Imperial College London

Dr Jonathan Underwood

Faculty of MedicineDepartment of Infectious Disease

Honorary Clinical Research Fellow



+44 (0)20 3312 1466jonathan.underwood Website CV




Winston Churchill WingSt Mary's Campus






BibTex format

author = {Cole, JH and underwood, J and Caan, MWA and De, Francesco D and van, Zoest RA and Leech, R and Wit, FWNM and Portegies, P and Geurtsen, GJ and Schmand, BA and Schim, van der Loeff MF and Franceschi, C and Sabin, CA and Majoie, CBLM and Winston, A and Reiss, P and Sharp, DJ},
doi = {10.1212/WNL.0000000000003790},
journal = {Neurology},
pages = {1349--1357},
title = {Increased brain-predicted ageing in treated HIV disease},
url = {},
volume = {88},
year = {2017}

RIS format (EndNote, RefMan)

AB - Objective: To establish whether HIV disease is associated with abnormal levels of age-related brain atrophy, by estimating apparent “brain age” using neuroimaging and exploring whether these estimates related to HIV-status, age, cognitive performance and HIV-related clinical parameters.Methods: A large sample of virologically-suppressed HIV-positive adults (N = 162, aged 45-82 years) and highly-comparable HIV-negative controls (N = 105) were recruited as part of the COBRA collaboration. Using T1-MRI scans, a machine-learning model of healthy brain ageing was defined in an independent cohort (N = 2001, aged 18-90 years). Neuroimaging data from HIV-positive and HIV-negative individuals were then used to estimate brain-predicted age; then brain-predicted age difference (brain-PAD = brain-predicted brain age - chronological age) scores were calculated. Neuropsychological and clinical assessments were also carried out.Results: HIV-positive individuals had greater brain-PAD score (mean ± SD = 2.15 ± 7.79 years) compared to HIV-negative individuals (-0.87 ± 8.40 years; b = 3.48, p < 0.01). Increased brain-PAD score was associated with decreased performance in multiple cognitive domains (information processing speed, executive function, memory) and general cognitive performance across all participants. Brain-PAD score was not associated with age, duration of HIV-infection or other HIV-related measures.Conclusions: Increased apparent brain ageing, predicted using neuroimaging, was observed in HIV-positive adults, despite effective viral suppression. Furthermore, the magnitude of increased apparent brain ageing related to cognitive deficits. However, predicted brain age difference did not correlate with chronological age or duration of HIV-infection, suggesting that HIV disease may accentuate, rather than accelerate brain ageing.
AU - Cole,JH
AU - underwood,J
AU - Caan,MWA
AU - De,Francesco D
AU - van,Zoest RA
AU - Leech,R
AU - Portegies,P
AU - Geurtsen,GJ
AU - Schmand,BA
AU - Schim,van der Loeff MF
AU - Franceschi,C
AU - Sabin,CA
AU - Majoie,CBLM
AU - Winston,A
AU - Reiss,P
AU - Sharp,DJ
DO - 10.1212/WNL.0000000000003790
EP - 1357
PY - 2017///
SN - 0028-3878
SP - 1349
TI - Increased brain-predicted ageing in treated HIV disease
T2 - Neurology
UR -
UR -
VL - 88
ER -