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Localized cerebral proton MR spectroscopy in HIV infection and AIDS.
AJNR Am J Neuroradiol
PURPOSE: To document differences in the cerebral proton MR spectra of patients with early and late stages of human immunodeficiency virus (HIV) infection. METHOD: We studied the relative N-acetyl-aspartate (NAA) levels by localized proton spectroscopy of the parietooccipital region of the brain in 43 HIV-seropositive patients, including 26 with an acquired immunodeficiency syndrome (AIDS)-defining diagnosis, and in eight control subjects. RESULTS: Reduced relative NAA levels were shown in those HIV-1-seropositive patients: 1) with AIDS against HIV-1-seropositive patients without AIDS (P < .04); 2) with HIV-1-associated cognitive/motor complex against neurologically healthy patients (P < .007); 3) with encephalopathic changes on MR against those with normal imaging (P < .001); and 4) on follow-up against their results on initial study (P < .03). CONCLUSIONS: By clinical (Centers for Disease Control classification) and radiologic (MR evidence of white-matter disease) criteria indicating late-stage HIV infection, reduced relative levels of NAA have been demonstrated. Spectroscopic abnormalities can be quantitatively tracked with time. This paper demonstrates the clinical use of detecting NAA as a putative in vivo measure of the neuronal loss that has been demonstrated in postmortem studies of patients with AIDS. This neuronal loss, which is believed to underlie the HIV-1-associated cognitive/motor complex, is thought to be attributable directly or indirectly to the presence of HIV in the brain. Proton spectroscopy may serve as a quantitative noninvasive indicator of this aspect of cerebral involvement in HIV disease.
|Title:||Localized cerebral proton MR spectroscopy in HIV infection and AIDS.|
|Keywords:||AIDS Dementia Complex, AIDS-Related Complex, Acquired Immunodeficiency Syndrome, Adult, Aspartic Acid, Brain Chemistry, Choline, Creatine, Diagnosis, Differential, HIV Seropositivity, Humans, Magnetic Resonance Spectroscopy, Middle Aged|
|UCL classification:||UCL > School of Life and Medical Sciences
UCL > School of Life and Medical Sciences > Faculty of Medical Sciences
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