期刊
NEUROIMAGE
卷 17, 期 3, 页码 1638-1648出版社
ACADEMIC PRESS INC ELSEVIER SCIENCE
DOI: 10.1006/nimg.2002.1254
关键词
brain; HIV; magnetic resonance spectroscopy; MRS; neuropsychological tests
资金
- NCRR NIH HHS [M01-RR00425] Funding Source: Medline
- NIDA NIH HHS [K20-DA00280] Funding Source: Medline
- NINDS NIH HHS [R01-NS38834] Funding Source: Medline
This study aims to determine the relationship among cerebral metabolite concentrations (on proton magnetic resonance spectroscopy or H-1 MRS), cognitive function, and clinical variables (CD4, plasma and CSF viral loads, and lipids) in antiretroviral medication-naive HIV patients. We hypothesized that the probable glial markers myo-inositol [MI] and choline compounds [CHO] would correlate with cognitive function, CD4 count, and viral loads, but not with serum lipids. Forty-five antiretroviral-drug-naive HIV patients and 25 control subjects were evaluated. Frontal lobe [MI], [CHO], and total creatine [CR] were elevated, while basal ganglia [CR] were decreased, with increasing dementia severity. As a group, HIV patients showed slowing on fine motor (Grooved Pegboard) and psychomotor function (Trails A & B), and deficits on executive function (Stroop tasks). Lower CD4 counts and elevated plasma viral loads were associated with elevated frontal white matter [MI], which in turn correlated with the Stroop tasks. These findings suggest that systemic factors (resulting from suppressed immune function and higher plasma viral load) may lead to glial proliferation (elevated [MI], [CHO], and [CR]) in the frontal white matter, which in turn may contribute to deficits on executive function in HIV. Studying antiretroviral-naive patients minimized the confounding effects of antiretroviral treatment on the clinical, MRS, and neuropsychological variables, and allowed for a more accurate assessment of the relationships among these measurements. Metabolite concentrations, rather than metabolite ratios, should be measured since [CR], a commonly used reference for metabolite ratios, varies with disease severity in both frontal lobe and basal ganglia. (C) 2002 Elsevier Science (USA).
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