Human immunodeficiency virus 1-associated minor motor disorders: perfusion-weighted MR imaging and H MR spectroscopy.
OBJECTIVE
To investigate whether advanced magnetic resonance (MR) imaging techniques such as diffusion-weighted (DW) and perfusion-weighted (PW) MR imaging and hydrogen 1 (1H) MR spectroscopy can depict functional and pathophysiologic mechanisms in patients who have minor motor deficits (MMDs) associated with human immunodeficiency virus 1 (HIV-1).


METHODS
Thirty-two patients with results seropositive for HIV-1 and different degrees of HIV-1-related MMD underwent conventional brain MR imaging, as well as DW and PW MR imaging and 1H MR spectroscopy of the basal ganglia. PW MR imaging data were computed pixel by pixel for creation of time-to-peak, relative regional cerebral blood volume, and bolus amplitude parameter maps. In addition, quantitative regional cerebral blood flow (rCBF) maps were calculated with respect to the arterial input function by using the singular value decomposition algorithm. For 1H MR spectroscopy, a stimulated echo acquisition mode 20, or STEAM 20, sequence was used. Spectra were fit for determination of the signal intensities of the different metabolites. According to psychomotor testing results, patients were divided into three groups: group 1, 10 patients with normal motor function; group 2, eight patients with psychomotor slowing for the first time; and group 3, 14 patients who had had sustained pathologic psychomotor slowing for at least 6 months before the MR imaging examination.


RESULTS
No patients had an abnormality at either conventional or DW MR imaging. PW MR imaging depicted significantly elevated rCBF in group 2 patients (P =.039, analysis of variance [ANOVA]) and significantly elevated myo-inositol-to-creatine ratio levels in group 3 patients (P =.020, ANOVA).


CONCLUSIONS
Quantitative PW MR imaging and 1H MR spectroscopy can depict pathologic changes in patients who have HIV-1-related MMD but normal clinical examination and conventional MR imaging findings.
Wenserski
Frank
F
Department of Diagnostic Radiology and Neurology, Heinrich-Heine-University, Moorenstr 5, 40225 Duesseldorf, Germany. wensersk@uni-duesseldorf.de
von Giesen
Hans-Juergen
HJ
Wittsack
Hans-Joerg
HJ
Aulich
Albrecht
A
Arendt
Gabriele
G
D000328:Adult; D001923:Brain Chemistry; D038524:Diffusion Magnetic Resonance Imaging; D015658:HIV Infections / Q000150:complications*; D015497:HIV-1; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D011596:Psychomotor Disorders / Q000175:diagnosis* / Q000209:etiology