Localized cerebral proton MR spectroscopy in HIV infection and AIDS.
OBJECTIVE
To document differences in the cerebral proton MR spectra of patients with early and late stages of human immunodeficiency virus (HIV) infection.


METHODS
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.
Chong
W K
WK
MR Unit, Middlesex Hospital, London, England.
Paley
M
M
Wilkinson
I D
ID
Hall-Craggs
M A
MA
Sweeney
B
B
Harrison
M J
MJ
Miller
R F
RF
Kendall
B E
BE
D015526:AIDS Dementia Complex / Q000378:metabolism; D000386:AIDS-Related Complex / Q000378:metabolism; D000163:Acquired Immunodeficiency Syndrome / Q000378:metabolism*; D000328:Adult; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000032:analysis; D001923:Brain Chemistry; D002794:Choline / Q000032:analysis; D003401:Creatine / Q000032:analysis; D003937:Diagnosis, Differential; D006679:HIV Seropositivity / Q000378:metabolism*; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008875:Middle Aged
D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline