Fernando Moradel Cano
University of Miami
Co-Authors: Teddy Salan1, Sulaiman A Sheriff1, Dario N Ayala1, Yoibel Perez1, Anjalie Geffard1, Clara Morales1, Ranya Marrakchi El Fellah1, Suresh Pallikkuth1, Lisa J Reidy1, Eva Widerstrom-Noga1, Denise C Vidot1, Allan E Rodriguez1, Robert L Cook2, Varan Govind1
1University of Miami, 2University of Florida
Background: Myo-inositol (MI) is a brain metabolite associated with glial cell activity and osmotic regulation, often linked to neuroinflammatory responses that may impact cognition and other processes. Acute HIV infection can induce neuroinflammation, which typically subsides after antiretroviral therapy (ART) initiation. However, research on how different brain cells respond to cannabis use in the context of HIV remains limited. This study examines associations between cannabis use (CB+) and brain MI levels in people with HIV (PWH) and HIV-negative (HIV-) individuals, focusing on brain regions involved in stress and emotion processing.
Methods: Ninety-three participants (males/females: n=47/46; HIV+/HIV-: n=48/45; Mean age = 36, SD = 7.7; age-range: 18-50 years) were enrolled into four groups: HIV+CB+, HIV-CB-, HIV+CB-, and HIV-CB+. Eligibility criteria included no MRI contraindications, no primary psychiatric or neurological conditions, and cannabis use within the past month, or no cannabis use at all. Assessment data consists of a 3-Tesla whole-brain magnetic resonance spectroscopy to examine MI levels in 47 brain regions, cannabis metabolite concentrations obtained from blood plasma, and perceived stress scale-10 (PSS-10) scores. Two-way ANOVA and Pearson correlation with significance testing at p < 0.05 were used.
Results: Significant MI levels were observed in combined interactions of cannabis use and HIV status in the right insula (F = 4.42, p = 0.041) and right putamen (F = 4.10, p = 0.049). Independent cannabis associations on MI levels were observed in the left thalamus (F = 8.36, p = 0.006), left insula (F=5.37, p=0.025), and right putamen (F=8.51, p=0.005). Independent HIV status associations on MI were observed in the thalamus bilaterally (F=6.07, p=0.017 for left; F=6.40, p=0.015 for right) and right insula (F=6.83, p=0.012). MI in all four groups had positive correlations with blood plasma Δ9-THC in the bilateral insula (R = 0.49, p = 0.0001) and right putamen (R = 0.64, p < 0.0001). HIV+CB+, HIV-CB+, and HIV-CB- groups showed moderate stress scores (16-19 range), with HIV-CB+ having relatively higher scores. There were no significant correlations between MI levels and PSS-10 scores.
Conclusion: The findings indicate that cannabis and HIV status have combined and independent associations with MI in brain regions linked to stress and emotion processing. In all four groups, MI levels were positively correlated with blood plasma Δ9-THC. Additionally, the HIV-CB+ group exhibited higher stress scores. These results highlight the need for further exploration with larger samples to understand how cannabis influences brain inflammation and stress responses.