Older persons with HIV (OPWH) often have trouble walking and suffer from falls. Locomotion control is centered in the brain’s fronto-striatial circuitry—shown to be disrupted by the HIV-caused neuroinflammation that also contributes to cognitive impairment among persons with HIV.

Roee Holtzer, Ph.D., Anjali Sharma, M.D., M.S., and colleagues were awarded a five-year, $4-million National Institutes of Health grant to study the role of brain circuits and neuroinflammation in causing walking problems and falls in OPWH and to determine whether training could improve mobility in OPWH.

The study will examine the effects of brain structure, function, and inflammation on walking ability and risk of falling in 120 OPWH (age 50 and older) and 120 people without HIV. As they participate in a “dual task” walking procedure validated for predicting falls in older people, the subjects’ brain function will be evaluated using functional-near-infrared-spectroscopy. In addition, several MRI methods will independently assess disruptions in fronto-striatial circuitry. Measures of neuroinflammation will be collected as well. The study’s findings may lead to effective physical, cognitive, or drug treatments to correct mobility impairments and reduce the risk of falls among OPWH.

Dr. Holtzer is professor in the Saul R. Korey Department of Neurology at Einstein. Dr. Sharma is professor of medicine at Einstein. (1R01NS127697-01A1)