HIV-related metabolic abnormalities in the brain: depiction with proton MR spectroscopy with short echo times.
OBJECTIVE
To analyze brain metabolite changes in human immunodeficiency virus (HIV)-positive neurologically asymptomatic patients and patients with acquired immunodeficiency syndrome (AIDS) dementia complex (ADC).


METHODS
Twelve ADC patients, 11 HIV-positive asymptomatic patients, and 10 healthy control subjects underwent magnetic resonance (MR) imaging and proton MR spectroscopy with short echo times. Changes in N-acetyl aspartate (NAA), choline (Cho), myoinositol (MI), and creatine (Cr) were presented as ratios with Cr as the reference.


RESULTS
Statistically significant (P < .05) differences were noted. In ADC patients, all with MR findings of brain atrophy and diffuse white matter disease, NA/Cr decreased (white matter, -31.8%; gray matter, -22.3%), MI/Cr increased (white matter, +42.5%; gray matter, +51.8%), and Cho/Cr increased (white matter, +20.6%; gray matter, +51.7%) compared with healthy control subjects. In HIV-positive asymptomatic patients, NA/Cr decreased slightly (white matter, -6.9%; gray matter, -5.1%), MI/Cr increased slightly (white matter, +13.7%; gray matter, +10.7%), and Cho/Cr did not change.


CONCLUSIONS
ADC has a uniform pathologic metabolic pattern that affects NAA, MI, and Cho. Proton MR spectroscopy with short echo times helps detect early abnormalities in clinically asymptomatic patients.
Laubenberger
J
J
Department of Diagnostic Radiology, Klinikum der Albert-Ludwigs-Universität, Freiburg, Germany.
Häussinger
D
D
Bayer
S
S
Thielemann
S
S
Schneider
B
B
Mundinger
A
A
Hennig
J
J
Langer
M
M
D015526:AIDS Dementia Complex / Q000175:diagnosis / Q000378:metabolism; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001921:Brain / Q000378:metabolism*; D005260:Female; D005583:Fourier Analysis; D015658:HIV Infections / Q000175:diagnosis / Q000378:metabolism*; D015497:HIV-1; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D009682:Magnetic Resonance Spectroscopy / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011522:Protons; D013997:Time Factors
D011522:Protons