Progressive peripheral and central sensory tract lesion in HIV-infected patients evidenced by evoked potentials (a three-year follow-up study).
OBJECTIVE
To investigate progression of peripheral and central sensory tract lesion and its correlation to immunological deterioration.


METHODS
Clinical and neurophysiological investigation (evoked potentials of the median and tibial nerve) and immunological parameters (CD4-cells, beta 2-microglobuline) were followed up in 160 patients (24 females, 136 males, HIV infection for 2.7 +/- 2.3 years, mv +/- 1 sd) up to four times over approximately 3 years regardless of disease stage and evidence of neurological symptoms. Recordings were done using needle electrodes over the Th12 and C7 spinous process and from the scalp (10/20 system) in the conventional manner. Statistical analysis was performed intraindividually and in comparison to normal laboratory values (n = 96).


RESULTS
All parameters deteriorated during the follow-up period. Statistical analysis showed significant differences between probands and patients for evoked potentials, but also a significant deterioration for evoked potentials after three years at the end of the follow-up study. A significant correlation between progressive impairment of evoked potentials and laboratory data was found.


CONCLUSIONS
HIV infection induces a progressive lesion of the ascending sensory tracts. The results indicate a peripheral neuropathy as well as a progressive lesion of the ascending central sensory tracts. Pathogenesis of polyneuropathy and of central sensory tract lesion is up to now conjectural. Laboratory investigations indicate a clear-cut correlation between immunological alterations induced by HIV infection and its neurologic manifestation on ascending sensory tracts.
Klinik und Poliklinik für Neurologie der Westfälische Wilhelms-Universität, Münster, Germany.
I W
IW
Husstedt
S
S
Evers
D
D
Reichelt
A
A
Sprinz
M
M
Riedasch
K H
KH
Grotemeyer
D000328:Adult; D018791:CD4 Lymphocyte Count; D018450:Disease Progression; D005071:Evoked Potentials; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000145:classification / Q000276:immunology / Q000503:physiopathology*; D015497:HIV-1; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000503:physiopathology*; D009475:Neurons, Afferent / Q000502:physiology; D013979:Tibial Nerve / Q000503:physiopathology*; D013997:Time Factors; D001613:beta 2-Microglobulin / Q000032:analysis
D001613:beta 2-Microglobulin