Basal ganglia metabolite abnormalities in minor motor disorders associated with human immunodeficiency virus type 1.
BACKGROUND
Minor motor disorders (MMDs) associated with human immunodeficiency virus type 1 (HIV-1) predict HIV-1 dementia and death. Little is known about the time course and neuropathologic mechanisms of HIV-1 MMDs.


OBJECTIVE
To investigate the relationship between HIV-1 MMDs, as assessed by psychomotor speed, and metabolic alterations in the basal ganglia, as detected by proton magnetic resonance spectroscopy.


METHODS
A total of 32 HIV-1-seropositive patients (10 with no MMD, 8 with incipient MMD, and 14 with sustained MMD, assessed through electrophysiologic testing of psychomotor speed including contraction times; 29 treated with highly active antiretroviral therapy) and 14 HIV-1-seronegative control subjects were examined for cerebral metabolite abnormalities in the basal ganglia by means of magnetic resonance spectroscopy.


RESULTS
The 3 patient groups showed significantly different ratios of myoinositol/creatine (P =.02) in the basal ganglia. Whereas patients with no MMD or incipient MMD showed normal ratios, patients with sustained MMD showed higher values for myoinositol/creatine as a sign of glial proliferation. No differences in N-acetyl compounds, indicative of neuronal loss, were found.


CONCLUSIONS
Whereas metabolic alterations in the basal ganglia were not detected in patients with incipient HIV-1 MMD, patients with sustained HIV-1 MMD did have significantly altered metabolic spectra indicative of glial proliferation.
von Giesen
H J
HJ
Department of Neurology, Heinrich-Heine-Universität, Düsseldorf, Postfach 10 10 07, D-40001 Düsseldorf, Germany. giesenhj@uni-duesseldorf.de
Wittsack
H J
HJ
Wenserski
F
F
Köller
H
H
Hefter
H
H
Arendt
G
G
D015526:AIDS Dementia Complex / Q000175:diagnosis / Q000378:metabolism*; D000328:Adult; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001479:Basal Ganglia / Q000378:metabolism*; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism*; D004594:Electrophysiology; D015497:HIV-1; D006801:Humans; D007294:Inositol / Q000378:metabolism*; D009682:Magnetic Resonance Spectroscopy; D008875:Middle Aged; D011597:Psychomotor Performance
D001224:Aspartic Acid; D007294:Inositol; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline