Localized brain proton MRS metabolic patterns in HIV-related encephalopathies.
We have examined 9 healthy volunteers and 63 HIV-patients (16 asymptomatic patients and 47 patients with clinical AIDS-dementia complex, ADC) by magnetic resonance spectroscopy (MRS) and imaging (MRI) on a Siemens Magnetom SP63 (1.5 T). Proton MRS of the brain was performed at 63 MHz using the PRESS sequence (echo time = 135 ms, TR = 1.6 s). Four main results have been found: (1) HIV-related encephalopathy induces significant modifications of brain metabolism analyzed by MRS and the most sensitive metabolic parameter is the N-acetyl-aspartate/Choline ratio, (2) the correlation between MRS and MRI is good in 75% of patients, (3) in 4 of the 16 neuro-asymptomatic patients (i.e. 25%) a metabolic encephalopathy was found while MRI was still normal, and (4) MR spectra describe 3 different pathological metabolic patterns in the brain of HIV patients. Two patterns might correspond to the two entities of HIV-induced lesions i.e. HIV encephalitis and HIV-related progressive leukoencephalopathy.
Vion-Dury
J
J
Centre de Résonance Magnétique Biologique et Médicale (CRMBM), URA CNRS 1186, Faculté de Médecine, Marseille, France.
Confort-Gouny
S
S
Nicoli
F
F
Dhiver
C
C
Gastaut
J A
JA
Gastaut
J L
JL
Cozzone
P J
PJ
D015526:AIDS Dementia Complex / Q000378:metabolism*; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000032:analysis; D001921:Brain / Q000378:metabolism*; D002794:Choline / Q000032:analysis; D003401:Creatine / Q000032:analysis; D015658:HIV Infections / Q000378:metabolism; D006801:Humans; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D010725:Phosphocreatine / Q000032:analysis
D010725:Phosphocreatine; D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline