Abnormal cerebral glucose metabolism in HIV-1 seropositive subjects with and without dementia.
This study was undertaken in order to extend our previous finding of relative basal ganglia hypermetabolism in AIDS dementia complex (ADC) and to develop clinically useful metabolic indices of CNS involvement in HIV-seropositive (HIV+) subjects.


METHODS
Twenty-one HIV+ subjects (11 with AIDS) underwent FDG-PET scanning; 12 had a follow-up scan at 6 mo and 4 had a third scan at 12 mo. Forty-three age-matched heterosexual volunteers served as controls. FDG-PET scanning was performed with arterial blood sampling, and scan data were analyzed using the Scaled Subprofile Model (SSM) with principal component analysis.


RESULTS
SSM/principal component analysis of the combined (HIV+ and controls) FDG-PET dataset extracted two major disease-related metabolic components: (a) a nonspecific indicator of cerebral dysfunction, which was significantly correlated with age, cerebral atrophy and ADC stage and (b) the striatum, which was heavily weighted (relatively hypermetabolic) and appeared to provide a disease-specific measure of early CNS involvement.


CONCLUSIONS
FDG-PET scans provide quantitative measures of abnormal functional connectivity in HIV-seropositives-with or without AIDS or ADC. These measures, which are robust across centers with respect to instrumentation, scanning technique and disease severity, appear to track the progression of CNS involvement in patients with subclinical neurologic or neuropsychologic dysfunction.
Rottenberg
D A
DA
PET Imaging Service, Minneapolis VA Medical Center, Minnesota 55417, USA.
Sidtis
J J
JJ
Strother
S C
SC
Schaper
K A
KA
Anderson
J R
JR
Nelson
M J
MJ
Price
R W
RW
D015526:AIDS Dementia Complex / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000378:metabolism*; D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging* / Q000378:metabolism*; D016022:Case-Control Studies; D003847:Deoxyglucose / Q000031:analogs & derivatives*; D005260:Female; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D005947:Glucose / Q000378:metabolism*; D006679:HIV Seropositivity / Q000000981:diagnostic imaging / Q000378:metabolism*; D015497:HIV-1; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D013997:Time Factors; D014055:Tomography, Emission-Computed
D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D003847:Deoxyglucose; D005947:Glucose