Bryan K Smith

Southern Illinois University Edwardsville | SIUE · Department of Applied Health

Background Cardiovascular disease (CVD) and neuroinflammation are thought to exacerbate neurocognitive dysfunction in treated people with HIV (PWH). Here, we longitudinally measured brain glucose metabolism as a measure of neuronal integrity in treated PWH using [18F]Fluorodeoxyglucose (FDG) PET/CT in correlation with atherosclerotic cardiovascular...

Objectives: After acute coronavirus disease-2019 (COVID-19), people often experience fatigue, "brain fog," or other central neurologic symptoms (neuro-post-acute SARS-CoV2, or "Neuro-PASC"). In this observational study we evaluated whether abnormalities noted on initial evaluation persist after at least another year. Methods: Neuro-PASC research...

Background and objectives: The diagnosis of multiple sclerosis (MS) can be challenging in clinical practice because MS presentation can be atypical and mimicked by other diseases. We evaluated the diagnostic performance, alone or in combination, of the central vein sign (CVS), paramagnetic rim lesion (PRL), and cortical lesion (CL), as well as the...

Human immunodeficiency virus type-1 (HIV-1) is responsible for significant mortality and morbidity worldwide. Despite complete control of viral replication with antiretrovirals, cells with integrated HIV-1 provirus can produce viral transcripts. In a cross-sectional study of 84 HIV+ individuals of whom 43 were followed longitudinally, we found that...

Prolonged and chronic sedentary behavior contributes to negative metabolic health conditions. Recent research has shown that a single bout of combined arm and leg cycling (CALC) can improve acute glucose metabolism in non-diabetic college aged adults. If a short bout of CALC can improve glucose metabolism in individuals that are non-diabetic then o...

Post-infectious myalgic encephalomyelitis/chronic fatigue syndrome (PI-ME/CFS) is a disabling disorder, yet the clinical phenotype is poorly defined, the pathophysiology is unknown, and no disease-modifying treatments are available. We used rigorous criteria to recruit PI-ME/CFS participants with matched controls to conduct deep phenotyping. Among...

Objective To investigate the relationship between neurocognitive deficits and structural changes on brain magnetic resonance imaging in people living with HIV (PLWH) with good virological control on combination antiretroviral therapy, compared with socioeconomically matched control participants recruited from the same communities. Methods Brain ma...

Cardiac adipose tissue (CAT) has become an important target for the reduction of disease risk. Supervised exercise programs have shown potential to "significantly" reduce CAT; however, the impact of different exercise modalities is not clear, and the relationships between CAT, physical activity (PA) levels and fitness (PFit) remain unknown. Therefo...

PurposeA comprehensive investigation of various maximum voluntary contraction (MVC) positions to determine the optimal positions for vastus lateralis (VL), biceps femoris (BF), gastrocnemius lateralis (GL), and tibialis anterior (TA).Methods Twelve participants performed total of seventeen MVC positions for major lower limb muscle groups (VL, BF, G...

Purpose of Review Progressive multifocal leukoencephalopathy (PML) is a severe opportunistic infection that remains an important cause of morbidity and mortality in people living with HIV (PLWH). Immune checkpoint molecules are negative regulators of the immune response that have been targeted as a strategy to bolster anti-viral immunity in PML, wi...

BACKGROUND Prolonged and chronic sedentary behavior (SB) contributes to negative health problems including cardiovascular and metabolic diseases. Research has shown that short bouts of exercise throughout the day can minimize the negative cardiovascular and metabolic effects resulting from SB. The purpose of this study was to determine the effects...

Background HIV persistence during antiretroviral therapy (ART) is the principal obstacle to cure. Lymphoid tissue is a compartment for HIV, but mechanisms of persistence during ART and viral rebound when ART is interrupted are inadequately understood. Metabolic activity in lymphoid tissue of patients on long-term ART is relatively low, and increase...

Obesity among aging women is associated with increased risk for metabolic and cardiovascular diseases. Weight-loss has been shown to reduce disease risk; however, it remains unclear how changes in adipokines following weight-loss are associated with markers of metabolic and cardiovascular health in women. The aim of this study was to determine the...

Objective: Human Endogenous Retroviruses have been implicated in neurodegenerative diseases including amyotrophic lateral sclerosis (ALS). Expression of human endogenous retrovirus K (HERV-K) subtype HML-2 envelope (Env) in human neuronal cultures and in transgenic mice results in neurotoxicity and neurodegeneration and mice expressing HML-2 Env d...

Background: Retinal measurements correlate with disease progression in patients with multiple sclerosis; however, whether they associate with neurologic disease in people with controlled HIV is unknown. Using spectral domain optical coherence tomography, we evaluated retinal differences between people with HIV and HIV-negative controls and investi...

Background and Objectives Recovery from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection appears exponential, leaving a tail of patients reporting various long COVID symptoms including unexplained fatigue/exertional intolerance and dysautonomic and sensory concerns. Indirect evidence links long COVID to incident polyneuropathy...

Electromyography (EMG) analysis is a well-established methodology to understand ergonomic studies, human biomechanics, and post-injury exercises. To assess EMG, data should be normalized with maximum voluntary contractions (MVC), which eliminates the EMG differences between the subjects. However, the choice of the MVC movement for the subjects is h...

The primary purpose of this study was to determine prevalence of the Male Athlete Triad (MAT) conditions: low energy availability (EA), low bone mineral density (BMD), and low testosterone in male collegiate athletes from different sports. Participants included 44 collegiate male athletes (age, 20.4 ± 0.2 years; body mass index, 25.3 ± 1.3 kg/m²) f...

Human immunodeficiency virus (HIV)-associated neurocognitive disorder (HAND) affects around 20–50% of people living with HIV (PLWH). Although batteries of tests are used to identify neurocognitive impairment (NCI), they are long and difficult to perform during a routine clinic visit, thus impairing the ability to diagnose HAND. Therefore, a brief y...

Background Progressive multifocal leukoencephalopathy, a rare disease of the CNS caused by JC virus and occurring in immunosuppressed people, is typically fatal unless adaptive immunity is restored. JC virus is a member of the human polyomavirus family and is closely related to the BK virus. We hypothesised that use of partly HLA-matched donor-deri...

Background Anosmia and ageusia are symptoms commonly associated with COVID-19, but the relationship with disease severity, onset and recovery are unclear. Objective To examine factors associated with anosmia and ageusia and the recovery from these symptoms in an ethnically diverse cohort. Methods Individuals tested for SARS-CoV-2 between March an...

Recurrent episodes of neurological dysfunction and white matter lesions in a young adult raise suspicion for multiple sclerosis (MS). However, occlusive retinopathy, hearing loss and absence of CSF oligoclonal bands are atypical for MS and should make the clinician consider an alternative diagnosis. We describe a man with hearing loss, visual signs...

Objective: We evaluated brain glucose metabolism in people living with HIV (PLWH) with [18F]-Fluoro-Deoxyglucose (FDG) PET/CT before and after antiretroviral therapy (ART) initiation.Design: We conducted a longitudinal study where ART-naïve late-presenting untreated PLWH with CD4 counts < 100 cells/uL were prospectively assessed for FDG uptake at...

Objective To test the hypothesis that brain white matter hyperintensities (WMH) are more common in people living with HIV (PLWH), even in the setting of well-controlled infection, and to identify clinical parameters that correlate with these abnormalities. Methods Research brain MRI scans, acquired within longitudinal studies evaluating neurocogni...

Rationale: SARS-CoV2 infection causes loss of sense of smell. We hypothesized that specific smell loss is associated with COVID-19. Methods: Patients recruited for the study within 48 hours of COVID-19 test at Montefiore Medical Center, Bronx, NY were evaluated for sense of smell by UPSIT (University of Pennsylvania Smell Identification Test®). A f...

Background Possible human immunodeficiency virus (HIV)-1 clearance has been rarely reported. Here we describe a unique case of an HIV-positive, combination antiretroviral therapy (cART)-experienced woman with prior acquired immunodeficiency syndrome (AIDS) who has not experienced viral rebound for over 12 years since discontinuing cART. Methods Le...

COVID-19 has shaken the core of the medical health system. The wide spread death and destruction of patients and health care workers in unprecedented in the modern era. While the pulmonary complications have received the most attention, it is the neurological manifestations that are disabling, persistent and common in patients infected with SARS-Co...

In multiple sclerosis (MS), a subset of chronic active white matter lesions are identifiable on MRI by their paramagnetic rims, and increasing evidence supports their association with clinical disease severity. Here we study their potential role in differential diagnosis, screening an international multicenter clinical research‐based sample of 438...

Background: Interpersonal trauma (IPT) is highly prevalent among HIV-positive (HIV+) individuals but its relationship with brain morphology and function is poorly understood. Setting: This cross-sectional analysis evaluated the associations of IPT with cognitive task performance, daily functioning, MRI brain cortical thickness and bilateral volu...

Human immunodeficiency virus (HIV) infection in the pre‐antiretroviral drug era was known to cause a variety of neurological syndromes, including HIV‐associated dementia, myelopathy, peripheral neuropathy, opportunistic infections of the nervous system and primary central nervous system (CNS) lymphoma. The era of efficient combined antiretroviral t...

Objective: The aim of this study was to measure the protein concentration and biological activity of HIV-1 Tat in cerebrospinal fluid (CSF) of individuals on suppressive antiretroviral therapy (ART). Design: CSF was collected from 68 HIV-positive individuals on ART with plasma viral load less than 40 copies/ml, and from 25 HIV-negative healthy c...

Background In spite of viral suppression with antiretroviral therapy (ART), neurocognitive impairment (NCI) affects ~20% of those infected with HIV; most are asymptomatic or only mildly impaired based on instrumental activity of daily living (IADL) self-reported questionnaires. Previous studies have shown a strong association between depression, co...

Although runners are at high risk of back and lower extremity injuries, available tools detect only current injury. Here, a model was developed to analyze kinetic and kinematic running gait data collected by an optical motion capture system to predict future injuries based on an individual’s running gait pattern. The two key points, when the joints...

Objective: To characterize cerebral arterial remodeling in HIV-infected (HIV+) individuals in-vivo, and to study its clinical and immunological associations. Methods: T2*-weighted magnetic resonance imagining sequences was used to determine cross-sectional area (vascular caliber) of the anterior (A1 segment) and middle (M1 segment) cerebral arterie...

Background Progressive multifocal leukoencephalopathy (PML) is an opportunistic brain infection that is caused by the JC virus and is typically fatal unless immune function can be restored. Programmed cell death protein 1 (PD-1) is a negative regulator of the immune response that may contribute to impaired viral clearance. Whether PD-1 blockade wit...

Background Brain- and lesion-volumes derived from magnetic resonance images (MRI) serve as important imaging markers of disease progression in neurodegenerative diseases and aging. While manual segmentation of these volumes is both tedious and impractical in large cohorts of subjects, automated segmentation methods often fail in accurate segmentati...

Snyder, NC, Willoughby, CA, and Smith, BK. Comparison of the Polar V800 and the Garmin Forerunner 230 to predict V[Combining Dot Above]O2max. J Strength Cond Res XX(X): 000-000, 2018-The purpose of this study was to compare maximal oxygen consumption (V[Combining Dot Above]O2max) values (Amax) with predicted V[Combining Dot Above]O2max values obtai...

Background: Both traditional and HIV-specific risk factors contribute to greater incidence of cardiovascular disease in persons living with HIV (PLWH). Using state-of-the-art, high-resolution magnetic resonance (MR) imaging of the common carotid arteries, this study aimed to evaluate the relationship between carotid vessel wall thickness (c-VWT) a...

Objective: To quantitatively measure brain glucose metabolism in treated HIV-positive individuals with [18F]-labeled fluorodeoxyglucose (FDG) PET/CT. Methods: We performed a cross-sectional comparison of FDG uptake in 47 treated HIV+ individuals, 10 age-matched controls (HIV-) sharing many of the comorbid conditions seen in the HIV+ group, and 1...

Intrathecal antibody synthesis is a well-documented phenomenon in infectious neurological diseases as well as in demyelinating diseases, but little is known about the role of B cells in the central nervous systems. We examined B cell and T cell immunophenotypes in CSF of patients with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/T...

Background and purpose: Human immunodeficiency virus (HIV) infection has been shown to increase both ischemic and hemorrhagic stroke risks, but there are limited data on the safety and outcomes of intravenous thrombolysis with tPA (tissue-type plasminogen activator) for acute ischemic stroke in HIV-infected patients. Methods: A retrospective cha...

Immune reconstitution inflammatory syndrome (IRIS) describes a syndrome of aberrant reconstituted immunity, often in association with HIV infection, beginning with a normalization of CD4+ T-cell counts resulting in a dysregulated immune response against an infecting opportunistic pathogen and the host. In this chapter, we discuss the unique nature...

Self-report is typically used to differentiate between asymptomatic neurocognitive impairment (ANI) and mild neurocognitive disorder (MND) in the assessment of HIV-associated neurocognitive disorders (HAND). Yet, it is unclear whether the lack of self-reported functional impairments in individuals with ANI is indicative of a genuine absence of func...

Objective: To assess the prevalence and the specificity of leptomeningeal enhancement (LME) on postcontrast T2-fluid-attenuated inversion recovery (FLAIR) MRI in multiple sclerosis (MS) compared to a variety of inflammatory and noninflammatory neurologic conditions assessed in 2 academic research hospitals. Methods: On 3T postcontrast T2-FLAIR i...

Nearly 30 years after the advent of antiretroviral therapy (ART), CNS opportunistic infections remain a major cause of morbidity and mortality in HIV-positive individuals. Unknown HIV-positive disease status, antiretroviral drug resistance, poor drug compliance, and recreational drug abuse are factors that continue to influence the morbidity and mo...

Objective: To determine whether there is activation of human endogenous retrovirus K (HERV-K) in amyotrophic lateral sclerosis in HIV infection and whether it might respond to treatment with antiretroviral drugs. Methods: In this case series, we present 5 patients with HIV infection who subsequently developed motor neuron disease involving both...

Ebola virus disease is one of the deadliest pathogens known to man, with a mortality rate between 25-90% depending on the species and outbreak of Ebola. Typically, it presents with fever, headache, voluminous vomiting and diarrhea, and can progress to a hemorrhagic illness; neurologic symptoms, including meningoencephalitis, seizures, and coma, can...

Background: Posttraumatic stress disorder (PTSD) may be associated with chronic immune dysregulation and a proinflammatory state. Among HIV-infected individuals, PTSD is associated with greater morbidity and mortality, but the association with immune dysfunction has not been evaluated. This study explores the association between PTSD and selected...

The risk of having a first stroke is nearly twice as high among African Americans compared to Caucasians. HIV/AIDS is an independent risk factor for stroke. Our study aimed to report the risk factors and short-term clinical outcomes of African Americans with HIV infection and new-onset stroke admitted at the Johns Hopkins Hospitals (2000-2012). Mul...

Various inflammatory neurologic diseases are associated with viral infections. These agents may cause direct damage of infected cells associated with immunological alterations such as chronic activation, immunodeficiency and infiltration of inflammatory cells into the central nervous system that underlie the pathogenesis of inflammatory neurologic...

OBJECTIVE: To characterize the cellular immunophenotype of cells in cerebrospinal fluid (CSF) of patients with virus-associated neurologic diseases. BACKGROUND: Various inflammatory neurologic diseases are associated with viral infections. These agents may cause direct damage of infected cells associated with immunological alterations such as chron...

Dietary supplementation with almonds has demonstrated dose-dependent decreases in low-density lipoprotein cholesterol (LDL-C), likely because of their composition of beneficial nutrients including mono- and polyunsaturated fatty acids, fiber, and protein. The primary objective of this study was to determine the changes in the lipid profile (LDL-C,...