title: Proton spectroscopy of the brain in HIV infection: correlation with clinical, immunologic, and MR imaging findings.
abstract: Abnormalities at cerebral proton spectroscopy occur in patients with the acquired immunodeficiency syndrome (AIDS). N-acetyl aspartate (NAA) is believed to be a neuronal marker, and neuronal loss is thought to underlie the human immunodeficiency virus (HIV)-associated cognitive/motor complex. The proton spectra in 103 HIV-seropositive patients and 23 control subjects were compared and correlated with clinical, immunologic, and radiologic measures of HIV infection. Significant (P < .05) reductions in the mean NAA/choline (Cho) and NAA/creatine (Cr) ratios were seen in patients with immune suppression and neurologic signs. Significant increases in the Cho/Cr ratios were seen in patients with low CD4 lymphocyte counts and abnormal magnetic resonance (MR) images. Reduced NAA ratios correlated with diffuse but not focal MR imaging abnormalities. Combined MR imaging and spectroscopy provides closer relationships to clinical and immunologic measures of disease than either modality alone. Spectroscopy is an adjunct to MR imaging and augments the value of an MR imaging study.
authors.affiliation: MR Unit, Middlesex Hospital, London, England.
authors.forename: W K
authors.initials: WK
authors.lastname: Chong
authors.forename: B
authors.initials: B
authors.lastname: Sweeney
authors.forename: I D
authors.initials: ID
authors.lastname: Wilkinson
authors.forename: M
authors.initials: M
authors.lastname: Paley
authors.forename: M A
authors.initials: MA
authors.lastname: Hall-Craggs
authors.forename: B E
authors.initials: BE
authors.lastname: Kendall
authors.forename: J K
authors.initials: JK
authors.lastname: Shepard
authors.forename: M
authors.initials: M
authors.lastname: Beecham
authors.forename: R F
authors.initials: RF
authors.lastname: Miller
authors.forename: I V
authors.initials: IV
authors.lastname: Weller
mesh_terms: D000328:Adult; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001921:Brain / Q000378:metabolism / Q000473:pathology*; D015496:CD4-Positive T-Lymphocytes; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000276:immunology / Q000378:metabolism; D006801:Humans; D007958:Leukocyte Count; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged
chemical_list: D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline