM, Kitahata MM, Crane HM. A structural equation model of HIV-related stigma, depressive symptoms, and medication adherence. AIDS Behav. 2012;16(3):711–6. - PMC - PubMed
    1. Norcini Pala A, Steca P, Bagrodia R, Helpman L, Colangeli V, Viale P, Wainberg ML. Subtypes of depressive symptoms and inflammatory biomarkers: an exploratory study on a sample of HIV-positive patients. Brain Behav Immun. 2016;56:105–13. - PMC - PubMed

MeSH terms

LinkOut - more resources