title: Proton MRS and quantitative MRI assessment of the short term neurological response to antiretroviral therapy in AIDS.
abstract: OBJECTIVE
  To investigate MRI and proton spectroscopy changes in five patients with HIV associated dementia complex (HADC) treated with antiretroviral therapy.
  
  
  METHODS
  Three markers were evaluated: (1) CSF/intracranial volume ratio; (2) T2 weighted signal ratio between parieto-occipital white and subcortical grey matter; and (3) metabolite ratios from long echo time (TE=135 ms) single voxel proton spectra of parieto-occipital white matter.
  
  
  RESULTS
  Spectroscopic changes indicated initial increases in N-acetyl/(N-acetyl + choline + creatine) ratio (NA/(NA+ Cho+Cr)) and progression of atrophy after initiation of antiretroviral therapy in four of five patients. When the neurological status of the patients subsequently deteriorated (two of five patients), the NA/(NA+Cho+Cr) ratio also declined.
  
  
  CONCLUSIONS
  Spectroscopic changes mirror reversible neuronal dysfunction. These objective, non-invasive techniques may be used for monitoring the neurological effects of antiretroviral drug therapy in patients with HADC.
authors.affiliation: Department of Medical Physics and Bioengineering, The Middlesex Hospital, University College London Hospitals NHS Trust, UK.
authors.forename: I D
authors.initials: ID
authors.lastname: Wilkinson
authors.forename: S
authors.initials: S
authors.lastname: Lunn
authors.forename: K A
authors.initials: KA
authors.lastname: Miszkiel
authors.forename: R F
authors.initials: RF
authors.lastname: Miller
authors.forename: M N
authors.initials: MN
authors.lastname: Paley
authors.forename: I
authors.initials: I
authors.lastname: Williams
authors.forename: R J
authors.initials: RJ
authors.lastname: Chinn
authors.forename: M A
authors.initials: MA
authors.lastname: Hall-Craggs
authors.forename: S P
authors.initials: SP
authors.lastname: Newman
authors.forename: B E
authors.initials: BE
authors.lastname: Kendall
authors.forename: M J
authors.initials: MJ
authors.lastname: Harrison
mesh_terms: D015526:AIDS Dementia Complex / Q000188:drug therapy* / Q000473:pathology; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009778:Occipital Lobe / Q000473:pathology; D010296:Parietal Lobe / Q000473:pathology; D015215:Zidovudine / Q000627:therapeutic use*
chemical_list: D000998:Antiviral Agents; D015215:Zidovudine